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FOR OFFICE USE ONLY <br />PERMIT NUMBER <br />SITE ADDRESS <br />ZONING <br />SUB -PERMITS <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 <br />STRUCTION <br />STORIES <br />I <br />GROUP <br />LOAD <br />YES NO <br />I <br />c 44 <br />Z <br />12� <br />NEW FIRE SPRINKLER <br />REASON <br />NEW FIRE ALARM <br />REASON <br />REQ'D <br />REQ'D <br />APPROVED DATE <br />COMMENTS v %2 c <br />6rTr qlz*lor <br />boS'6c svfh(p C <br />VALUATION 17% S 4/L/ <br />BUILDING <br />SURCHARGE <br />ADD PLAN CHK <br />PLUMBING <br />MECHANICAL <br />SPRINKLE <br />PUBLIC WORKS <br />TOTAL <br />A/ 4 <br />PLAN CHECK FEE G ✓ , ` <br />FEES <br />WATER <br />SEWER <br />SYS. DEV. <br />TRAFFIC MIT. <br />OTHER <br />TOTAL <br />