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FOR OFFICE USE ONLY PERMIT# L t Q-D�°1 <br /> BUILDING PLANNING <br /> Bldg/TI/Addn/Rem Size Zoning Classification <br /> Garage Size Overlay/Agreement <br /> VALUATION 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_ Fin / Unfin Landscape or Planning Inspection <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 /> Reason Approved . _Date: 0(77- 7 / <br /> Existing Fire Alarm Yes No Unk Historic Appr. -. by: 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: /VBG y (i.Qc t L Date: I/11/(7 School Impact Fee Credit: <br /> Comments: / Total School Impact Fee Owed: <br /> Okrb (1 hkt,✓k IDI)Ape cry os: DCS st fit, <br /> Intake OK by: <br /> Intake OK by: f1,r$VLS V V/i,1/(7 <br /> PUBLIC WORKS <br /> FEES INTAKE: Checked By:')M,, Date: <br /> Plan Check Fee Comments: <br /> io� to <br /> Building Permit ar� 60�/V"''� V <br /> Surcharge High Hazard Sites(Dental,Medical,Animals,Mortuary,et RPBA) <br /> Additional Plan Check ELPublic Works/Sys Dev/Traffic Mit./RPBA-NOT REQUI D <br /> Plumbing Fee 0 Route for Public Works Review(bldg folder, PW Worksheet) <br /> Mechanical Fee 0 Public Works Permit-Conc ent Review(separate green folder) <br /> Ping Bldg Review Fee PW REVIEW: PW Reviewer: I SI Date: (O1Z717A( , <br /> Water Fee 0 PW Permit Approved-PW <br /> Sewer Fee 0 See PW Review Worksheet <br /> Systems Dev. Fee titPW 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 />