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� <br />FOR OFFICE USE ONLY PERMIT # �V� � ��� <br />BUILDING <br />Bldg/TI/Addn/Rem Size �J(/ S7 � <br />Garage Size �l,! <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 Re 'd Yes No <br />Approved by: Date:� ' <br />Comments: ��lS //'�-� <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 />Water Fee <br />Sewer Fee <br />Systems Dev. Fee <br />Traffic Mitigation Fee <br />Public Works Fee <br />School Mitigation Fee <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: I <br />Landscape or Planning Inspection <br />needed before final? Yes No ✓ <br />Planning Inspector: --� <br />Phone #: <br />Approve Date: � Z ; <br />Historic Approved by: Date: <br />Sch Mitigation qd? Yes No <br />Everett School'DTs �feo School Dist <br /># of Net New Units: <br />Calculated School Impact Fee: <br />School Impact Fee Credit: <br />Total School Impact Fee Owed: <br />Comments: <br />�(�,lQt� � I,N��-V'� 'l�-'�l(J1.1[�'L- <br />� l ��t — �2 c� <br />PUBLIC WORKS <br />Intake Checked By: <br />Intake Comments: <br />PW Permit Application Submitted? Yes No <br />PW Worksheet Required? Yes No <br />PW REVIEW: PW Reviewer: Date: <br />_ SEE PW WORKSHEET-returned to file <br />PW Permit Approved. � PW Permit Not Reauired <br />FIRE DEPARTMENT <br />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 Bidg. _ <br />Approved by: Date: <br />Comments: <br />