12902 19TH AVE SE GENUINE SMILE DENTISTRY 2021-02-23

• t.: n Intake &Approval Sheet �i Cili n LA�AU,I 6-9AH'"H' IVLY) • PERMIT# 6(10 - 0 * BUILDING PLANNING Intake OK by: Date: Intake OK by:( �]�r ) Assign To: / Date: /0/I tP//CI Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑ Attach to Project No. ❑ Route to Residential Building ❑ oute to Historic Reviewer ❑ Make this a"W"Permit K to Route to Other Departments Bldg/TI/Addn/Rem Size )t/"7q Hold in Planning File Drawer r 1 Garage/Accessory StructrSize N/o4 Zone C Number of Stories / Overlay/Agreement ,/ Basement EiNo ❑ 1-}Vt Yes, Fin/Unfin Nonresidential Use Pe( 1 0I'1 t'C ._ Type of Construction v 8' Residential Use Occupancy Group a Proposed No.of Dwelling Units: Occupancy Load /S Total No.of Dwelling Units: Fire Sprinklers: ❑Update Existing ❑New System - Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes No Reason Sprinklers Required: "In Lie e:Type: ount$ Fire Alarm: Update Existing El New System El Not Req'd School Impact Fee: tal $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes rl No 0 chool Dist ❑Mukilteo I Dist Addl RCW 64.55 does required prior to final? oyes tiNo Additional Notes: VALUATION CALCULATION: Total$ Z7' a0°. DO Approved By(/ Date: 1 d/�k 1/ PUBLIC WORKS / Intake OK by: Ade- Date: /Ol 4 7�lp� Additional Notes: Intake Comments: r� �6��950 PW Worksheet Needed if: .if.- ,eM I`/��""'"`—• DSys Dev Eval Traffic Mit Eval /f t(. ~IP' 01/73)rk. Site Work or Drainage Proposed Approved By.:\A_I2:- Date:`a//6/z0/q ��7i of f"" t JBackflow Prevention for high hazard: PM et, ;(dental,medical,animals,mortuary,hospital, �f� 740 :supportive housing) FIRE DEPARTMENT ALRoute this folder for PW Review at end ---PW Review Worksheet Separate/ $: erred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) ❑Fire Sprinkler- ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: td This Permit is Approved by Public Works I% See PW Review Worksheet and associated attached items Fire Dept. Fees: 0 A Separate PW Permit is Required (Permit#: PW ) ❑ Review of As-Built Plans-NO FIR E AND ❑ Is located in this folder ❑ Minimal or No Fire Scope-NO FIRE FE ❑ Is in a Separate Green Folder join with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE 0 Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By .,��jec- Date: /yd / g ❑ Public Works has no scope---PW Not Required Additional Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: 7/0 /q2-oi9