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� [ '� OC�-� Z3 <br /> FOR OFFiCE USE ONLY <br /> BUILDING ZONING <br /> Bld .lT.I. Size Lot Area V V� ' <br /> �t(� sf` �j� <br /> ,arage Size Front Selback � <br /> VALUATION 3 S S Z o Rear Setback <br /> -� un <br /> — ' I ' ocn �ucn <br /> No.of Stories � Side Selback <br /> Occupanc Group U Vacant Sitc 1'es_ No <br /> OccupantLoad Use Zone � <br /> Ba,ement Yes No�. Hei hl Limitation <br /> Type o(Construclion No.o(Dwellin Units d �� <br /> Fire Sprink Reqd Landscape 1 Planning Irsp^ction <br /> Reason needed before finel? Yes No <br /> Firc Alarm Reqd Approved by Date 3 <br /> Rr.ason Commenls:� (,01'1'i����I(I5� a I �J <br /> -�- <br /> CO Reyulred4 K° � �.�j h�' c�UY11 �`� Y��� <br /> Enclosure(RCW64.55) d� x�n Ih5 �`�• <br /> ApProved b I � Dale � Z� � �� f��� ��� (��i�CS�JO �J-Ir�1`^r�s <br /> cemmenu: Z�`f //eG � W11d,5� �' 1'(iVYIOJ ��m � "�� <br /> 2�r�tit'� ' E��yti�� ����• <br /> FEES $� WVG�GLV�7�' 25�0 1� <br /> Plan Check Fee ��'�-}� L����"" <br /> Buildin Pertnit <br /> Surchar e ���u,l ���I„ ��-�'k <br /> Additional Plan Clieck b� U <br /> 1Nater ��v"rr I 3' GL� <br /> )_L, <br /> Sr.wer <br /> Syslems Develo ment <br /> !'ublic Works <br /> TreKc Miti ation <br /> Other <br /> 2'�_ <br />