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� <br />FOR OFFICE USE ONLY <br />BUILDING <br />Bldg/TVAddn/Rem Size '�/ <br />Garage Size <br />VALUATION <br />NQ, of Stories �% <br />Occupancy Group 3 <br />Occupant Load �°'`� <br />Basement Yes No �Fin/Unf <br />Type of Construction �j� — � <br />Exstg Sprinkler System? Yes No Unk <br />Fire Sprink Reqd? Yes ✓ No <br />Reason <br />Exstg Fire Alarm? Yes V� No Unk <br />Fire Alarm Reqd? Yes � No <br />Reason � <br />Enclosure (RC � 64.55) IYes __ No <br />Approved by: '` Date: — J �_ <br />Comment <br />�., , <br />FEES <br />Plan Check Fee <br />Building Permit <br />Surcharge <br />Additional Plan Check <br />Water <br />Sewer <br />Systems Dev. Due? Yes <br />Public Works <br />Traffic Mitiqation Due? Yes <br />� <br />�3( �,���c (� <br />PLANNING <br />Zoning•Classification <br />Overlay/Agreement <br />Nonresidential Use � <br />Residential Use ' <br />Proposed No. of Dwelling Units; <br />Total �lo. of Dwelling Units: <br />Landscape or Planning Inspection <br />needed before final? Yes No <br />Planning Inspector: <br />Phone #: <br />Approved by: Date: <br />Historic Approved by: Date: <br />School Mitigation Reqd? Yes No <br />Commenis <br />�� <� �% ����c.L� ���� r,��� �l <br />_—'�— <br />No Rcpt # <br />Z'/2 <br />