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FOR OFFICE USE ONLY PERMIT# CA?I(---66 2, <br /> BUILDING . <br /> :Id.a I/Addn/Rem Size , 40 5 Zoning Classification ?-', <br /> Garage Size Or Overlay/Agreement <br /> VALUATION 7-Z ,3 Z0 Nonresidential Use <br /> Number of Stories I Residential Use 5e i -1-. i9A120 <br /> Occupancy Group 12, Proposed No. of Dwelling Units: y 19A49 0 <br /> Occupant Load Total No. of Dwelling Units: i 5 4- tM a) <br /> Basement No_2(._Yes Fin / Unfin Landscape or Planning Inspection <br /> Type of Construction needed before final? Yes A No <br /> Existing Sprinkler System? Yes_ No_Unk_ Planning Inspector: (q _ <br /> Fire Sprinkler Required Yes_ No_ Phone#: y'LS-z,si- <br /> n z, s"*" <br /> Reason Approved by: It.111,-0, <br /> Date: it-. 114'1'1 <br /> Existing Fire Alarm Yes_ No_Unk Historic Approved by: Date: <br /> Fire Alarm Required Yes_ No_ School Mitigation Reqd? Yes_ No K <br /> Reason Everett School Dist Mukilteo School Dist <br /> RCW 64.55 MF worksheet req'd for permit? Yes No_ #of Net New Units: <br /> Add!RCW 64.55 docs required prior to final?Yes_ No_ Calculated School Impact Fee: <br /> Architectural Approved By/Date: /Z./7// . School Impact Fee Credit: <br /> Structural Approved By/Date: Total School Impact Fee Owed: <br /> Comments: 7/6— fe...e_ , //9/C" Comments: Poly'� IIS kb ice ?ay.ea <br /> Sttinirviale4iik %t A-cli._My,d4 <br /> ain ec OOe_/ <br /> _�y�. 'L <br /> Intake OK by: Cj ► Intake OK by: to Ok to route A" Hold <br /> Make this a"W" Permit? Yes No <br /> PUBLIC WORKS <br /> FEES INTAKE: Checked By: A23 Date: /1-6'- /7 <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 Public Works/ yslDev/ <br /> Plumbing Fee El Route 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: Date: /1-Z0-1i <br /> Water Fee ,2iPW Permit Approved-PW /7// 4923 <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 /> 7 <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: \\\14')‘‘ Date: (9 - 2.- , <br /> Comments: <br />