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110 • <br /> FOR OFFICE USE ONLY PERMIT#b((O(L -0 3O <br /> BUILDING PLANNING <br /> Bld TI/ do em Si e\ I 1 SO Zoning Classification - <br /> Garage Size Overlay/Agreement <br /> VALUATION SLf✓ recnst Nonresidential Use `(f'-e_-5\,dall <br /> � <br /> Number of Stories I Residential Use <br /> Occupancy Groupe Proposed No.of Dwelling Units: <br /> Occupant Load 401 Total No. of Dwelling Units: <br /> Basement No 10 Yesn _ Fin / Unfin Landscape or Planning Inspection <br /> 1} <br /> Type of Construction V needed before final? Yes No <br /> Existing Sprinkler System? Yes No X) Unk Planning Inspector: <br /> Fire Sprinkler Required Yes No )4 Phone#: <br /> Reason t--- (1S71/JC.) USE Approved by: -----SP Date: “it COC ICD <br /> Existing Fire Alarm Yes No ),41 Unk Historic Approved by: Date: <br /> Fire Alarm Required Yes No /" School Mitigation Reqd? Yes No <br /> Reason C- ((S 1(Ai G V S r Everett School Dist Mukilteo School Dist <br /> Enclosure Law Applies Yes #of Net New Units: <br /> Deferred Submittal Req'd Yes No Calculated School Impact Fee: <br /> Approved by: M (, 11-\-t0 Date: 2-114{-2-114{-(() School Impact Fee Credit: <br /> Comments: Total School Impact Fee Owed: <br /> Comments: <br /> Iv) e oC N..30,(4‘. <br /> Intake OK by: <br /> Intake OK by:1/4.11/1 0 Jl id )kvieurQ- <br /> UBLIC WORKS <br /> FEES INTAKE: Checked By: Date: P-- /6-f <br /> Plan Check Fee Comments: S ` ./J Sat,. O1 C _ p eF ,c, , <br /> Building Permit No.i 1Th7 do—C8D Ne irecurbeet> Pam-tjN. <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 1K Route for Public Works Review(bldg folder, PW Worksheet) <br /> Mechanical Fee 0 Public Works Permit-Concur entR-eview(separateggreen folder) <br /> Ping Bldg Review Fee PW REVIEW: PW Reviewer:) { Date: 2- /-2.NY <br /> Water Fee 0 PW Permit Approved-PW 1 S �ks4t f4 / <br /> Sewer Fee 0 See PW Review Worksheet--s a ' <br /> Systems Dev. Fee — El PW Permit Not Required No SYS dvi <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 /> r <br />