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� FOR OFFICE USE OIVLY <br />BUILDING <br />B1dg/TI/Addn Size <br />Garage 5ize <br />VALUATION <br />Number of Stories <br />Occupancy Group � <br />Occupant Load <br />Basement Yes No Fin/Unf <br />Type of Construction <br />Existing Sprinkler System? Yes No Unk <br />Fire Sprinkler Required Yes No. <br />Reason <br />Existing Fire Alarm Yes No Unk <br />Fire Alarm Required Yes No <br />Reason <br />Enclosure Law Applies Yes <br />Deferred Submittal Req'd Yes No <br />Approved by: Date: 7 <br />Comments: 2olS /�, � <br />FEES <br />Plan Check Fee <br />Building Permit <br />Surcharge <br />Additional Plan Check <br />Plumbing Fee <br />Mechanical Fee <br />Ping Bldg Review Fee <br />Wafer Fee <br />Sewer Fee <br />Systems Dev. Fee <br />Traffic Mitigation Fee <br />Public Works Fee <br />School Mitigation Fee <br />�PERM17 # V �'�' I �� � � <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 />Approved by: Date: <br />Historic Approved by: Date: <br />School Mitigation Reqd? Yes No <br />Everett School Dist Mukilteo School Dist <br /># of Net New Units: <br />Calculated School lmpact Fee: <br />School Impact Fee Credit: <br />Total School Impact Fee Owed: <br />Comments: <br />PUBLIC WORKS <br />Intake Checked By: Date: <br />Intake Comments: <br />PW Permit Application Submitted? Yes No, <br />PW Worksheet Required? Yes No <br />REVIEW: PW Reviewer: Date: <br />SEE PW WORKSHEET-refurned to file <br />_ PW Permit Approved, PW Permit Not Required <br />FIRE DEPARTMENT <br />Update/New Sprinklers Yes No Existing Bldg. <br />Updafe/ New Detection Yes No Existing Bldg. __ <br />Updafe/ New Chemical Yes No Existing Bldg. _ <br />Update/ New Fire Service Yes No Existing Bldg. <br />Approved by: Date: <br />Comments: <br />