2525 RUCKER AVE 2023-06-22 - Laserfiche WebLink

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) i PERMIT# Q 2o `0 BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: - ❑ Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit 0 OK to Route to Other Departments BldglTl/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone Number of Stories Overlay/Agreement Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use Type of Construction Residential Use Occupancy Group Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: El Update Existing ❑New System El Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: ❑Update Existing [hew System El Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: VALUATION CALCULATION: Total$ Approved By: Date: 136i0 CO (4- 4-t-AA PUBLIC WORKS f k ev t S Intake OK by: Date: Additional Notes: Jo\mac (U t. Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval El Site Work or Drainage Proposed Approved By: 79 Date: (oL-to-( c I❑BackflowPreventionforhighhazard: =(dental,medical,animals,mortuary,hospital, ;supportive housing) FIRE DEPARTMENT El Route this folder for PW Review at end ---PW Review Worksheet Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) El Fire Sprinklers OFire Alarm ❑Other: AND OCreate Green Folder ❑Submitted Previously ❑Deferred Additional Notes: 0 This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items Fire Dept.Fees: ❑ A Separate PW Permit is Required (Permit#: PW ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is located in this folder O Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder(join with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately(separate Green Folder,PW issued ahead of Bldg) Approved By: Date: ❑ Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: