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FOR OFFICE USE ONLY <br />BUILDING <br />Bldg/TI/Addn/Rem Size 0 O <br />Garage Size <br />VALUATION <br />No. of Stories 1 rt • 1 <br />Occupancy Group <br />Occupant Load <br />Basement <br />IYes No ✓Fin/Unf <br />Type of Construction <br />I I 1 — t <br />Exstg Sprinkler System? <br />Yes No Unk <br />Fire Sprink Reqd? <br />Yes _ No _ <br />Reason <br />S L <br />Exstg Fire Alarm? <br />Yes V No _ Unk_ <br />Fire Alarm Reqd? <br />Yes ✓ No <br />Reason <br />#Car S T <br />CO Required? <br />Yes No <br />Enclosure (RC 64.55) Yes No <br />Approved by <br />Date: .. /,r. / <br />Comm <br />FEES <br />Plan Check Fee <br />Building Permit <br />Surcharge <br />Additional Plan Check <br />Water <br />Sewer <br />Systems Dev. Due? <br />Public Works <br />Traffic Mitigation Due? <br />School Mitigation Paid` <br />es <br />es <br />PLANNING <br />Fzoing Classification <br />Overlay/Agreement <br />Nonresidential Use <br />Proposed No. of Dwelling Units: <br />Total No. of Dwelling Units: <br />Landscape or Planning Inspection <br />needed before final? Yes No <br />Planning Inspector: <br />Phone M <br />Approved by: Date: <br />Historic Approved by: Date: <br />School Mitigation Reqd? Yes _ No _ <br />Comments: <br />No <br />No _ Rcpt # <br />No Date Pd <br />2f� <br />