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FOR OFFICE USE ONLY <br />PERMIT NUMBER SUB -PERMITS <br />SITE ADDRESS <br />ZONING <br />LOT AREA <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />VACANT SITE <br />USE ZONE <br />HEIGHT LIMITATION <br />YES NO <br />NO. OF DWELLING <br />APPROVED BY DATE <br />COMMENTS <br />UNITS <br />BUILDING <br />BLDG/T.I. SIZE <br />GARAGE SIZE <br />NO. OF <br />OCCUPANCY <br />OCCUPANT <br />BASEMENT <br />TYPE OF CONSTRUCTION <br />STIES <br />GROUP <br />LOAD <br />YES NO <br />2 2 -7 6 <br />F Q CI /' <br />J 1" <br />C. <br />� <br />I� <br />NEW FIRE SPRINKLER <br />REASON <br />NEW FIRE ALARM <br />REASON <br />REQ'D <br />REQ'D <br />APPROVED 13Y <br />DATE <br />COMMENTS Z. 101 O j //ZC- V, k J'V <br />!v/i3/G <br />2oo s�C <br />VALUATION Z-Lgo -/ 73 <br />BUILDING <br />SURCHARGE <br />ADD PLAN CHK <br />PLUMBING <br />MECHANICAL <br />SPRINKLE <br />PUBLIC WORKS <br />TOTAL <br />PLAN CHECK FEE �(J(J /EJ ✓(/ <br />FEES <br />WATER <br />SEWER <br />SYS. DEV. <br />TRAFFIC MIT. <br />OTHER <br />TOTAL <br />