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FOR OFFICE USE ONLY • PERMIT # <br />6LA <br />BUILDING <br />Bldg/TI/ ddn/Rem Size <br />a Q) s <br />Garage Size <br />VALUATION <br />Number of Stories <br />Occupancy Group <br />nn <br />Occupant Load <br />aQ 0 <br />Basement <br />No X Yes _ Fin / Unfin <br />Type of Construction <br />V <br />Existing Sprinkler System? <br />Yes_ No �_ Unk_ <br />Fire Sprinkler Required <br />Yes _ No <br />Reason <br />W PA- %$ <br />Existing Fire Alarm <br />Yes _)C _ No 4L Unk <br />Fire Alarm Required Yes l No <br />Reason I tZ (' <br />RCW 64.55 MF worksheet req'd for permit? Yes No <br />Add'1 RCW 64.55 docs required prior to final? Yes No _ <br />Architectural Approved: <br />l%6 J�O L(- Date: i <br />Structural Approved: <br />Date' <br />Comments: <br />Intake OK by: r <br />Date: ' �., 1� <br />U <br />FEES <br />Plan Check Fee <br />Building Permit <br />Surcharge <br />Additional Plan Check <br />Plumbing Fee <br />Mechanical Fee <br />Ping Bldg Review Fee <br />Water Fee <br />Sewer Fee <br />Systems Dev. Fee <br />Traffic Mitigation Fee <br />Public Works Fee <br />School Mitigation Fee <br />PLANNING <br />Zoning Classification <br />Overlay/Agreement <br />Nonresidential Use <br />I QCMVN k'C"G, oe_S w <br />Residential Use <br />Proposed No. of Dwelling Units: <br />Total No. of Dwelling Units: <br />I -'-1 <br />Landscape or Planning Inspection <br />needed before final? Yes 1Z/ No _ <br />Planning Inspector: Tf'�PSG. we- d v <br />Phone #: 4,vq ' 0V <br />Approved by: Date: <br />Historic Approved by: -" Date: <br />School Mitigation Reqd? Yes No <br />Everett School Dist Mukilteo School Dist <br /># of Net New Units: <br />Calculated School Impact Fee: <br />School Impact Fee Credit: ' <br />Total School Impact Fee Owed: <br />Comments: 1p - p`/�,��- b r ct> v ► v- <br />�e f <br />TC6 ar CO. <br />Intake OK by: <br />PUBLIC WORKS <br />INTAKE: Checked By: ke Date: 3 V 3 <br />Comments: <br />High Hazard Sites (Dental, Medical, Animals, Mortuary, etc -Review for RPBA) <br />❑ Public Works / Sys Dev / Traffic Mit. / RPBA - NOT REQUIRED <br />❑ Route for Public Works Review (bldg folder, PW Worksheet) <br />tK Public Works Perm it-Concuryent Review (separate green folder) <br />PW REVIEW: PW Reviewer:-AE3- _Date:q-ZS-Z,01S <br />PW Permit Approved - PW 1103-CZZ <br />1'�!` See PW Review Worksheet <br />❑ PW Permit Not Required <br />FIRE DEPARTMENT <br />Update/New Sprinklers <br />Yes &No Existing Bldg._ <br />Update/ New Detection <br />Yes No_ Existing Bldg. <br />Update/ New Chemical <br />Yes Noy Existing Bldg. <br />Update/ New Fi Service <br />Yes No_ Existing Bldg. <br />Approved by: <br />Date: 2 "le) <br />Comments: <br />i <br />72f <br />