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FOR OFFICE USE ONLY PERMIT# <br /> BUILDING PLANNING <br /> Bldg/TI/Addn/Rem Size Zoning Classification L <br /> GazisgwSize ' ' '5 Overlay/Agreement <br /> VALUATION Nonresidential Use <br /> Number of Stories Residential Use <br /> Occupancy Group Proposed No. of Dwelling Units: <br /> Occupant Load Total No.of Dwelling Units: <br /> Basement No Yes Fin / Unfin Landscape or Planning Ins ion <br /> Type of Construction lye needed before fin Yes No <br /> Existing Sprinkler System? Yes No Unk Planning In ector: <br /> Fire Sprinkler Required Yes No Phone#: <br /> Reason Approved by: Date: L �� <br /> Existing Fire Alarm Yes No Unk Historic Approved by: Date: <br /> Fire Alarm Required Yes No School Mitigation Reqd? Yes N <br /> Reason Everett School Dist Mu '# o School Dist <br /> Enclosure Law Applies Yes #of Net New Units: <br /> Deferred Submittal Req'd Yes No Calculated Scho mpact Fee: <br /> Approved by: Date: / _ School Impa Fee Credit: <br /> Comments: G C)15- /2G Total School Impact Fee Owed: <br /> Comments: <br /> (_\�\\0& ` ,eX�S__h`1Q� <br /> Intake OK by: C <br /> Intake OK by: <br /> PUBLIC WORKS <br /> FEES INTAKE: Checked By: Date: /,R- —/6 <br /> Plan Check Fee Intake Comments: <br /> Building Permit <br /> Surcharge <br /> Additional Plan Check ❑ Public Works/Sys Dev/Traffic Mitigation- 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 FIRE DEPARTMENT <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 /> " K/ <br />