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0 • <br />FOR OFFICE USE ONLY a l `-f D1_ Q (."5 <br />BUILDING <br />Bldg/TI/Addn/Rem Size <br />2, V <br />Garage Size <br />VALUATION <br />No. of Stories <br />Occupancy Group <br />Z <br />Occupant Load <br />Basement <br />Yes <br />_ No _Fin/Unf_ <br />Type of Construction <br />— A <br />Exstg Sprinkler System? <br />Yes <br />No nk <br />Fire Sprink Reqd? <br />Yes <br />No <br />Reason <br />Exstg Fire Alarm? <br />Yes <br />_ No _ Unk <br />Fire Alarm Reqd? <br />Yes <br />No <br />Reason <br />Enclosure (R 64.55) <br />Yes No <br />Approved by.J& <br />Date: <br />_ <br />10 r. 13 - <br />Comment <br />PLANNING <br />Zoning Classification <br />` <br />Overlay/Agreement <br />Nonresidential Use <br />Residential 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; Date: c� <br />Historic Approved by: Date: <br />School Mitigation Reqd? Yes No <br />Comments: <br />FEES <br />Plan Check Fee <br />Building Permit <br />Surcharge <br />Additional Plan Check <br />Water <br />Sewer <br />Systems Dev. Due? Yes No <br />Public Works <br />Traffic Mitigation Due? Yes No Rcpt # <br />21�. <br />