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FOR OFFICE USE ONLY <br />BUILDING <br />Bldg /f.l. Size <br />Garage Size <br />VALUATION <br />No of Stories <br />Occupancy Group <br />Occu and Load <br />Basement <br />Yes _ No _ <br />Type of Construction <br />Dzh <br />Fire Sprink Rood <br />Reason <br />Fire Alan Reqd <br />Reason <br />CO Required? <br />Enclosure (RCV <br />6455) <br />Approved by <br />Date •l <br />Comments <br />Check Fee <br />no Pend <br />Plan <br />� (30 -oZ� <br />ZONING <br />Lot Area <br />Front Setback <br />Rear Setback <br />1 <br />Side Setback <br />Vacant Site <br />Yes No <br />Use Zone <br />R —Z <br />Height Limitation <br />l <br />'1.10E, <br />No. of Dwelling Units <br />Q 0 N <br />Landscape Planning Inspection / <br />needed before f al? Yes _ No 1 <br />Aoproveo by <br />Date <br />Comments _P,,,J j r I <br />5Pu1Z-(�IZ s SVL(-1�1 i";-03 <br />Z{y <br />