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� <br />FOR OFFICE USE ONLY <br />BUILDING <br />Bldg/TI/Addn/Rem Size t7 <br />Garage Size <br />VALUATION <br />No. of Stories � <br />Occupancy Group — � <br />Occupant Load '� <br />Basement Yes No �Fin/Unf <br />Type of Construction -, <br />Exstg Sprinkier System? Yes No Unk <br />Fire Sprink Reqd? Yes � No <br />Reason ,( �'G . <br />Exstg Fire Alarm? Yes ✓ No Unk <br />Fire Alarm Reqd? Yes ✓ No <br />Reason �C `rCY . <br />CO Required? Yes No ✓ <br />Enclosure (RC 64.55) Yes No <br />Approved by: Date: _ <br />Cornment . <br />FEES <br />Plan Check Fee <br />Buildinq Permit <br />Surcharge <br />Additional Plan Check <br />Water <br />Sewer <br />Dev. Due? <br />Public Works <br />Traffic Mitigation Due? Yes <br />School Mitiqation Paid? Yes <br />PLANNING <br />Zoning Classification <br />Overlay/Agreement <br />Nonresidential Use <br />Proposed No. of Dwelling Units: <br />Total No. of Dwelling Units: <br />Landscape or Planning Inspection <br />needed before final? Yes No <br />Planning Inspector: <br />Phone #: <br />Approved by. ,l�/�7ate s J <br />Historic Approv by: Date: � � <br />School Mitiga ion Reqd? Yes No <br />Comments: <br />No <br />No Rcpt # <br />No Date Pd <br />