1031 SE EVERETT MALL WAY MODERN DENTISTRY 2022-03-07

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