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FOR OFFICE USE ONLY PERMIT# r-o( <br /> -CO3 <br /> BUILDING PLANNING <br /> Bldg/TI/Addn/Rem Size • Zoning Classification <br /> Garage Size �� <br /> ,^� <br /> Overlay/Agreement <br /> VALUATION 4 040 Nonresidential Use <br /> Number of Stories Residential Use 1„E <br /> Occupancy Group Proposed No.of Dwelling Units: ---- <br /> Occupant Load Total No.of Dwelling Units: 2. <br /> Basement No,X Yes_ Fin / Unfin Landscape or Planning Inspection <br /> Type of Construction `- --6 needed before final? Yes No C� <br /> Existing Sprinkler System? Yes_ No_Unk Planning Inspector: <br /> Fire Sprinkler Required Yes No Phone#: ,�,, <br /> Reason Approved 13,/,'13,/,'(p( Date: (0((/// <br /> /�' <br /> Existing Fire Alarm Yes No Unk Historic Appr(ved by: Date: G / <br /> Fire Alarm Required Yes_ No_ School Mitigation Reqd? Yes_ No <br /> Reason Everett School Dist Mukilt-• 'chool Dist <br /> Enclosure Law Applies Yes #of Net New Units: <br /> Deferred Submittal Req'd Yes_ No Calculated Sch.: mpact Fee: <br /> Approved by: Date:S7Z2I/i School - •act Fee Credit: <br /> Comments: 2_0� " fi C • al School Impact Fee Owed: <br /> Comments: ittYB1(0-03 / –fb (5-t.-1, <br /> L Intake OK by: 1��� <br /> LCJ <br /> Intake OK by:e �1 Old <br /> ?UBLIC WORKS <br /> FEES INTAKE: Checked By: Date:_ -_ <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-Concur nt Re iew(separate ree 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 154 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 />