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FOR OFFICE USE ONLY PERMIT# 122 t 12 V OC <br /> BUILC)ING <br /> `: PLANNIhIG <br /> Bldg/Tl/Addn/Rem Size I 1 9 )-LI Zoning Classification <br /> Garage Size Overlay/Agreement <br /> VALUATION Nonresidential Use • <br /> Number of Stories Residential Use • <br /> Occupancy Group T) Proposed No. of Dwelling Units: <br /> ' Total No. of Dwelling Units: <br /> Occupant Load ' I k � <br /> Basement Yes_ No-Fin/Unf Landscape or Planning Inspection <br /> Type of Construction 1 " needed before final? Yes— No <br /> Existing Sprinkler System? Yes V No—Unk_ Planning Inspector: <br /> Fire Sprinkler Required Yes No Phone#: <br /> Reason '/-: Approved by: i 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 iIF Everett School Dist Mukilteo School Dist <br /> Enclosure Law A plies Yes_ #of Net New Units: <br /> Deferred Submit 1 Req'd Yes `• No_ Calculated School Impact Fee: <br /> Approvedby: /11,.. Date..q- IS- -(h School Impact Fee Credit: <br /> Comment Total School Impact Fee Owed: <br /> Comments: . <br /> 4'\C, c ev\e ce v„se), tLn `II r1 ip <br /> PUB:L1C WORK CSI :: <br /> S_=: Intake Checked By i• Date. q 1 `7- i/ <br /> Plan Check Fee Intake Comments: <br /> Building Permit 114 <br /> l (41.(��,t,�l — .N-t 191,0 aeli/uvotS <br /> Surcharge '1 U` A Q0 A <br /> Additional Plan Check PW Permit Application Submitted? Yes' No-(4-1( <br /> Plumbing Fee PW Worksheet Required? - Yes No X <br /> Mechanical Fee PW REVIEW: PW Reviewer;& Date: I-/q-ZO/ <br /> Ping Bldg Review Fee by 11;-SEE PW WORKSHEET-returned to file <br /> Water Fee PW Permit Approved, >< PW Permit Not Required <br /> Sewer Fee <br /> Systems Dev. Feei : . 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 /> r <br /> /17,/ <br />