3927 RUCKER AVE BASE FILE 2019-04-17

Intake &Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT#If` \ O -CO J BUILDING PLANNING - Intake OK by: Date: Intake OK by: Date: Intake Comments: Intake Comments: Assign To: ❑ Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W"Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer Garage/Accessory Struct. Size Zone ''E 1. Hob Number of Stories Overlay/Agreement t-\0 O i LRAr Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use J .A Type of Construction Residential Use Occupancy Group Proposed No. of Dwelling Units: Occupancy Load Total No. of Dwelling Units: Fire Sprinklers: DUpdate Existing ONew System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes [BNo Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ Fire Alarm: DUpdate Existing ❑New System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Gres' . RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No ❑Everett School Dist ❑Mukilt--o School Dist Add'I RCW 64.55 docs required prior to final? DYes ❑No Additional Notes: c c � �ter��- L ) _ _ )��,,,� VALUATION CALCULATION: Total.$ IvLc,W W11,,L ,¢.siti.).1,-, e) arct,,,46%-x,1 Screa,Mrse) Approved By: Y.\,1 A Date: j b--Z.is‘ 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` �L/ Date: 4/26/24•4 ❑Backflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT DRoute this folder for PW Review at end ---PW Review Worksheet Intake: (Needed for Townhomes,Alley load SFR,New Commercial) ❑This project also has a separate concurrent PW Review(Green Folder) ❑Route to Fire Drawer---Fire Preliminary Review Notice AND ❑Create Green Folder ❑Submitted Previously ❑Deferred ❑Sending Fire Notes to Project Team 0 This Permit is Approved by Public Works Date: (OK to Route to Other Departments) ❑ See PW Review Worksheet and associated attached items Fire Sprinklers: ❑Update Existing ❑New System 0 Not Req'd 0 A Separate PW Permit is Required (Permit#: PW ) Fire Alarm: DUpdate Existing ❑New System 0 Not Req'd AND 0 Is located in this folder Chemical Sup: DUpdate Existing ❑New System ❑ Not Req'd 0 Is in a Separate Green Folder(join with this folder for permit issuance) Additional Notes: ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: 0 Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: