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FOR OFFICE USE ONLY PERMIT# � � \�`Tl.O " O� <br /> ���BUILD � " , ._ ., .. . <br /> ; � _ �NG ': i . . > . . - ,PLAI�1�IlN� ,:. . . ' <br /> �_.... .� _ <br /> BldgiTl/Addn/Rem Size Zoning Classification �J <br /> Garage Size Overlay/Agreement L�(,� <br /> VALUATION Nonresidential Use <br /> Number of Stories Residential Use �— <br /> Occupancy Group Proposed No.of Dwelling Units: .i" <br /> Occupant Load Total No.of Dwelling Units: <br /> Basement No Yes Fin / Wnfin Landscape or Planning Inspection <br /> Type of Construction needed before final? Yes_ No'� <br /> Existing Sprinkier System? Yes No Unk Planning Inspector: <br /> Fire Sprinkler Required Yes No Phone#: <br /> Reason Approved by: Date: �.C�-�JO-��� <br /> Existing Fire Alarm Yes No_Unk Historic Approved by: Date: <br /> Fire Alarm Required Yes No School Mitigation Reqd? Yes_ No <br /> Reason E�erett 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? es No Galculated SChool Impact Fee: <br /> Architectural Approved By/Date: �, , School Impact Fee Credit: <br /> Structural Approved By/Date: Total School Impact Fee Owed: <br /> Comments: Comments: ;� � ���� � <br /> vlt,S� ��'�' <br /> � � <br /> Intake OK by: Intake OK by: Ok to route _ Ho d _ <br /> Make this a"W" Permit? Yes No <br /> �tiBLIC WQRK�.. <br /> ��E� ` INTAKE: Checked By: Date: <br /> _..... .. ... . . . _ .._. .._.._ <br /> Plan Check Fee Comments: ` <br /> Building Permit ��� ��U�� <br /> Surcharge High Hazard Sites(Dental/Medicaf,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 :' �IR�;DEPARTME,NT ; <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: <br /> �10�" Z Z <br />