2923 RUCKER AVE AT YOUR LEISURE 2017-01-13

� FOR OFFICE USE ONLY BUILDING Bldg/TllAddn/Rem Size Garage Size VALUATION Number of Stories Occupancy Group Occupant Load Basement Yes No Fin/Unf T pe of Construction Existing Sprinkler System? YeS NO Unk Fire Sprinkler Required Yes No Reason Existing Fire Alarm Yes No Unk Fire Alarm Required Yes No Reason Enclosure Law Applies Yes Deferred Submittal Req'd Yes No Approved by: Date: Comments: FEES Plan Check Fee Building Permit Surcharge Additional Plan Check Plumbing Fee Mechanical Fee Ping Bldg Review Fee Water Fee Sewer Fee Systems Dev. Fee Traffic Miti ation Fee Public Works Fee School Mitigation Fee � . PERMIT # � � � '� � � � PLANNING Zoning Classification Overlay/Agreement Nonresidential Use Residential Use Proposed No. of Dwelling Units: Total No. of Dwelling Units: Landscape or Planning Inspection needed before final? Yes No Planning Inspector: Phone #: Approved by: Date: Historic Approved by: Date: School Miti ation Reqd? Yes _ No Everett School Dist Mukilteo School Dist # of Net New Units: Calculated School Impact Fee: School Impact Fee Credit: Total School Impact Fee Owed: Comments: PUBLIC WORKS ntake Checked By:�_ Date: '� -�¢ -/,� ntake Comments: �/a S�S'�Q �,�, � � -�pe Q�ccQ {r ��iS %t-N�l"D✓�'rnPhf . �c�rd pr�'U�avsl�� �W Permit Application Submitted? Yes No �W Worksheet Required? Yes No 'W REVIEW: PW Reviewer: Date: SEE PW WORKSHEET-returned to file PW Permit Approved, � PW Permit Not Required FIRE DEPARTMENT Update/New Sprinklers Yes No _ Existin Bldg._ Update/ New Detection Yes No _ Existin Bld ._ Update/ New Chemical Yes No _ Existin Bldg. _ Update/ New Fire Service Yes No Existing Bldg. _ Approved b : Date: Comments: