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� <br />FOR OFFICE USE ONLY <br />BUILDING <br />Bldg. .IJSize `� G = <br />Garage Size <br />VALUATION <br />No. of Stories ' <br />Occupancy Group <br />Occupant Load ti <br />Basement Yes No /"�� <br />Type of Construction i ; <br />Fire Sprink Reqd �v ;� � <br />Reason '_ r 5' 1 �� <br />Fire Aiarm Reqd <br />Reason "� � "� (,; <br />CO Required? ';: <br />Enclosure (RC 64.55) <br />Approved by r Date � -� �' { . <br />� , <br />Comments: � ; � '. <br />FEES <br />Plan Check Fee <br />Building Permit <br />Surcharge <br />Additional Plan Check <br />Water <br />Sewer <br />Systems Development <br />Public Works <br />Traffic Mitigation <br />Other <br />Lot Area <br />Front Setback <br />Rear Setback <br />Side Setback <br />Vacant Site Yes No <br />Use Zone <br />Height Limitation <br />No. of Dweliing Units <br />Landscape / Planning Inspection <br />needed before final? Yes No <br />Approved by Date <br />Comments: <br />��'�' ��lfi1/'� %� '' -jl 1 <br />/i � �' �' <br />_�.� <br />� �= ��_' � '/�2 <br />f. <br />