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FOR OFFICE USE ONLY PERMIT# ` POLA -mak �- <br /> r' v�y� a e qy s ,,•.'$. S ;>:.'e 4� i <br /> 111011•11111400,11111111111.t; r � �z x,. x; � s -`�G{ F,.j� k,�C cefa 2��. �. ��,y(� <br /> ,, aj.. ;{„,,,.s sEa iii• ,,. .! :.1:.i.. .,.....,..,..Yr ......-x,.ak.d::_. <br /> $ 4 y' ti <br /> 4....a s,+��:.::....':..-a.�ae. z, _.<,.,,.,fr.>x.s.�..,,c_,. S.. 55S 3 �, <br /> Bldg/TI/Addn/Rem Size Zoning Classification <br /> Garage Size Overlay/Agreement <br /> VALUATION tag( a 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 Inspection <br /> Type of Construction needed before final? Yes _No— <br /> Existing Sprinkler System? Yes No_Unk_ Planning Inspector: <br /> Fire Sprinkler Required Yes_ No— Phone#: <br /> Reason Approved by: Date: <br /> Existing Fire Alarm Yes No Unk_ Historic Approved by: Date: <br /> Fire Alarm Required Yes_ No_ School Mitigation Reqd? Yes_ No_ <br /> Reason Everett School Dist Mukilteo School Dist <br /> RCW 64.55 MF worksheet req'd for permit? Yes_ No— #of Net New Units: <br /> Add'I RCW 64.55 docs required prior to final?Yes_ No_ Calculated School Impact Fee: <br /> Architectural Approve.: Date: 1 School Impact Fee Credit: <br /> Structural Approved: */ Date: 112-5/14- Total School Impact Fee Owed: <br /> Comments: f Comments: <br /> Intake OK by: Intake OK by: Ok to route _ Hold _ <br /> Make this a"W"Permit? Yes No <br /> Ing* <br /> a x1 Y,i > +, Y' c •:r n-ONw t t xr t �f 4,�,t� �Ra'<hi`t'd�'�4 a <br /> 'wV` �g �v,Wa " 'geLa,Wi: ;1 $ 3azx" i* r _:" ;b1 <br /> INTAKE: Checked By: Date: <br /> Plan Check Fee Comments: <br /> Building Permit <br /> Surcharge High Hazard Sites(Dental,Medical,Animals,Mortuary,etc-Review for RPBA) <br /> Additional Plan Check 0 Public Works/Sys Dev/Traffic Mit./RPBA-NOT REQUIRED <br /> Plumbing Fee 0 Route for Public Works Review(bldg folder, PW Worksheet) <br /> Mechanical Fee 0 Public Works Permit-Concurrent Review(separate green folder) <br /> Ping Bldg Review Fee PW REVIEW: PW Reviewer: kg Date: 4 -/7--/7 <br /> Water Fee PW limit Approved-PW <br /> Sewer Fee 0 See PW Review Worksheet <br /> Systems Dev. Fee 0 PW Permit Not Required <br /> Traffic Mitigation Fee <br /> Public Works Fee giLASSIONERMENWINNNINIMOSISSIB <br /> School Mitigation Fee Update/New Sprinklers Yes Z' 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 7. No_ Existing Bldg._ <br /> Approved by: Date: 9 <br /> Comments: �' <br />