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� <br />FOR OFFICE USE ONLY <br />PERMIT NUMBER C05 r, I- a f 5 <br />SITE ADDRESS <br />LOT AREA <br />IJO. OF UWt <br />UNITS ^ <br />/y <br />SUB-PERMITS <br />ZONING <br />FRONT SETBACK REAR SE i BACK SIDE SETBACK I VACANT SITE USE ZONE HEIGHT LIIdITATION <br />J\ O� r 5 INT. VES NO `� `� � <br />� � � Si12.�%cZ <br />qPPRO`JED6Y DATE COMMENTS '('aJ yVl4Kh'I S�"�1 ��"�'� �� <br />.1��� .tl� a�n�1 N1ui9 FhLi i1�L�5� 01�-(� �f%� S( G.hi <br />BUILDING <br />6lDG(f.l. SIZE GARAGE SIZE I NO. OF OCCUPANCY OCCUPANT I BASEMENT TYPE OF CONSTRUCTION <br />�STORIES GROUP LOAD YrS NO � <br />3 Z"3 S . 43 � <br />NEIN FlR[ SPRINKLER REASON <br />REQ'D <br />AFpROVEDOY DATE <br />VALUATION I�f"�' 3� � - <br />EiUILDING <br />SURCHARGE <br />ADD PLAN CHK <br />PLU1.161NG <br />MECHANICAL <br />SPRINI<LE <br />PUOLIC WORKS <br />TOTAL <br />I ° <br />NE\N FIRE ALAi2M REASON <br />R[G'D <br />COMMENTS 2ovG 1 �L� W S%�" �' wS v/q R� <br />� <br />PLAN CHECK FEE � %� � � � — <br />FEES <br />WATER <br />5[WER <br />SYS.DEV. <br />TRAFFIC MIT. <br />OTHER <br />TCTAL <br />