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(f <br />rscriptlon of work cordinusd: <br />DA C.✓lci Nl V1'� ��llfV\�tr`OJ IY1S�\� <br />New Wax.✓ <br />Fna oFFI[E USE ONLY <br />BUILDING <br />ZONING <br />VALUATION <br />Lot Area <br />Bld /T.1. Size <br />Garage Size <br />No. of Stories <br />�. <br />Front Setback <br />Rear Setback <br />Side Setback <br />Basement <br />Type of Construciton <br />Yes No <br />Vacant Site <br />Hei ht Limitation <br />Yes No <br />occupancy Group <br />Use Zone <br />Occupant Lost <br />Fire Sprinkler R 'd <br />No. of Dwellin Units <br />roved by Date <br />Reason <br />Comments: <br />Fire Alarm R 'd <br />Reason <br />Approved by Dale <br />Comments: <br />FEES <br />Plan Check Fee <br />Building Permit <br />Surcharue <br />Additional Plan Check <br />Water <br />Sewer <br />Sys. Development <br />Public Works <br />Trefflc NI ' stion <br />Other <br />