1013 RUCKER AVE 2025-08-20 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLr PERMIT# " BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone —Z ❑ Make this a"W"Permit ❑ SRC Required(Pre-Insp) Overlay/Agreement PuG (•67(6i:M lq(S�c Bldg1TI/Addn/Rem Size / Nonresidential Use Garage/Accessory Struct.Size Residential Use S � Number of Stories 2 Proposed No.of Dwelling Units: Basement o []Yes, Fin/Unfin Total No.of Dwelling Units: Type of Construction ( Planning/Landscape Inspection Required before Final? ❑Yes ❑No Occupancy Group "In Lieu"Fee:Type: Amount$ Occupancy Load School Impact Fee: Total $ Cert.of Occpuancy Required Yes ❑Shell Only Calculated: Credit: Code Year 2021 2018 112015 []Everett School Dist ❑Mukilteo School Dist Fire Sprinklers: ❑Update Existing El New System RNot Req'd Park Impact Fees for permits applied for after 11112022: Reason Sprinklers Required: ��vvtt Park Impact Fee Total$ (net due after credit for existing uses) Fire Alarm: ❑Update Existing ❑New System WlNot Req'd Fee Schedule Used For Calculation(Year): Reason Fire Alarm Required: "•'�"�"`"""�' ---•----_____.,..._____________._.._...._.._.__.._..___�_...._ RCW 64.55 MF worksheet req'd for permit? ❑Yes El No Add'I RCW 64.55 dots required prior to final? ❑Yes Wo Additional Notes: VALUATION CALCULATION: Total$ tl C�: z u; cj jgAV 0-67 C.GLSSC Ky Approved By: Date: PUBLIC WORKS v� Intake OK by: Date: _ _ S s z Intake Comments: -PWReview&Worksheet Needed if., I IJ Sys Dev Eval: Additional Notes: R ff e4v1D W/ VYI k(Z\C--V f S I ❑Water ❑Sewer []Storm ❑Traffic Mitigation Eval i Approved By Date: Z []Site Work/Drainage(shown/triggered) ❑Address Letter FIRE DEPARTMENT ❑Backflow Prevention for high hazard: Separate/Deferred Submittals Required: j(dental,medical,animals,mortuary, hospital,supportive housing) ❑Fire Sprinklers ❑Fire Alarm ❑Other: I Additional Notes: This Permit is Approved by Public Works ee 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 fully digital 0 Minimal or No Fire Scope-NO FIRE FEE ❑ Is located in this folder ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Is in a Separate Green Folder Qoin 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 on this permit---PW Not Required ELECTRICAL/PLUMBING Additional Notes: Additional Notes: Approved By: Date: Completed By: Date: 1Z 2 Z0Z-3