1502 RUCKER AVE 2023-12-08 - Laserfiche WebLink

Intake &Approval Sheet • (FOR PERMIT STAFF ONLY) PERMIT# \I` 22A 0- o`iS BUILDING •LAN NING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone Overlay/Agreement ❑ Route to Commercial Building Nonresidential Use ❑ Route to Residential Building Residential Use ❑ Make this a"W" Permit Proposed No.of Dwelling Units: Bldg/TI/Addn/Rem Size Total No.of Dwelling Units: Garage/Accessory Struct.Size Planning/Landscape Inspection Required before Final? ❑Yes ❑No Number of Stories "In Lieu"Fee:Type: Amount$ Basement ❑No ❑Yes , Fin/Unfin School Impact Fee: Total $ Type of Construction Calculated: Credit: Occupancy Group El Everett School Dist ❑Mukilteo School Dist Occupancy Load Park Impact Fees for permits applied for after 1/1/2022: Fire Sprinklers: ❑Update ExistingAllew System ❑Not Req'd Park Impact Fee Total$ Reason Sprinklers Required: Fee Schedule Used For Calculation(Year): Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd Permit Technicians:Apply Credit Per EMC19.53.200 Reason Fire Alarm Required: 0 100%Credit-Issued 1/1/2022-9/2/2022 RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑ 50%Credit-Issued 9/3/2022-6/2/2023 Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No ❑ 0%Credit-Issued 6/3/2023 or later VALUATION CALCULATION: Total $ Db6• 0 6 Additional Notes: "DfYIOi4i 1 (zqiv_ Approved By: Date: PUBLIC WORKS Additional Notes: Intake OK by: Date: Intake Comments: PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval Approved Bye\e.,,� Date: /B�zT6' Z� ❑Site Work or Drainage Proposed :ff '' 11 ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, FIRE DEPARTMENT supportive housing) Separate/Deferred Submittals Required: ❑Route this folder for PW Review at end ---PW Review Worksheet ❑Fire Sprinklers ❑Fire Alarm ❑Other: ❑This project also has a separate concurrent PW Review(Green Folder) Additional Notes: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred ❑ This Permit is Approved by Public Works Fire Dept. Fees: ❑ See PW Review Worksheet and associated attached items ❑ Review of As-Built Plans-NO FIRE FEE 0 A Separate PW Permit is Required(Permit#: PW ❑ Minimal or No Fire Scope-NO FIRE FEE AND ❑ Is located in this folder ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) Approved By: Date: ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) ❑ Public Works has no scope---PW Not Required ELECTRICAUPLUMBING Additional Notes: Additional Notes: Approved By: Date: Approved By: Date: