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4~ <br />FOR OFFICE USE ONLY <br />PERMIT NUMBER GoLA k (7 -( SUB -PERMITS <br />SITE ADDRESS <br />LOT AREA <br />FRONT SETBACK <br />REAR SETBACK <br />tszv <br />ao <br />qL6 <br />NO' IF DV ELLING <br />APPROVED BY <br />DATE <br />UNITS <br />O i _7 1 <br />ZONING <br />SIDE SETBACK <br />5 <br />COMMENTS <br />BUILDING <br />VACANT SITE I USE ZONE I HEIGHT LIMITATION <br />YES NO <br />r_ � .L CY l <br />TY I"1 ?G� <br />BLDGfT.I. SIZE <br />GARAGE SIZE <br />I NO. OF <br />OCCUPANCY <br />OCCUPANT <br />I BASEMENT <br />TYPE OF CONSTRUCTION <br />STORIES <br />GROUP <br />LOAD <br />YES NO <br />F <br />447 sF, <br />r.3 u <br />L n 5z <br />its <br />NEW FIRE SPRINKLER <br />REASON <br />NEW FIRE ALARM <br />REASON <br />REQ'D <br />REQ'D <br />APPROV BY <br />DATE <br />COMMENTS ?CO3 G. Zv.J3 <br />i'V4 !'f ✓��4� <br />J /I <br />VALUATION G I `�r�FC1 <br />PLAN CHECK <br />FEES <br />BUILDING <br />WATER <br />SURCHARGE <br />SEWER <br />ADD PLAN CHKl + l,'d ll <br />SYS. DEV. <br />PLUMBING <br />TRAFFIC MIT. <br />MECHANICAL <br />OTHER <br />SPRINKLE <br />PUBLIC WORKS <br />TOTAL <br />TOTAL <br />