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12-101®A FOR OFFICE USE ONLY 3ERMIT# £ <br /> BUILDING PLANNING <br /> Bldg/TI/Addn/Rem Size 1.111 Zoning Classification <br /> Garage Size .26 Overlay/Agreement <br /> VALUATION 'L\ Nonresidential Use <br /> Number of Stories Q Residential Use <br /> Occupancy Group 1 LA Proposed No.of Dwelling Units: <br /> Occupant Load Total No.of Dwelling Units: <br /> Basement Yes_ No A.Fin/Unf Landscape or Planning Inspection <br /> Type of Construction 316 needed before final? Yes_ No_ <br /> Existing Sprinkler System? Yes_ No Unk Planning Inspector: <br /> Fire Sprinkler Required Yes_ No.._ Phone#: <br /> Reason Approv•d by: I <br /> Existing Fire Alarm Yes_ No_Unk Historic App • ed 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' Yes_ No Calculated School Impact Fee: <br /> Approved by: Date?/2///(o School Impact Fee Credit: <br /> Comments: Total School Impact Fee Owed: <br /> W t5 ( 12.6_, 4- W66C1 Comments: <br /> PUBLIC WORKS <br /> FEES Intake Checked By: Date: <br /> Plan Check Fee Intake Comments: <br /> Building Permit <br /> Surcharge <br /> Additional Plan Check PW Permit Application Submitted? Yes No <br /> Plumbing Fee PW Worksheet Required? Yes No <br /> Mechanical Fee PW REVIEW: PW Reviewer: 419 Date: 7—.30- <br /> Ping Bldg Review Fee SEE PW WORKSHEET-returned to file <br /> Water Fee �( PW Permit Approved, PW Permit Not Required <br /> Sewer Fee <br /> Systems Dev. Fee FIRE DEPARTMENT <br /> Traffic Mitigation Fee Update/New Sprinklers Yes_ No_ Existing Bldg.__ <br /> Public Works Fee Update/New Detection Yes_ No_ Existing Bldg._ <br /> School Mitigation Fee Update/New Chemical Yes_ No_ Existing Bldg._ <br /> Update/New Fire Service Yes_ No_ Existing Bldg._ <br /> Approved by: Date: <br /> Comments: <br />