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FOR OFFICE USE ONLY PERMIT# � I ` � " �� <br /> 1 �% � l i� �( I � <br /> ��� ✓.�}� <br /> BUILDING PLANNING <br /> Bldg/TI/Addn em Siz l��� J/��/G- �, Zoning Classification ' L <br /> Garage Size � Overlay/Agreement <br /> � �} � � <br /> VALUATION V�,- C � Nonresidential Use �-` <br /> Number of Stories � �L/� ��x <br /> Y Residential Use <br /> Occupancy Group � -1,� Proposed No. of Dwelling Units: <br /> Occupant Load ��'� Total No.of Dwelling Units: �" `�� <br /> Basement No Yes Fin / Unfin Landscape or Planning Inspectior� <br /> Type of Construction � �"' needed before final? Yes No <br /> ExistingSprinklerSystem7 Yes No<" Unk Planninglnspector: �---- <br /> Fire Sprinkler Required Yes No Phone#: �— <br /> — — � <br /> Reason Approved by: � � Date: L "�� z��\� <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 /> Enclosure Law Applies Yes #of Net New Units: <br /> Deferred Submittal Req'd Yes No C� Calculated School Impact Fee: <br /> Approved by: � Date: 3 t. School Impact Fee Credit: <br /> Comments: c,��t� � Total School Impact Fee Owed: -- <br /> `f <br /> Comments: � � �\�y��+� �:�;� ���'� `:��'� ���ir��`a� ��� <br /> � t t��yV�� � <br /> �:� �:<���`�`��� C�v�k i; �i. �Mvvl�l.u��c C�,����. C'lC\J�v��V {v;�v <br /> .� � , `I . . ;� <br /> � L�d#��C�,f....> '�CZ? ��'� a2 �� i� (G 1.l'�4� <br /> Intake OK by:� Q� �y.,s`v � �� ;�,E <br /> Intake OK by: ��'T 0r..,t �i �` Di��t ,�� <br /> PUBLIC WORKS <br /> FEES INTAKE: Checked By: ,<�%�' Date: l-�'�' -/� <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 ❑ 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 <br /> Sewer Fee ❑ See PW Review Worksheet , �,� ��G�r fS <br /> Systems Dev. Fee PW Permit Not Required u����'���������'��j�,("!�� <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 /> ����� <br />