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F4R 4FF10E US� ONLY � � 3��� G� <br />BUILDING <br />BItIg:Tk`Addn�Rem Si�e <br />Garage 5i_e <br />VALUATION <br />No. of Stories <br />Occu anc � Group <br />Occupant Load <br />Basement Yes No FiniUnf <br />T e of Const��uction <br />Exstg Sprinkler System7 Yes No Unk <br />Fire 5prink Reyd? Yes No <br />Reason <br />Ex:stg Fire Alarm? Yes No Unk <br />Fire Alarm Reqcl? Yes No <br />Reason <br />CO Required. Yes No <br />Enclosure tRC 4.55� <br />Appioved by: Date: - <br />Co m m ents;�.� <br />FEES <br />Plan Check Fee <br />Building Permit <br />Surcharge <br />Aclditional Plan Check <br />W ater <br />Sewer <br />Systems Qevelo�ment <br />Public Works <br />Traffic fdlitigation <br />Other <br />PLANNING <br />�oning Classification �� � � � <br />OverlayiAgreement <br />Nonresiclential Use <br />Total No. of Dwelling Units: � IV� <br />Landscape or Planning Inspection <br />needed before final? Yes No v <br />Planning Inspector: <br />Phone #: _r <br />Approved by: ��� Date: `� r G�� L <br />Historic Approved by: ----- Date: '�- <br />Comments: <br />�'� <br />