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1031 SE EVERETT MALL WAY MODERN DENTISTRY 2022-03-07
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1031 SE EVERETT MALL WAY MODERN DENTISTRY 2022-03-07
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Last modified
3/7/2022 3:38:07 PM
Creation date
10/18/2017 11:40:01 AM
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Address Document
Street Name
SE EVERETT MALL WAY
Street Number
1031
Tenant Name
MODERN DENTISTRY
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• FOR OFFICE USE ONLY • PERMIT # t �J o2 <br />BUILDING <br />BldgRl/Addn em Size <br />Garage Size <br />VALUATION <br />Number of Stories <br />y <br />/ <br />Occupancy Group <br />Occupant Load <br />Basement <br />No25 Yes Fin / Unfin <br />Type of Construction <br />Existing Sprinkler System? <br />Yes No 4Unk <br />Fire Sprinkler Required <br />Yes No IV <br />Reason <br />Existing Fire Alarm <br />Yes No Unk> <br />Fire Alarm Required <br />Yes N <br />Reason <br />RCW 64.55 MF worksheet req'd for permit? Yes _ Nox <br />Add'I RCW 64.55 docs required prior to final? Yes <br />Architectural Approved: Date: <br />Structural Approved: Date:�j <br />Comments: <br />Intake OK by: Date: <br />FEES <br />Plan Check Fee <br />Building Permit <br />Surcharge <br />Additional Plan Check <br />Plumbing Fee <br />Mechanical Fee <br />Ping Bldg Review Fee <br />Water Fee <br />Sewer Fee <br />Systems Dev. Fee <br />Traffic Mitigation Fee <br />Public Works Fee <br />School Mitigation Fee <br />PLANNING <br />Zoning Classification <br />G <br />Overlay/Agreement <br />--� <br />Nonresidential Use <br />Residential Use <br />Proposed No. of Dwelling Units: <br />Total No. of Dwelling Units: <br />Landscape or Planning Inspection <br />needed before final? Yes No_ <br />Planning Inspector: C \Xce YQ\\\Q.(A <br />Phone #: L VS ,' `] . <br />Approved by: C Date:3 ItTl ZO <br />Historic Approved by: Date: <br />School Mitigation Reqd? Yes No X- <br />Everett School Dist Mukilteo School Dist <br /># of Net New Units: <br />Calculated School Impact Fee: <br />School Impact Fee Credit: <br />Total School Impact Fee Owed: <br />Comments: <br />�0,,SC c- ��,�;�� �� :REV l(p -�ZZ <br />Intake OK by: Cyr <br />PUBLIC WORKS <br />INTAKE: Checked By: Date: <br />Comments: <br />High Hazard Sites (Dental, Medical, Animals, Mortuary, etc -Review for RPBA) <br />❑ Public Works / Sys Dev / Traffic Mit. / RPBA - NOT REQUIRED <br />❑ Route for Public Works Review (bldg folder, PW Worksheet) <br />❑ Public Works Permit -Concurrent Review (separate green folder) <br />PW REVIEW: PW Reviewer: Date: <br />❑ PW Permit Approved - PW <br />❑ See PW Review Worksheet <br />❑ PW Permit Not Required <br />Update/New Sprinklers <br />FIRE DEPART <br />Yes No <br />Existing Bldg. <br />Update/ New Detection <br />Yes No <br />Existing Bldg. _ <br />Update/ New Chemical <br />Yes No <br />4,Existing Bldg. <br />Update/ New Fire Servicp <br />Y s No ZExisting <br />Bldg. _ <br />Approved by: rU <br />Date: �( <br />Comments: <br />
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