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II rr <br /> FOR OFFICE USE ONLY PERMIT#1)2) LO, 10- 020 <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 ate: (O Z.? <br /> Existing Fire Alarm Yes No Unk Historic Approv d 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: I`� Oi'P((,eyt Date: L(3�/ j1 School Impact Fee Credit: <br /> Comments: Total School Impact <br /> FeelOwed: <br /> A� �„ 1 aCg J�It Z k 0n I' 'DI�0 ComYments: oexty tDla'0 <br /> V u Intake_OK by: <br /> Intake OK by: <br /> PUBLIC WORKS <br /> FEES INTAKE: Checked By: Date: <br /> Plan Check Fee Comments: <br /> Building Permit artrye41 autAiVv " 4-41-101x0 <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: - ) (IA- Date: i 27(Za'G <br /> Water Fee ❑ PW Permit Approved-PW <br /> Sewer Fee 0 See PW Review Worksheet <br /> Systems Dev.Fee 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 />