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FOR OFFICE USE ONLY PERMIT# jt f4OCo --O( ( <br /> BUILDING, PLANNING - <br /> Bldg/TI/Addn/Rem Size Zoning Classification (2,-*Z„ <br /> Size G 2J £. i Overlay/Agreement <br /> VALUATION 75 Nonresidential Use <br /> Number of Stories Residential Use 'f— <br /> Occupancy Group 61 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 14.8. 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: �. q� Date: (0--22-1—11 <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 Approved By/Date: 5t/ /,//?. School Impact Fee Credit: <br /> Structural Approved By/Date: Total School Impact Fee Owed: <br /> Comments: 27/5 //'C. Comments: <br /> Intake OK by: C.:71/ft' Intake OK by: Ok to route Hold — <br /> Make this a"W" Permit? Yes No <br /> PUBLIC VV°RKS <br /> •F ES ; / INTAKE: Checked By: r Date: a 2 <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: Date: <br /> Water Fee 0 PW Permit Approved-PW <br /> Sewer Fee 0 See PW Review Worksheet <br /> Systems Dev. Fee 1F.I. PW Permit Not Required <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 /> v <br />