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FOR OFFICE USE ONLY PERMIT# Q(e'(r , -01 (9, <br /> BUILDING PLANNING <br /> Bldg/TI/Addn/Rem Size ‘ Zoning Classification <br /> Garage Size Overlay/Agreement <br /> r- <br /> VALUATION 2® 1-49. Nonresidential Use <br /> Number of Stories Residential Use <br /> Occupancy Group Proposed No. of Dwelling Units: <br /> Occupant Load 4 Total No.of Dwelling Units: <br /> Basement No K Yes_ Fin / Unfin Landscape or Planning Inspection <br /> Type of Construction \\113 needed before final? Yes_ No <br /> Existing Sprinkler System? Yes_ No X' Unk_ Planning Inspector: <br /> Fire Sprinkler Required Yes_ No X Phone#: <br /> Reason Approved by: Date: <br /> Existing Fire Alarm Yes No ( Unk Historic Approved 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: Date: g/P3/P- School Impact Fee Credit: <br /> Comments: 41 Total School Impact Fee Owed: <br /> Comments: <br /> ttelhfrn j gfn1-oval kick <br /> retired �1,u,Ar , gaw <br /> Intake OK by: <br /> Intake OK by: - <br /> PUBLIC WORKS <br /> FEES INTAKE: Checked By: Date: <br /> Plan Check Fee Comments: <br /> Building Permit <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(separategreen folder) <br /> Ping Bldg Review Fee PW REVIEW: PW Reviewer: Kj 8 Date: 9-14--1 7 <br /> Water Fee O PW Permit Approved-PW /6i jZ NS. <br /> Sewer Fee 0 See PW Review Worksheet fi. SS tie d <br /> Systems Dev. Fee 0 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 />