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FOR OFFICE USE ONLY PERMIT# � I �p. ��i' �r1 <br /> BUILDING PLANNING <br /> Bldg/TI/Addn em Siz �� ���/v� �3 , Zoning Classification r � <br /> Garage Size Overlay/Agreement �"— <br /> � ^ �.\ �.. <br /> VALUATION (1'� V' 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 f Fin / Unfin Landscape or Planning Inspectior. <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 /> '' � 'L <br /> Reason Approved by: �"� Date: � '�(.)\�� � <br /> Existing Fire Alarm Yes_ N _Unk_ Historic Approved by: �1 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 Calculated School Impact Fee: <br /> Approved by: � Date: 3 � School Impact Fee Credit: � <br /> Comments: �c�'[.� Total School impact Fee Owed: �-- <br /> Comments: �.i�M�� ��5�'� �� �iVc�� "�C��:� <-4>.��ilf',� ���A <br /> tr \ \ �-�. <br /> � L� l':`.\�J�`ti:�� C�v\(�Pl: � V��vv\V.V1<'�y �.�?N��i. �\��-1J\J�ti\?� 't'v�f�.1 <br /> � � ?� •�,e 1.�;� < � �'i• 1ur�p` <br /> C�'Jl.SS.C'�t.f_.� ���'��, <br /> Intake OK by:� 4� ��:��� .v � <br /> Intake OK by: ��' Ot.�.t � 6` �a�-�t✓� <br /> PUBLIC WORKS <br /> FEES INTAKE: Checked By:��1>' Date: /,:,�'r " �� <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 (�`,1��, ,����„� L�'r�'��f '' <br /> J��`G!, �i <br /> Systems Dev. Fee PW Permit Not Required /�I�r,� <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 Bidg._ <br /> Approved by: Date: <br /> Comments: <br /> Z��v <br />