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A <br />FOR OFFICE USE ONLY PERMIT # V 1" 01' bU <br />BUILDING <br />Bldg/TI/Addn/Rem Size <br />E6 6 v <br />Garage Size <br />VALUATION <br />'l <br />Number of Stories <br />2- <br />Occupancy Group <br />Occupant Load <br />Basement <br />Yes <br />Noy_Fin/Unf <br />Type of Construction <br />Existing Sprinkler System? <br />Yes <br />No Unk <br />Fire Sprinkler Required <br />Yes_ <br />No. J, <br />Reason <br />Existing Fire Alarm <br />Yes <br />No _ Unk <br />Fire Alarm Required <br />Yes — <br />No <br />Reason <br />Enclosure Law Applies <br />Yes <br />Deferred Submittal Req'd <br />Yes <br />No <br />Approved by: <br />Date: <br />Comments: `5 Q) <br />FEES <br />Plan Check Fee <br />Building Permit <br />Surcharge <br />Additional Plan Check <br />Plumbing Fee <br />Mechanical Fee <br />Ping Bldg Review Fee <br />Water Fee <br />Sewer Fee <br />Systems Dev. Fee <br />Traffic Mitigation Fee <br />Public Works Fee <br />School Mitigation Fee <br />PLANNING <br />Zoning Classification <br />Overlay/Agreement <br />Nonresidential Use <br />Residential Use <br />Proposed No. of Dwelling Units: <br />Total No. of Dwelling Units: <br />Landscape or Planning Inspection <br />needed before final? Yes No <br />Planning Inspector: <br />Phone #: A A\ <br />Approved b bate: <br />Historic Approve y: Date: <br />School Mitigation Reqd? Yes No <br />Everett School Dist Mukilteo School Dist <br /># of Net New Units: <br />Calculated School Impact Fee: <br />School Impact Fee Credit: <br />Total School Impact Fee Owed: <br />Comments: - <br />PUBLIC WORKS <br />Intake Checked By: Date: <br />Intake Comments: <br />PW Permit Application Submitted? Yes No <br />PW Worksheet Required? Yes No <br />PW REVIEW: PW Reviewer:4�3. Date: 9 _.217 <br />SEE PW WORKSHEET-returned to file <br />PW Permit Approved, PW Permit Not Required <br />FIRE DEPARTMENT <br />Update/New Sprinklers <br />Yes <br />No Existing Bldg._ <br />Update/ New Detection <br />Yes <br />No Existing Bldg. _ <br />Update/ New Chemical <br />Yes <br />No Existing Bldg. _ <br />Update/ New Fire Service <br />Yes <br />No Existing Bldg. _ <br />Approved by: <br />Date: <br />Comments: <br />