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PERMIT NUMBER <br />SITE ADDRESS <br />ZONING <br />LOT AREA FRONT SETBACK REAR SETBAGK SIDE SETBACK <br />u0� 20� si <br />VO. OF DWELLING APPROVED BY qTH / COMMENTS <br />:1NIT5 . / <br />BLDG/T.I. SIZE <br />CA�'p <br />NEW FIRE SPRINKLER I RE�SUN <br />RE�'D <br />DATE <br />� <br />VALUATION _� ��%a- <br />BUILDING <br />SURCHARGE <br />A�D PLAN CHK <br />PLUMBING <br />MECHANICAL <br />SPRINKLE <br />PUBLIC WORKS <br />TOTAL <br />SUB-PERMITS <br />VACANT SITE <br />YES NO <br />BUILDING <br />NO.OF OCCUPANCY OCCUPANT <br />�iORIES GROUP LOAD <br />U-� <br />NEWFIREALAHM REASON <br />REQ'D <br />� L� <br />l /� ( �l <br />COMMENTS <br />USEZONE I HEIGHTLIMITATION <br />� -Z <br />BASEMENT I TYPE.; CONSTRUCTION <br />YES NO <br />PLAN CHECK FEE J S I D <br />FEES <br />WATER <br />SEWER <br />SYS. DEV. <br />TRAFFIC MIT. <br />OTHER <br />TOTAL �� lp � <br />