1000 SE EVERETT MALL WAY SUITE 200 KELLER WILLIAMS 2017-01-13

�� I I � � FOR OFFICE USE ONLY �MIT # �1( i I"��=� BUILDING Bldg/TI/Addn/Rem Size Garage Size VALUATION Number of Stories Occupancy Group Occupant Load Basement Yes No Fin/Unf Type of Construction Existing Sprinkler System? Yes No Unk Fire Sprinkler Required Yes No Reason Existing Fire Alarm Yes No Unk Fire Alarm Required Yes No Reason Enclosure Law a�plies Yes Deferred Submi tal Req'd Yes No Approved by;i ' � Dat . Comments: : . FEES Plan Check Fee Building Permit Surcharge Additional Plan Check Plumbing Fee Mechanical Fee Ping Bldg Review Fee Water Fee Sewer Fee Systems Dev. Fee Traffic Mitigation Fee Public Works Fee School Mitigation Fee PLANNING Zoning Classification Overlay/Agreement Nonresidential Use Residential Use Proposed No. of Dwelling Units: Total No. of Dwelling Units: Landscape or Planning Inspection needed before final? Yes No Planning Inspector: Phone #: Approved by: Date: Historic Approved by: Date: School Mitigation Reqd? Yes No Everett School Dist Mukilteo School Dist # of Net New Units: Calculated School Impact Fee: School Impact Fee Credit: Total School Impact Fee Owed: Comments: PUBLIC WORKS Intake Checked By: Date: Intake Comments: PW Permit Application Submitted? Yes No PW Worksheet Required? Yes No PW REVIEW: PW Reviewer: Date: SEE PW WORKSHEET-returned to file PW Permit Approved, PW Permit Not Required FIRE DEPARTMENT Fire Sqrinkler Repuired? Yes No Fire Alarm Required? Yes No APPROVAL TO ISSUE PERMITS: Yes No Fire Reviewer: Date Reviewed: Reviewed Under Permit Type/#: Comments: Z��