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FOR OFFIC�' USE ONLY <br /> �(�c�3 -a�,� <br /> BUILDING PLANNING <br /> BldgtTUAddn/Rem Size Zoning Classification <br /> Garage Size Overlay/Agreement � <br /> VALUATION Nonresidential Use • <br /> No, of Stories Residential Use <br /> Occupancy Group Proposed No.of Dwelling Units: <br /> Occupant Load Total No. of Dwelling Units: <br /> Basement Ye No Fin/Unf_ Landscape or Planning Inspaction <br /> Type of Construction Ci' needed before final? Yes No <br /> Exstg Sprinkler System? Yes No_Unk_ Planning Inspector: <br /> Fire Sprink Reqd? Yes_ No � Phone#: <br /> Reason Approved by: Dafe: <br /> Exstg Fire Alarm? Yes No Unk_ Historic Approved by: Date: <br /> Fire Alarm Reqd? Yes_ No_ School Mitigation Reqd? Yes No <br /> Reason Comments P���n�� rQU�,Wv <br /> Enclosure(RC 4.55) Yes_ No_ f , <br /> Approved b Date: .- — �,�� ��/� �e� <br /> Comment : ' � �T G�-�z I � <br /> � <br /> FEES <br /> Plan Check Fee <br /> Building Permit <br /> Surcharge <br /> Additional Plan Check � <br /> Water <br /> Sewer ` <br /> Systems Dev. Due? Yes No <br /> Public Works <br /> Traffc Mitigation Due? Yes_ No_ Rcpt# <br /> y,��,�.r <br /> 2J�, <br /> �� ,.n�` s�i�� <br />