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t . 1 <br /> FOR OFFICE USE ONLY �I �V D' Ob(?) <br /> PERMIT# <br /> BUILDING <br /> PLANNING <br /> Bldg/TI/Ad n/Rem Siz <br /> Zoning Classification <br /> Garage Size <br /> Overlay/Agreement <br /> VALUATION 5 i R-o.N T <br /> Nonresidential Use <br /> Number of Stories <br /> / Residential Use <br /> Occupancy Group <br /> / Proposed No.of Dwelling Units: <br /> Occupant Load • <br /> Total No.of Dwelling Units: <br /> Basement No Yes_ Fin / Unfin <br /> Landscape or Planning Inspection <br /> Type of Construction// needed before final? Yes No_ <br /> Existing Sprinkler Sys am? Yes_ No_Unk <br /> Planning Inspector: <br /> Fire Sprinkler Re uired Yes_ No <br /> Phone#: <br /> Reason Approved ..,• /' 0 (. 77'(6, <br /> Existin ire Alarm Yes No_Unk Historic Apprp'ed by: Date: <br /> Fir Iarm Required Yes No_ School Mitigation Reqd? Yes_ No_ <br /> Reason Everett School Dist Mukilteo School Dist <br /> RCW 64.55 ME worksheet req'd for permit? Yes_ No X #of Net New Units: <br /> Add'l RCW 64.55 docs required prior to final?Yes No_ Calculated School Impact Fee: 1.{VOt C sCy-0041�.(, <br /> Architectural Approved: rntL' t-Nec� Date:5L/j7 School Impact Fee Credit: n <br /> Structural Approved: Date:,.4 ,g4-4-- Total School Impact Fee Ow 6.--7-171 /-7 <br /> Comments: oo fr4&( <br /> �.. 5.(,_(l.tr k t--) Comments: <br /> twoQ ® Cg0111vJ? <br /> t e <br /> In ak OK y: <br /> Intake OK by: Date: <br /> PUBLIC WORKS y <br /> FEES - INTAKE: Checked By: I a, Date:(D AIN(6 <br /> Comments: <br /> Plan Check Fee 1 <br /> Building Permit I A rd a � tai -0High Altai <br /> (Dental,Medical,Animals,TAortuary,etc-Review for RPBA) <br /> Surcharge <br /> ®Public Works/Sys Dev/Traffic Mit./RP -NOT REQUIRE <br /> Additional Plan Check <br /> 0 Route for Public Works Review(bldg folder,PW Worksheet) <br /> Plumbing Fee <br /> 0 Public Works Permit-Concu rent Review(separate green folder) <br /> Mechanical Fee <br /> PW REVIEW: PW Reviewer: u.�� U. Date: to/Z7/Z(7ic, <br /> Peng Bldg Review Fee <br /> 0 PW Permit Approved-PW <br /> Water Fee 0 See PW Review Worksheet <br /> Sewer Fee OPW Permit Not Required <br /> Systems Dev.Fee <br /> Traffic Mitigation Fee FIRE DEPARTMENT <br /> Public Works Fee Update/New Sprinklers Yes No Existing Bldg. <br /> School Mitigation Fee 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 />