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FOR OFFICE USE ONLY PERMIT#1)1. 1.0 I 1'- CCg. <br /> BUILDING PLANNING <br /> Bldg/TI/Addn/Rem Size ! 1 1 0 Zoning Classification <br /> Garage Size Overlay/Agreement <br /> VALUATION Nonresidential Use ie' \ \CC)COSS n CV\ <br /> Number of Stories )VIA Residential Use <br /> Occupancy Group - Z Proposed No.of Dwelling Units: <br /> Occupant Load z- / Total No.of Dwelling Units: <br /> Basement No_ Yes v Fin / Unfin Landscape or Planning Inspectio <br /> Type of Construction / needed before final? s_ No <br /> Existing Sprinkler System? Yes_ No i/ Unk Planning Inspector: <br /> Fire Sprinkler Required Yes ✓ No Phone#: <br /> Reason (0A/G1 I h( E:A ,P4) Approved by: CLQ Date: \\\02_ I C C\ <br /> Existing Fire Alarm Yes No (/Unk Historic Approved by: Date: <br /> Fire Alarm Required Yes(/' No_ School Mitigation Reqd? Yes No <br /> Reason '* 0" Everett School Dist Mukilteo School ' <br /> Enclosure Law Appj?es Yes—s #of Net New Units: ✓ <br /> Deferred Submitt Req'd Yes to/ No Calculated School Impar e: <br /> Approved by: , 2'' Date:/ .- g f / School Impact Fe redit: <br /> Comments: Total School pact Fee Owed: <br /> N6 tmcc-(LS `T ?per 'Do E- ii,./ M/04. Comments: —cce.,C \ an\\ , I\k‘A%N covvvio\\I <br /> �M r S fin, err 1)21 v.)r 'C(E\)T. \s-®e�, -k- �Cc-W CQ( , A,uS\ <br /> Q\0\-0:‘,A cAy (-u5;d1e SS S he l\ceAses, <br /> Intake OK by: `-tANC,Q f \U -QR <br /> Intake OK by: <br /> PUBLIC WORKS <br /> FEES INTAKE: Checked By: Date: <br /> Plan Check Fee Comments: ._ i(le) ..ryS dei -fee dcie <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: /0 Date: j 1—4-4 6, <br /> Water Fee 0 PW Permit Approved-PW <br /> Sewer Fee 0 See PW Review Worksheet <br /> Systems Dev. Fee .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 />