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0 FOR OFFICE USE ONLYO PERMIT# C/tO3 O(? <br /> .. P <br /> .IA. :1161-414.0H::_,: ii", :.! -.. !: ,, :;!1 :. :!i l... <br /> Bldg/TI/Addn/Rem Size t.? (AA Zoning Classification 3 Z FE; _ <br /> Garage Size P✓11 Overlay/Agreement ; . <br /> • <br /> VALUATION lbTl1 6460 Nonresidential Use <br /> Number of Stories 3 Residential Use MOW) - V-cri' <br /> 1 y <br /> Occupancy Group 2.M Proposed No.of Dwelling Units: <br /> • <br /> Occupant Load Total No.of Dwelling Units: <br /> l Z - <br /> Basement No X Yes_ Fin / Unfin Landscape or Planning-lnspection <br /> Type of Construction :(g needed before final? Yes 4 No <br /> Existing Sprinkler System? Yes No Unk Planning Inspector: k? J <br /> Fire Sprinkler Required Yes No Phone#: 1.1.2 s- i7 '7 Z 5 <br /> Reason Approved by: u,.4"a Date: S--11'11 <br /> Existing Fire Alarm Yes No Unk Historic Approved by: —�- Date: --- <br /> Fire Alarm Required Yes No School Mitigation Reqd? Yes X No <br /> Reason Everett School Dist X Mukilteo School Dist <br /> RCW 64.55 MF worksheet req'd for permit? Yes_ No #of Net New Units: 2 <br /> Add'I RCW 64.55 docs required prior to final?Yes_ No X Calculated School Impact Fee:- $37,'?-,0 <br /> Architectural Approved By/Dat io(so ig, School Impact Fee Credit: <br /> -gtructoral Approved By/Date: F.tAnk •Ii.1 Total School Impact Fee Owed: $62, <br /> • Comments: 2dIS f&C. * -PS-6G Comments: pee_ rra1I'• 1 ' sunr2t. <br /> 061/4vVik N3 if`VecAiv`O. <br /> Intake OK by: Ot 1" Intake OK by: it' 4 r", c to route _ Hold)( <br /> Make this a"W"Permit? Yes No 04. i <br /> .. ... ...:. 'FEES..:.-: ' .. .. . CheckedBy: Date:INTAKE: <br /> Plan Check Fee . Comments: Qn t r' / v--! ;n1 by c)cill�/S <br /> r " j f Works tek. it �' <br /> Building Permit r�r �[4 ' � ����r� ��', <br /> 1 '5/yn L6�Ne r 4-or S J/ws'Oat <br /> Surcharge nigh Hazar Site (Dental/Medical,Animals,Mortuary,etc-Review for RPBA) <br /> Additional Plan Check 0 Public Works/Sys Dev/Traffic Mit./RPBA-NOT REQUIRED <br /> Plumbing u W (bldg , e <br /> Mechanical <br /> Fee Fee PublicRote WfororksPublic Permit-ConcurrentorksReview Review(separate folder greenPWWorksh folder) et) <br /> Ping Bldg Review Fee PW REVIEW: PW Reviewer: i Date: .5 -ZO/7 <br /> Water Fee PW Permit Approved-PW�g0Z O3a / ��/ 1 cu <br /> Sewer Fee gSee PW Review Worksheet <br /> Systems Dev. Fee . 0 PW Permit Not Required <br /> Traffic Mitigation Fee <br /> Public Works Fee :.. :.Flk E•DEPARTMENT:T.' - <br /> School Mitigation Fee Updat: ew Sprinklers Yes)< No Existing Bldg. <br /> Update/ ew etection -Yes No Existing Bldg. <br /> Update/New Chemical Yes No Existing Bldg. <br /> Update/New Fire Service Yes No Existing Bldg. <br /> Approved by: ,Z.C6Wr Date: �0-/q <br /> Comments: <br />