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FOR OFFICE USE ONLY PERMIT# � t�� l"Ol� <br /> , , ; , <br /> , ;BUILDING ' : , 'P�.ANNINE�.-: ,.,.. .:. <br /> BI /T Addn/Rem Size Zoning Classification <br /> Garage Size ^" Overlay/Agreement <br /> VALUATION � d� Nonresidential Use ��` � <br /> Number of Stories l Residential Use <br /> Occupancy Group � Proposed No. of Dwelling Units: <br /> Occupant Load 6 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 Date: ] <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 ' eo 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 ool Impact Fee: <br /> Architectural Approved By/Date: l0 �- /7 Scho mpact Fee Credit: <br /> Structural Approved By/Date: —� � al School Impact Fee Owed: <br /> Comments: Comments: <br /> Intake OK by: Intake OK by: Ok to route _ Hold _ <br /> Make this a"W" Permit? Yes No <br /> ' BL.IG WOI�KS <br /> FEES .I ' INTAKE: Checked By: Date: <br /> _. . _. _. <br /> _ . _.. . . <br /> _ <br /> Plan Check Fee <br /> Comments:� �r�VIU��I.� /�'� Ud'�,0 � �� <br /> Building Permit ��d �� <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 f Ider) <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 � r <br /> Public Works Fee FIR� DEP�lRTIVIENT <br /> School Mitigation Fee Update/New Sprinklers Yes� No_ Existing Bldg. <br /> Update/New Detection Yes No Existing Bidg.� <br /> Update/New Chemical Yes No Existing Bldg._ <br /> Update/New Fire S rvice Ye No Existing Bidg._ <br /> Approved by: Date: �,�� ?�1"1� <br /> Comments: �...e,�,,� <br /> �Y�? cc. S`t S ' n <br /> s a-c� �e v�c�a.-Y�':.�- <br /> rJ <br />