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� <br />FOR OFFICE USE ONLY <br />7 � ( Z--� s <br />PERMIT NUNiBER � Q 5 O S "� � � SUB-PERMITS <br />SITE ADORESS � b�-� d'" "�^"' j�u <br />✓ <br />l0T AREA FRON! SETBPCK REAR SETBACK <br />- - ze'- {�d r S ' <br />NO. OF DWELLING APPROVED BV �AT <br />UNITS <br />�Ai � /S6S <br />IBLDG?.I. SIZE I GARAGE SIZE I S ORIES <br />INEW FIRE SPHINKLER I REASON <br />REO'D <br />BV �ATE <br />F S�2`/5 <br />VALUATIOtv I 4� � 8 3✓� <br />I BUILDING <br />SURCHAR3E <br />iADD PLP.N CHK <br />IPLUMBING <br />i <br />I MECHANICAL <br />SPRINKLE <br />� PUBLIC WORHS <br />� TOTAL <br />�' <br />20NING <br />SIDE SETBACK VACANT SITE <br />� YES NO <br />r s - �Sf �� n . <br />COIdMENTS <br />USE ZONE HEIGHT LIMITATION <br />� -3 zss' <br />BUILDING <br />OCCUPANCY OCCUPANT BASEMF�': i I TYPE OF CONSTRUCTION <br />GROUP LOAD YES NJ <br />�¢-3/� n �: IZB <br />N[W FlriC ALARM REASON <br />REO'D <br />COMA :N?S <br />� 3 �,C,c. w.r� c� wr�r a 4 c <br />PLAN CHECK FEE � .�/v, <br />FEES � � ��O . � <br />WATER __ <br />SEWER _ <br />SY6. UEV. _ <br />TRAFFIC MIT. _ <br />OTHER <br />TOTAL <br />