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BUILDING WORKSHEET <br /> TECHNICIAN: DATE: 0 PERMIT NO. p( 7j� <br /> SCOPE OF WORK 77 <br /> r <br /> i 11��RZ,U�L '\\ <br /> Cu - WJE�KmaLj <br /> Citation Number: Planning Application Number: <br /> PLAN CHECK FEES <br /> Plan Check: Y N Deposit Paid: Y N Master Plan: Y N PLAN CHECK ONLY: Y N <br /> BUILDING FEES <br /> Occupancy Group: Handicap: Y N Energy: Y N <br /> Type: "-bo Cost:EM, Square Feet: Z Type: Cost: Square Feet: <br /> Type: Cost: Square Feet: Type: Cost: Square Feet: <br /> Valuation: Other: <br /> PLUMBING FEES <br /> Sq. Ft.: Fixtures: Gas Line: Minimum Fee: <br /> Other: <br /> MECHANICAL FEES <br /> Combo or Furnace: Split System: <br /> Wood Stove: Gas Line: Minimum Fee: Other: <br /> ELECTRICAL FEES <br /> Sq. Ft. Service: Amps Horsepower: <br /> Fixtures: Outlets: Minimum Fee: Other: <br /> CHECKLIST <br /> Preinspection Report: Flood Certificate: <br /> School Certificate: Will Serve Letter: <br /> Public Works Release: Floor Plan: <br /> Recorded Deed: Owner-Builder Form: Contractor Info: Work Comp Cert: <br /> OTHER <br />