1516 RUCKER AVE 2024-06-25 - Laserfiche WebLink

Intake & Approval Sheet • (FOR PERMIT STAFF ONLY) • PERMIT#V 21°$ -Oo(0 BUILDING / PLANNING Intake OK by: 9A Date: kb I ZS/L2 Intake OK by: Assign To: Date: Intake Comments: 1 Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. IS-Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a "W" Permit CIOK to Route to Other Departments Bldg/; Adn/ m Siz ) 1-61 9 Z liti ❑ Hold in Planning File Drawer `rage/ ccessory Struct. Size SA 2. �. Zone IL�Z Number of Stories 2- Overlay/Agreement t(( Gip H.CS*'ft- Basement ❑No Yes,(i '+/Unfin Nonresidential Use Type of Construction L'0,-C Residential Use ( Occupancy Group Q.- Proposed No. of Dwelling Units: ( Cpv) Occupancy Load er Total No.of Dwelling Units: 2- Fire Sprinklers: ❑Update Existing ❑New System ERNot Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu" Fee: Type: Amount$ Fire Alarm: ❑Update Existing ONew System yIuNot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? El Yes Et No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes IErNo Additional Notes: VALUATION CALCULATION: Total $ 2-42-4,600 -eA /1 -llt t fAc- Fte; '- q4 i Approved By:A Date: I Z/ILf/2 z.. PUBLIC WORKS Intake OK by: '.--1 Date: 81 L 2.cr2-z Additional Notes: Intake Comments: PW Worksheet Neededif:• 9(Al Sc ME.r(; c...•cc 4 s �� ( .Sys Dev Eval ❑Traffic Mit Eval SEvosiesCa 'IWite Work or Drainage Proposed 'LLS i n `' ❑Backflow Prevention for high hazard: W Approved By: —Q R Date: i\i 4-11,7-- ;(dental,medical,animals,mortuary,hospital, :supportive housing) FIRE DEPARTMENT Route this folder for PW Review at end --- PW Review Worksheet Separate/Deferred Submittals Required: EIThis project also has a separate concurrent PW Review{6[e elder) ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: iziThis Permit is Approved by Public Works El See PW Review Worksheet and associated attached items Fire Dept. Fees: El A Separate PW Permit is Required (Permit#: PW 1 -Oa3 ) ❑ Review of As-Built Plans-NO FIRE FEE AND ® Is located in this folder Minimal or No Fire Scope- NO FIRE FEE ❑ 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: K Eirry a,'0 Date: '_1/ El Public Works has no scope--- PW Not Required / Additional Notes: ELECTRICAL/PLUMBING Additional Notes: Approved By: Date: Approved By /A N /► Date: �p 1 �,.0'L,8� _ Y 7� d r"