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FOR OFFICE USE ONLY • PERMIT # V (A_'6t93 <br />BUILDING <br />PLANNING <br />Bldg/TI/Addn/Rem Size <br />Zoning Classification <br />— <br />Garage Size <br />Overlay/Agreement <br />( <br />VALUATION <br />6 3 <br />Nonresidential Use <br />Number of Stories <br />Residential Use <br />rs <br />Occupancy Group <br />Proposed No. of Dwelling Units: Z <br />Occupant Load <br />Total No. of Dwelling Units: <br />Basement <br />No _ YesX Unfin <br />Landscape or Planning Inspection <br />needed before final? Yes ,� No <br />Type of Construction <br />Existing Sprinkler System? <br />Yes No Unk <br />Planning Inspector: <br />Fire Sprinkler Required <br />Yes _ No <br />Phone #: <br />Reason <br />Approved by: Date: <br />Existing Fire Alarm <br />IYes No Unk <br />Historic Approved by: Date: <br />Fire Alarm Required <br />Yes No <br />School Mitigation Reqd? Yes .)( No <br />Reason <br />Everett School Dist ?< Mukilteo School Dist <br />RCW 64.55 MF worksheet req'd for permit? Yes _ No <br /># of Net New Units: Z4, <br />Add'I RCW 64.55 docs required prior to final? Yes _ No _ <br />Calculated School Impact Fee: Zap <br />Architectural Approved By/Date: 6 l4 18 <br />School Impact Fee Credit: 3Z'50 <br />Structural Approved By/Date: <br />Total School Impact Fee Owed: 0 <br />Comments: Z0.,,3- <br />Intake OK by: <br />Comments: <br />Intake OK by: Ok to route Hold <br />Make this a "W" Permit? Yes No <br />UBLIC WORKS <br />FEES <br />INTAKE: Checked By: Date: <br />Comments: a'r <br />kovlk 'f 0 104) j Y Aai t%Tf, <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 />❑ Public Works Permit-Concurren Review (separate green folder) <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 />PW REVIEW: PW Reviewer: Date: C-12—ZO <br />IR PW Permit Approved - PW 1306 — 02j - <br />10 See PW Review Worksheet <br />❑ PW Permit Not Required <br />Water Fee <br />Sewer Fee <br />Systems Dev. Fee <br />Traffic Mitigation Fee <br />Public Works Fee <br />FIRE DEPARTMENT <br />School Mitigation Fee <br />Update/New Sprinklers <br />Yes No Existing Bldg._ <br />Update/ New Detection <br />Yes _ No Existing Bldg. <br />Update/ New Chemical <br />Yes No Existing Bldg. _ <br />Update/ New Hie Servi e <br />Yes No Existing Bldg. _ <br />_ <br />Approved by: Date: <br />Comments: <br />