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FOR OFFICE USE ONLY PERMIT# biSO 3-03? <br /> BUILDING PLANNING <br /> BId JAddn/Rem Size /0 t 'Jil Zoning Classification ]—., <br /> Garage Size ec �ca.5 Overlay/Agreement 4 0 N E <br /> VALUATION gti 1 0 C 0 Nonresidential Use eitiiAjt, <br /> Number of Stories l"c Residential Use <br /> Occupancy Group /3 Proposed No.of Dwelling Units: °'- <br /> Occupant Load /0 LI Total No. of Dwelling Units: <br /> Basement No is Yes Fin / Unfin Landscape or Planning Inspection / <br /> Type of Construction 11 needed before final? Yes_ No No/ <br /> Existing Sprinkler System? Yes 1.No—Unk_ Planning Inspector: - <br /> Fire Sprinkler Required Yes No— Phone#: <br /> Reason Appro ed b : '- *,/6 Date: 2pd /Dp <br /> Existing Fire Alarm Yes. No_Unk Historic Approved by: Date: <br /> Fire Alarm Required Yes V No_ School Mitigation Reqd? Yes_ No_V-------- <br /> Reason <br /> �Reason Everett School Dist Mukilteo School Dist <br /> RCW 64.55 MF worksheet req'd for permit? Yes_ Nol #of Net New Units: <br /> Add'I RCW 64.55 docs required prior to final?Yes_ No Calculated School Impact Fee: <br /> Architectural Approved By/Date: Lam" 1076,24, School Impact Fee Credit: <br /> Structural Approved By/Date: Total School Impact Fee Owed: <br /> Comments: Comments: ------ <br /> Intake <br /> 3 ►q Ig Ok to route 1.3/Xu,d.,....N1---,11 <br /> ._ <br /> Intake OK by: l � Intake OK by: ��' <br /> Make this a"W' ermit? Yes No <br /> PUBLIC WORKS <br /> FEES INTAKE. Checked By;,A,F.:* Date. <br /> Plan Check Fee Comments: /Vo191,02c op . <br /> Building Permit A/c o1- CGS€ <br /> Surcharge High Hazard Sites(Dental/Me icaI,Animals,Mortuary,etc-Review for RPBA) <br /> Additional Plan Check 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 eview(separate gre fol er) <br /> Ping Bldg Review Fee PW REVIEW: PW Reviewer: -- Date: <br /> Water Fee ❑ PW Permit Approved-PW <br /> Sewer Fee 0 See PW Review Worksheet <br /> Systems Dev. Fee grPW 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: 1(4?,1 k <br /> Comments: <br /> revno 0 o-E6'i`k ch..-.40 1've Aac,.w.,--‘. 1 <br /> r� b-e •rte 1�-S t . 1 <br />