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FOR OFFICE USE ONLY PERMIT# ' \ bO3 <br /> BUILDING PLANNIts Z <br /> �d�I/Addn/Rem Size ZO 10 S� Zoning Classification <br /> �J <br /> Garage Size -7s4. S ' Overlay/Agreement <br /> VALUATION 3b9, gq(p Nonresidential Use <br /> Number of Stories Z Residential Use ALY\e X <br /> Occupancy Group 0-/u Proposed No. of Dwelling Units: <br /> Occupant Load Total No. of Dwelling Units: IA (:\k-CILki <br /> Basement No x Yes_ Fin / Unfin Landscape or Planning Inspection <br /> Type of Construction ZS needed before final? Yes A No <br /> Existing Sprinkler System? Yes No Unk Planning Inspector: ',e_ e?pt 6, <br /> Fire Sprinkler Required Yes No Phone#: L{,Z5j", 2 . . <br /> Reason Approved by: Date: 2. \S• 2..exti- <br /> Existing Fire Alarm Yes_ No Unk Historic Approved by: r11/ c Date: <br /> Fire Alarm Required Yes_ No_ School Mitigation Reqd? Yes \I No <br /> Reason Everett School Dist K Mukilteo School Dist <br /> RCW 64.55 MF worksheet req'd for permit? Yes No #of Net New Units: --\-W0 (2-) <br /> Add] RCW 64.55 docs required prior to final?Yes No Calculated School Impact Fee: A \Zs." X t <br /> Architectural Approved By/Date: 5//to//e School Impact Fee Credit: 01, <br /> Structural Approved By/Date: Total School Impact Fee Owed: \%''' 250,06 <br /> Comments: Z0/5- //2G it 144 S£c_- Comments: r <br /> See Cv�\ P �' ks (' <br /> `gn. GS? <br /> Intake OK by: Intake OK by:C Ok to route I Hold <br /> Make this a"W" Permit? Yes Rio __, <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Intake Comments: PW Worksheet Needed if: <br /> ❑Sys Dev Eval ❑Traffic Mit Eval <br /> Site Work or Drainage Proposed <br /> ❑Backflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> FIRE DEPARTMENT Route this folder for PW Review at end ---PW Review Worksheet <br /> Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> ❑Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder Submitted Previously ❑Deferred <br /> Additional Notes: ❑ This Permit is Approved by Public Works <br /> ee PW Review Worksheet and associated attached items <br /> Fire Dept. Fees: IAA eparate PW Permit is Required (Permit#: PW 1(60. 00 ) <br /> El Review of As-Built Plans-NO FIRE FEE IAA <br /> ❑ Is located in this folder <br /> IR-Minimal or No Fire Scope- NO FIRE FEE 0 Is in a Separate Green Folder(join with this folder for permit issuance) <br /> 0 Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By: ►_,).n Date: pz�.9/er ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL A-, •', <br /> Additional Notes: /-- <br /> Approved By: Approved roved Date: By: Date: `` <br />