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catz5Act... FOR OFFICE USE •;,LY • PERMIT# :0 3 -/CO2— <br /> PLANNING <br /> Bldg/TI/Addn/Rem Size Zoning Classification <br /> Garage Size Overlay/Agreement <br /> VALUATION Nonresidential 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 by: Date: <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 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: <br /> ArchitpcturalApproved By/Date: School Impact Fee Credit: <br /> betc -"ck-F <br /> tructural Approved By/Date: Total School Impact Fee Owed: <br /> Comments: L_1-00 _ e()t `rp-Fle_b Comments: <br /> c.�SQFc�t or%4 4k. 2.0*(4- Nth- . Pt.4(„(.. <br /> GcReac-t^-gaS� I^› Af+- t.c.a-Y QoS�G pk•rrr J <br /> Intake OK"by: 4 - C "A ^1 cc '��" V'trkt UK br Ok to route Hold _ <br /> Make this a"W" Permit? Yes No <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: Date: <br /> Water Fee ❑ PW Permit Approved-PW <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: / Z <br />