10627 19TH AVE SE COOLEY SMILES DENTISTRY 2019-07-25

Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# \80q -©o BUILDING. PLANNING Intake OK by: Date: Intake OK by: Date: Intake Comments: Intake Comments: Assign To: ❑ Route to Commercial Building 0 Attach to Project No. ❑ Route to Residential Building 0 Route to Historic Reviewer ❑ Make this a"W"Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size 0 Hold in Planning File Drawer Garage/Accessory Struct. Size Zone 13 -92j Number of Stories Overlay/Agreement , _ p (�,, Basement ❑No DYes, Fin/Unfin Nonresidential Use V,/.(1.~6t b 4 ICQ_, Type of Construction Residential Use Occupancy Group Proposed No. of Dwelling Units: Occupancy Load Total No. of Dwelling Units: - . �,� Fire Sprinklers: ❑Update Existing ❑New System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes LI No Reason Sprinklers Required: "In Lieu".Fee:Type: Amount$ Fire Alarm: ❑Update Existing [hew System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes 0 N Additional Notes:1_4 riJSC� n a d "�/Lell VALUATION CALCULATION: Total$ (�� /S rcj0 Approved : Date: e3112 i ir PUBLIC WORKS Intake OK by: 11243 Date: 9/12// $ Additional Notes: Intake Comments: PW Worksheet Needed if: pal o ? ,i $toQC. ❑Sys Dev Eval ❑Traffic Mit Eval S i ..+ •.Tt•Tgt,,..A'r•O J ❑Site Work or Drainage Proposed Approved By: Date: V)�1 2j�a b +�-� ❑Backflow Prevention for high hazard: / (dental,medical,animals,mortuary,hospital, supportive housing) FIRE DEPARTMENT Route this folder for PW Review at end ---PW Review Works - t Intake: (Needed for Townhomes,Alley load SFR,New Commercial) ❑This project also has a separate concurrent PW Review s een Folder) ❑Route to Fire Drawer---Fire Preliminary Review Notice AND ❑Create Green Folder ❑Submitted Previo ❑Deferred ❑Sending Fire Notes to Project Team 0 This Permit is Approved by Public Work Date: (OK to Route to Other Departments) 0 See PW Review Worksheet and .- ociated attached items Fire Sprinklers: ❑Update Existing ❑New System 0 Not Req'd 0 A Separate PW Permit is R- ired (Permit#: PW ilk % r • Fire Alarm: ❑Update Existing ❑New System 0 Not Req'd AND 0 Is located in thi older p Chemical Sup: ❑Update Existing ❑New System 0 Not Req'd 0 Is in a Se..: ate Green Folder(join with this fold- , permit issuance) Additional Notes: ❑ Will b; ssued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: 0 Public k,orks has no scope--- PW Not Required Additi•-.1 Notes: ELECTRICAL Additional Notes: Approved By: Date: Approved By: Date: 64,,