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FOR OFFICE USE OIVLY PERMIT# � I lL �Z'�Z� <br /> BUILDING PLANNING <br /> Bldg/TI/Addn/Rem Size � Zoning Classification — y <br /> Garage Size Overlay/Agreement <br /> VALUATION Nonresidential Use <br /> Number of Stories I Residential Use � ��_ <br /> Occupancy Group l� Proposed No.of Dwelling Units: <br /> Occupant Load 1-- Total No. of Dwelling Units: <br /> Basement No Yes Fin / Unfin Landscape or Planning Inspection <br /> Type of Construction V — � needed before final? Yes No X <br /> Existing Sprinkler System? Yes No ' Unk Planning Inspector: <br /> Fire Sprinkler Required Yes No Phone#: <br /> Reason Approved by: Date: IZ—Z�— <br /> Existing Fire Alarm Yes N Unk Historic Approved by: Date: <br /> Fire Alarm Required Yes No School Mitigation Reqd? Yes No X <br /> Reason Everett School Dist Mukilteo School Dist <br /> Enclosure Law Ap lies Yes #of Net New Units: <br /> Deferred Submit Req'd Yes No � Calculated School Impact Fee: � <br /> Approved by� Date: — G School Impact Fee Credit: <br /> Comment . Total School Impact Fee Owed: <br /> Comments: � s� � �� �y ���SS� ���,� <br /> �N��(�5/ At�Es�.�aa�-t s1¢�civtr.ES '-all- 2Ea;��„s� <br /> Intake OK by: <br /> intake OK by: <br /> PUBLIC WORKS <br /> FEES INTAKE: Checked By: �,'�,` Date: I Z - -1�o <br /> Plan Check Fee Comments: <br /> Building Permit �'�'�� �� ��O �Z— �� ` <br /> Surcharge High Hazard Sites(Dental, Medical,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 g� � Z—��% f i�,�/(fd(JS�� <br /> Sewer Fee ❑ See PW Review Worksheet ��� S�b�"1°�fi <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 /> I � �� -. <br /> , <br /> � �,,s, <br />