1417 RUCKER AVE 2025-10-06 - Laserfiche WebLink

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# - UV I BUILDING PLANNING Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: Zone V_— Make this a" "Permit © SRC Required(Pre-Insp) Overlay/Agreement Pci,irr 6,-.-- b{ fJ-5-jr--ac- Bldg/TI/AddntRem Size I Nonresidential Use Garage/Accessory Struct.Size Residential Use Number of Stories 2 Proposed No.of Dwelling Units: Basement QNo ❑Yes, Fin/Unfin Total No.of Dwelling Units: Type of Construction SLR 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? ❑No ❑Yes ❑Shell Only Calculated: Credit: Code Year 102021 112018 112015 ❑Everett School Dist ❑Mukilteo School Dist Fire Sprinklers: ❑Update Existing ❑New System QNot Req'd Park Impact Fees for permits applied for after 111/2022: Reason Sprinklers Required: Park Impact Fee Total$ (net due after credit for existing uses) Fire Alarm: El Update Existing ❑New System ©Not Req'd Fee Schedule Used For Calculation(Year): -------"--- Reason Fire Alarm Required: RCW 64.55 MF worksheet req'd for permit? ❑Yes p No Add'[RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: VALUATION CALCULATION: Total$ r1 Approved By. Gib Date: t; 7 p PUBLIC WORKS Intake OK by: Date: Intake Comments: I PW Review&Worksheet Needed if.- (OSys Dev Eval Additional Notes: pQ 'n I ❑Water ❑Sewer ❑Storm � ► 4 i 0Traffic Mitigation Eva[ Approved By: r,_ ' Date: �..` / �d 1d�, p� I E]Site Work/Drainage(shown/triggered) �NI 1 � �� ,l]Address Letter i FIRE DEPARTMENT j13Backflow Prevention for high hazard: Separate/Deferred Submittals Required: (dental,medical,animals,mortuary, hospital,supportive housing) El Fire Sprinklers ❑Fire Alarm ❑Other: 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 fully digital ❑ 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 Goin 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: 01 Approved By: Date: lCompleted By: Date: 04 IN 1741.11