1422 RUCKER AVE 2025-01-28 - Laserfiche WebLink

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# C2-0o4-4) BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W" Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size '44±)O }' ❑ Hold in Planning File Drawer Garage/Accessory Struct. Size — Zone �Z Number of Stories Overlay/Agreement Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use Type of Construction l/ Residential Use (J'i1,eI 1-)1 V -' Occupancy Group Proposed No. of Dwelling Units: — Occupancy Load Total No. of Dwelling Units: I J Fire Sprinklers: ❑Update Existing ❑New System ®Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes 1 No Reason Sprinklers Required: "In Lieu" Fee: Type: ount$ / Fire Alarm: ❑Update Existing ❑New System [ INot Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Cre ' : RCW 64.55 MF worksheet req'd for permit? es ��yyy o ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to fi ? ❑Yes eJ N Additional Notes: �6tL.'6 VALUATION CALCULATION: To I$ A-94-'C.4'- (-11 (aa = 4.24 A- - 4 a- • W Div l(,�ul`, (Cp K � 3 0 .{- LD Approved By: �- Dat 3 Z.7,.LI 4-8 PUBLIC WORKS Intake OK by: Date: Additional Notes: Intake Comments: (PW Worksheet Needed if: ❑Sys Dev Eval ❑Traffic Mit Eval Site Work or Drainage Proposed Approved By: 7 Dater-1 I ft oZl =❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, ;supportive housing) FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet Separate I Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: 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 ❑ 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 0 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 ?5Date: `7( 1 /2'2.1 L