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FOR OFFICE USE ONLY PERMIT# (°(9' O 004- <br /> BUILDING <br /> 04- <br /> BUILDING PLANNING <br /> BI(/TI/A..n/Rem Size I_t 1 \.. 3 Zoning Classification 12- <br /> Ga <br /> j Ga .:- ize Overlay/Agreement <br /> VALUATIONNonresidential Use <br /> Number of Stories Residential Use <br /> Occupancy Group Proposed No.of Dwelling Units: <br /> Occupant Load Total No.of Dwelling Units: <br /> Basement No. 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'—' <br /> Fire Sprinkler Required Yes_ No Phone#:---- <br /> Reason Approved Date: j 1 l / j <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 S •-• list <br /> RCW 64.55 MF worksheet req'd for permit? Yes No_ #of Net New Units: <br /> Add'I RCW 64.55 docs required prior to final?Yes_ No_ Calculated Sc -• mpact Fee: <br /> Architectural Approved By/Date: ch/ ///.3// L. Scho• pact Fee Credit: <br /> Structural Approved By/Date: Total School Impact Fee Owed: <br /> Comments: Comments: <br /> /p es- �" ' �)� Intake OK by ✓ — <br /> Intake OK by: F <br /> l �� y:: Ok to route Hold <br /> Make this a"W" Permit? Yes— No 7 <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: Date: /at/q <br /> Water Fee 0 PW Permit Approved-PW <br /> Sewer Fee 0 See PW Review Worksheet f%j pvv <br /> Systems Dev. Fee ,=` 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 /> Ci/11 <br />