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_ I <br /> FOR OFFICE USE ONLY <br /> PERMIT NUMBER a(,�(;��j.�� � SUB-PERMITS P��� �y �(� ,p'�V <br /> SITE ADDRESS <br /> 5� <br /> ZONING <br /> LOT AREA FRONT SET[3ACK REAR SETOACK SIDE SETBACK VACANT SITE USE ZONE HEIGHT LIMITATION <br /> J� „� � YM1yrn � YES NO f, 4c 1 t <br /> fN+� *.k Y'J s � -�r1 Srr <br /> � 51� NP o!- S�.iC N� <br /> NO.OF DWELLING APPROVED BY DATE COMMENTS(�-�M r�Y �'� v-03j v SLPA Oo�o Ltl <br /> UNITS <br /> 8'l o • D� C'o�'t PLY �,,1 t i?� Ff t S rR�C Si�M+,��s <br /> BUILDING <br /> BLDG?.I.SIZE 6ARAGE SIZE NO.OF OCCUPANC OCCUPANT BASEMENT TYPE OF CONSTRUCTION <br /> STO�tIES OUI' LOAD YES NO �` A <br /> ;�; ��.;Cn � L� `��l'�S" � �l �-2�_2 I3� � /'` <br /> � <br /> NEW�FIRE SPRINKLER REASON N FIRE ALARM REASON <br /> REQ'D,, ; '_�� S,, ;_ REQ'D� � � j'. IJ <br /> \/ <br /> APPR ED�Y DATE COMMENTS <br /> �^ 7 <br /> •�' 1 � R � <br /> � VALUATION I I � % '- PLAN CHECK FEE J 3 �� ��7 �Q JND I� <br /> � l J FEES 1j� �� /.���� y J0�3i� �n/'�n. <br /> ' � ^' ,�tJ 3� L�/'Q,. <br /> BUILDING �__ ��� ' � � '/ WATER '� /����-� <br /> SURCHARGE � SEWER �.'J,f�I,' ��. �\) <br /> ADD PIAN CHK SYS.DEV. S X �-� � ' y�7�� �F��(�"'� l <br /> PLUMBING TRAFFIC MIT. ��Sv <br /> ME�HANICAL OTHER � <br /> �J <br /> � ��> <br /> SPRINKL[ ;11 { .I-._, �r:.. i�.• � . . . _ ; ^._ .3hQ� fh/ <br /> % �: /� � � � c�l�n� � <br /> PUOLIC WOR.KS '� <br /> TOTAL TOTAL <br /> 1 -:� �,F r f�! <br /> /� � � � �� <br /> l� - _ ' 1'�V.� qT` � �-�-.. '� � - <br /> n/ i� -a Jl.�� .1�� '_, <br /> ✓ <br /> Z/v <br />