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1110 FOR OFFICE USE ONLY r PERMIT# C nn o b 0 11 <br /> BUILDING PLANNING <br /> BIBI g Addn/Rem Size 0OZ/ 5/ Zoning Classification 12- t <br /> Garage Size J`-2.& ,$f4 Overlay/Agreement No t1 E <br /> VALUATION -AI01.3. Nonresidential Use b 0 E <br /> Number of Stories 2._ Residential Use F p- <br /> Occupancy Group Proposed No. of Dwelling Units: 1 <br /> Occupant Load Total No.of Dwelling Units: 1 <br /> Basement No,K Yes_ Fin / Unfin Landscape or Planning Inspectoo <br /> Type of Construction TL.ta needed before final? Yes No <br /> Existing Sprinkler System? Yes_ No_Link_ Planning Inspector: -11?,(e- { \N? A(J 0 IA <br /> Fire Sprinkler Required Yes No_ Phone#: - - —I 1 <br /> Reason Approved Date: 3/22 II <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 V Mukilteo School Dist <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 School Impact Fee: (-F' I CI S0 ' <br /> Architectural Approved: t ' Date:.S�`/// School Impact Fee Credit: IV 0‘').F� <br /> Structural Approved: Date: Total School Impact Fee Owe411,I CA S-CD---- <br /> Comments: EC,/ - /2C 0 14)c Comments: <br /> Intake OK by: <br /> Intake OK by: Date: <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 ❑ Public Works/Sys Dev/Traffic Mit./RPBA-NOT REQUIRED <br /> Plumbing Fee ❑ Route for Public Works Review(bldg folder, PW Worksheet) <br /> Mechanical Fee ❑ Public Works Permit-Concurrent Review(separate green folder) <br /> Ping Bldg Review Fee PW REVIEW: PW Reviewer: 6:3 Date: 4 26,^( 7 <br /> Water Fee 'PW Permit Approved- PW 1 i 0 .''D 3t) <br /> Sewer Fee ❑ See PW Review Worksheet <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 /> 217/ <br />