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FOR OFFICE USE ONLY S d ^�� <br /> BUILDING PLANNING <br /> Bldg/TI/Addn/Rem Size 1 el 1):1 Zoning Classification —` <br /> Garage Size a.3 0 Overlay/Agreement <br /> VALUATION Nonresidential Use Okkv Lc. <br /> No. of Stories . Residential Use CJ7A <br /> ;' <br /> Occupancy Group Pro o. o !,,elling Units: C <br /> Occupant Load LP To - ,o. of Dwelling ID . ' O <br /> Basement Yes\No_Fin/Unf Landscape or Planning Inspects• <br /> Type of Construction v' 5/ needed before final? Yes No_ <br /> Exstg Sprinkler System? Yes_ No UnkPlanning Inspector: 1 ik«CA leh <br /> Fire Sprink Reqd? Yes_ No ✓ Phone#: _I d6^• 57- 12 7s <br /> Reason W Approved by: %# Date:q•12Q/is <br /> Exstg Fire Alarm? Yes— No Unk_ -istoric Approved by: Date: <br /> Fire Alarm Reqd? Yes_ No ✓/ Soho. itigation Rergd?,Yes' "_-.No_ <br /> Reason ' E"verett Sc 4• Iist 'eoSchool Dist <br /> Enclosure(RC it.T Yes_ No #of Net New Units: <br /> Approved by:' Date: / -� h-- I :' Calculated S ••ol Imps ee: <br /> Comments: Schoo pact Fee Credit: <br /> T' al School Impact Fee Owed: <br /> Comments: <br /> FEES <br /> Plan Check Fee I b Ii,b I <br /> Building Permit <br /> '' , <br /> 26 <br /> Surcharge "I, <br /> Additional Plan Check') <br /> Water / / <br /> Sewer • • ' . <br /> Systems Dev. Due? Yes I No_.(.. <br /> Vl���_l�.. ,.rte • Systems Dev. Fees � 11� '�'P�1S116'JI�US2J <br /> Public Works . f t �0j <br /> Traffic Mitigation Due? Yes No Rcpt# A(ibto t� <br /> School Mitigation Fee i <br /> 07)1 <br />