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FOR OFFICE USE ONLY PERMIT# Cr I(p00— Cxil <br /> BUILDING PLANNING <br /> Bldg/Tl/Addn/Rem Size (&/&" �' Zoning Classification R-5 L <br /> Garage Size ' 33 . / Overlay/Agreement <br /> VALUATION Z o,6Q2 Nonresidential Use y�n <br /> Number of Stories 2 Residential Use ✓f <br /> Occupancy Group &Ai Proposed No.of Dwelling Units: <br /> Occupant Load Total No.of Dwelling Units: <br /> Basement No De Yes_ Fin / Unfin Landscape or Planning Inspection <br /> Type of Construction needed before final? Yes')( No <br /> Existing Sprinkler System? Yes_ No Unk Planning Inspector: Viej6p,.../ � <br /> Fire Sprinkler Required Yes No_ Phone#: u LS-257— '72`7C <br /> Reason Approved by: ) Date: l7_-15.)(p <br /> Existing Fire Alarm Yes No Unk Historic Approved by: Date: <br /> Fire Alarm Required Yes_ No School Mitigation Reqd? Yes )' No_ <br /> Reason Everett School Dist Mukilteo School Dist <br /> Enclosure Law Applies Yes_ #of Net New Units: l <br /> Deferred Submittal Req'd Yes No Calculated School Impact Fee: _ �,� <br /> Approved by: edit- Date:/4/1% k School Impact Fee Credit: 0, <br /> Comments: Total School Impact Fee Owed: V-V <br /> Comments: <br /> Intake OK by: <br /> Intake OK by: <br /> PUBLIC WORKS <br /> FEES INTAKE: Checked By: Date: <br /> Plan Check Fee Comments: <br /> Building Permit <br /> Surcharge High Hazard Sites(Dental,Medical,Animals,Mortuary,etc-Review for RPBA) <br /> Additional Plan Check 0 Public Works/Sys Dev/Traffic Mit./RPBA-NOT REQUIRED <br /> Plumbing Fee 0 Route for Public Works Review(bldg folder, PW Worksheet) <br /> Mechanical Fee 0 Public Works Permit-Concurrent Review(separate green folder) <br /> Ping Bldg Review Fee PW REVIEW: PW Reviewer: /-Q Date: / <br /> Water Fee 'PW Permit Approved-PW /l/2 -03 5' <br /> Sewer Fee 0 See PW Review Worksheet <br /> Systems Dev.Fee 0 PW Permit Not Required <br /> Traffic Mitigation Fee <br /> Public Works Fee FIRE DEPARTMENT <br /> School Mitigation Fee Update/New Sprinklers Yes_ No_ Existing Bldg. <br /> Update/New Detection Yes No Existing Bldg. <br /> Update/New Chemical Yes_ No_ Existing Bldg._ <br /> Update/New Fire Service Yes_ No Existing Bldg._ <br /> Approved by: Date: <br /> Comments: <br />