3625 RUCKER AVE 2025-04-17 - Laserfiche WebLink

• Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 13Z l Ui `0 I 0 BUILDING PLANNING • Intake OK by: Date: 2___ Intake OK by:fit Assign Too Date /6/2444 Intake Comments. Intake Comments: • 124 Route to Commercial Building ❑Attach to Project No. ❑ Route to Residential Building ❑ oute to Historic Reviewer ❑ Make this a"W"Permit ` OK to Route to Other Departments Bldg/TI/Addn/Rem Size Hold in Planning File Drawer Garage/Accessory Struct.Size Zone WI () Number of Stories Overlay/Agreement Basement El 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 ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes ❑No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: El Update Existing ❑New System ONot 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 El No Additional Notes: VALUATION CALCULATION: Total$ `TOW 0 Approved By: ai) Dater b12.0).,1 l� PUBLIC WORKS Intake OK by: . Date: Additional Notes: Intake Comments: -PW Worksheet Needed if: 1DSys Dev Eval ❑Traffic Mit Eval i DSite Work or Drainage Proposed Approved By: Date: iiill�f 1,y0?.4 1 UBackflow Prevention for high hazard: • =(dental,medical,animals,mortuary,hospital, Jsupportive 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) El Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder OSubmitted 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 ❑ 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: ./