4503 RUCKER AVE 2023-06-22 - Laserfiche WebLink

2,0 Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 0oq'U BUILDING PLANNING r� Intake OK by: Date: Intake O 'T Date: /-/1-Jq Intake Comments: Intake Comments: Assign To: ,/• v- d 0ki ❑ Route to Commercial Building 0 Attach to Project No._ ❑ Route to Residential Building GI Route to Historic Reviewer ❑ Make this a"W" Permit ErI K to Route to Other Departments I/ib!7 Bldg/TI/Adddip ize 36' ( 6', Hold in Planning File Drawer / i'i J 72 vi2*i-'/>? re • Garage/Accessory Struct.Size ,er Zone .. R- Number of Stories I Overlay/Agreement N0N E Basement iglNo ❑Yes, Fin/Unfin Nonresidential Use "'--.......-- Type of Construction 7$ Residential Use SF2 "I" Re&IZ 5FR. Occupancy Group R Proposed No. of Dwelling Units: NONE Occupancy Load Total No.of Dwelling Units: ,9 or) OY& SF2 lot y Fire Sprinklers: ❑Update Existing El New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes Wil o Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: t Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑ 1�I Yes yor No ❑Everett School Dist DMukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes 21No Additional Notes: �// �` �i _ VALUATION CALCULATION: Total$ I$;000 (Y fits, ' Approve : Date: // //el PUBLIC WORKS Intake OK by: .3 Date: C,41 Z- Additional Notes: Z J/$ /2C. it W-SIEc- Intake Comments: PW Worksheet eeded if: r ❑Sys Dev Eval ❑Traffic Mit Eval ' ejj/,t�e,t� Q_ rilsite Work or Drainage Proposed ❑Backflow Prevention for high hazard: Approved By: Date: '7/IO hi �CJ�C..-a (dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT 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) ❑Fire Sprinklers ❑Fire Alarm DOther: AND/�t ❑Create Green Folder OSubmitted Previously ❑Deferred Additional Notes: —This Permit is Approved by Public Works fli.See PW Review Worksheet and associated attached items Fire Dept.Fees: J S p rate PW Permit is Required(Permit#: PW 0`0 7- 0231 ❑ Review of As-Built Plans-NO FIRE FEE AND Is located in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE 0 Is in a Separate Green Folder(loin 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: 0 Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved Date: -7 /7 bej1 q