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USE ONLY i4� <br /> FOR OFFICE � Q O `{5 <br /> /p_i-) - 1 q <br /> BUILDINGPLANNING <br /> Bldg/TI/Addn/Rem Size "//.//�� Zoning Classification <br /> Garage Size Overlay/Agreement <br /> VALUATION Nonresidential Use <br /> No. of Stories 'L, Residential Use <br /> Occupancy Group a, '/ Proposed No. of Dwelling Units: <br /> / <br /> Occupant Load v Total No. of Dwelling Units: <br /> Basement Yes /No_Fin/Unf - Landscape or Planning Inspection <br /> Type of Construction V— 6 needed before final? Yes No <br /> Exstg Sprinkler System? Yes NoylkfJ Planning Inspector: <br /> Fire Sprink Reqd? Yes No Phone#: <br /> Reason Approved by: Date: <br /> Exstg Fire Alarm? Yes No Unk✓/ Historic Approved by: Date: <br /> Fire Alarm Reqd? Yes No✓ School Mitigation Reqd? Yes No <br /> Reason Everett School Dist Mukilteo School Dist <br /> Enclosure (RC/ 4.55) Yes No 4"/./ <br /> #of Net New Units: <br /> Approved by: Date:i 0 .% . 11� Calculated School Impact Fee: <br /> Commen : School Impact Fee Credit: <br /> Total School Impact Fee Owed: <br /> Comments: <br /> FEES <br /> Plan Check Fee <br /> Building Permit <br /> Surcharge <br /> Additional Plan Check <br /> Water <br /> Sewer <br /> Systems Dev. Due? Yes No <br /> Systems Dev. Fees <br /> Public Works <br /> Traffic Mitigation Due? Yes No Rcpt# <br /> School Mitigation Fee <br />