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FOR OFFICE USE ONLY S t �--D. F <br />BUILDING( <br />Bld /TI Addn/Rem Size <br />) 00 Z <br />Garage Size <br />VALUATION <br />No. of Stories <br />Occupancy Group <br />5 - - <br />Occupant Load <br />Basement <br />Yes Mn Fin/Unf <br />Type of Construction <br />Exstg Sprinkler System? <br />Yes No Unk <br />Fire Sprink Reqd? <br />Yes No _ <br />Reason <br />f-4� � �, <br />Exstg Fire Alarm? <br />Yes _ No Unk_ <br />Fire Alarm Reqd? <br />Yes ✓ No <br />Reason <br />05 <br />Enclosure (F�t,'W 4.55) <br />Yes No _ <br />Approved b . Date: <br />Comment <br />j <br />FEES <br />Plan Check Fee <br />Building Permit <br />Surcharge <br />Additional Plan Check <br />Water <br />Sewer <br />Systems Dev. Due? <br />Yes No <br />Systems Dev. Fees <br />Public Works <br />Traffic Mitigation Due? <br />Yes No <br />[School Mitigation Fee <br />PLANNING <br />Zoning Classification <br />Overlay/Agreement <br />Nonresidential Use <br />Residential Use <br />Proposed No. of Dwelling Units: <br />Total No. of Dwelling Units: <br />Landscape or Planning Inspection <br />needed before final? Yes No — <br />Planning Inspector: <br />Phone #: <br />Approve ate: 49i�� <br />Historic Approved by: -"Bate: — <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: <br />PUBLIC WORKS <br />Review Required? <br />Yes No <br />Reviewer: <br />Date: <br />Comments: <br />