5201 EVERGREEN WAY NORTHWEST DENTAL 2018-01-03

Permit#: B1607-030 Address: 5301 Evergreen Way 2016 SYSTEM DEVLOPMENT FEE 2016 SYSTEM DEVLEOPMENT FEE Project Name: Northwest Dental TI DUE CREDIT Unit of Cost Per #Of #Of Measure Unit Units Fee Cost Per Unit Units Credit SFR 0-1000 sf each 6,764.00 0 $ - 6,764.00 0 $ - Is Credit to be Given? SFR 1001-2000sf each 7,962.00 0 $ - 7,962.00 0 $ - Select: Yes or No in Yellow Box SFR 2001sf& over each 9,910.00 0 $ - 9,910.00 0 $ - Yes Mobile Home each 5,541.00 0 $ - 5,541.00 0 $ - Tire retail store to dental office. Duplex Per2 units 11,575.00 0 $ - 11,575.00 0 $ - C�.�x conversion Per 1 adtnl 5,788.00 0 $ - 5,788.00 0 $ - A�ssory Dwelling Unit (ADU) Per Unit 2,200.00 0 $ - 2,200.00 0 $ - Triplex Per 3 units 15,372.00 0 $ - 15,372.00 0 $ - Multi-Family Per Unit 5,124.00 0 $ - 5,124.00 0 $ - Senior Housing Per Unit 2,200.00 0 $ - 2,200.00 0 $ - Commercial Use Automotive Shop Sq. Ft. 1.2202 0 $ - 1.2202 0 S - Examination of Citv Limits & Barber Shop Chair 1,549.0000 0 $ - 1,549.0000 0 � - Water/Sewer Districts Beauty Salon Station 1,602.6900 0 $ - 1,602.6900 0 $ - (Select: Yes or No in Yellow Box) Car Wash Per Bay 8,515.1300 0 $ - 8,515.1300 0 $ - Water Fees Onl ? No Church Sq. Ft. 0.6267 0 $ - 0.6267 0 $ - Sewer Fees Onl ? No Day Care "Child 415.0700 0 $ - 415.0700 0 $ - Outside City Limits? No Dental Clinic Sq. Ft. 6.3955 1917 $ 12,260.17 6.3955 0 $ - Dry Cleaner Sq. Ft. 23.4013 0 $ - 23.4013 0 $ - If water and or sewer district is Gas Station w/service bay(s) Sq. Ft. 3.9521 0 $ - 3.9521 0 $ -� other than City of Everett, please Gas Station w/o service bay Flat Rate 6,371.0000 0 $ - 6,371.0000 0 $ - select from list below: G�ry Sq. Ft. 2.9157 0 $ - 2.9157 0 $ - Water District: Everett Ld dromat Sq. Ft. 2,739.5300 0 $ - 2,739.5300 0 $ - Sewer District: Everett Manufacturing Employee 104.6100 0 $ - 104.6100 0 $ - Medical Clinic Sq. Ft. 6.4000 0 $ - 0.4000 0 $ - Prepared By/Date: Motel/Hotel Room 2,004.3300 0 $ - 2,004.3300 0 $ - Nursing Home Bed 3,499.6200 0 $ - 3,499.6200 0 $ - Office Sq. Ft. 1.5660 0 $ - 1.5660 0 $ - Reviewed �/Date: Restaurant Seat 351.3000 0 $ - 351.3000 0 $ - Retail Sq. Ft. 0.8835 0 $ - 0.8835 1917 $ 1,693.G7 School Student 104.6100 0 $ - 104.6100 U $ - Warehouse Sq. Ft. 0.0922 0 $ - 0.0922 0 � - $ 12,260.17 $ 6,371.00 Svstem Dev. Fees Due? **The minimum utility connection charge is: 6,371.00 TOTAL FEE DUE $ 5,889.17 YES N1ini�rium lJtility Connectior Credit A.pplie�i 8/12/2016