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FOR OFFICE USE ONLY PERMIT# 1/t)10 U`")I O <br /> BUILDING PLANNING <br /> Bldg/TI/Addn/Rem Size Zoning Classification <br /> Garage Size �Z sf Overlay/Agreement <br /> VALUATION jet "I7 Coo Nonresidential Use <br /> Number of Stories I Residential Use (Alit , 66^e <br /> Occupancy Group (it Proposed No. of Dwelling Units: <br /> Occupant Load Total No. of Dwelling Units: I <br /> Basement No K Yes_ Fin / Unfin Landscape or Planning Inspection <br /> Type of Construction TTi3 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: c'2,S--) <br /> Existing Fire Alarm Yes— No—Unk_ Historic Approved by: Date: <br /> Fire Alarm Required Yes No School Mitigation Reqd? Yes No;C <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 /> Architectural Approved By/Date: atfr 7/I0 j J f School Impact Fee Credit: <br /> Structural Approved By/Date: c Total School Impact Fee Owed: <br /> Comments: -la /p2C. Comments: vecA_ and C fets,re_ <br /> ;\-- ' <br /> • <br /> Intake OK by: - Intake OK by: Ok to route Hold <br /> Make this a"W" Permit? (Yes.0(s. 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, eview(separate green older) <br /> Ping Bldg Review Fee PW REVIEW: PW Reviewer: Date: 3 2.-S <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: �� v1/4e/ ta Z/ <br />