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rpplica^e �ro compicce :n.s :�,���� /�" n� i <br /> If more than one buildinq is to be contructed, suGmit a separate permit applica- � <br /> � tion for each building. A _,e��arate permit will be issued °ot esch buil�ing. <br /> Ovner � " � � ' �)��: k Building Address ,;2 //� ���//�/✓i C j <br /> t <br /> Address �1C,4;_�_� l�f�},Yl S Lot��x �_ Hlock ��_� t <br /> City �;�l�= i2_ 4' /�_ Phone �� Subdivision (Plat) � �/�� ( .� ,Ey � <br /> Architect/Engineer /� ✓ � � <br /> City Phone _ Metes 6 Bounds (Unplatted) ! <br /> Contractor�����/=/� r il�, r�i� L� �i��d'�ec. �' RQe ( <br /> Address ��(� •1'�ctk / �{U I <br /> City �, �/F_��� Phone,%i.-1��i y'/.�, Buildinq Use <br /> State License Number 2Z-� -75/ �i, n�� Describe Wo=ic to Be Done � <br /> Expiration Date � - 0� -7� <br /> SRETCH PLOT FLF+� BELOW <br /> Use of Building <br /> �t �'�l. Q i Y �l�F� !' S � ❑New ❑ Addition �Repair/Rert:odel <br /> 1Y Z �U �� h �, Valuation of Construction 5 �o� <br /> P v <br /> � , %c7 � IAT �J/`� b . �'� YLOT PLAN REQUIREPIENTS - <br /> �H� . �, W°��,,' ,�'� <br /> � � � Indicate lot si2e, name of streets, <br /> / � � indicate loca'.ion and wiz:h of � <br /> i� �Q l�ry /�g alleys, locate proposed and all <br /> existing buildinqs, snow distances , <br /> �.���,�,(qJ�.�,�'�y .:�{ Vy�lC � � to property lines, show distances � . <br /> ' between buildings. <br /> � � ✓J Q�F V �//1��� �.:� �,�, r� --- — �� <br /> I,ot size x � <br /> � Lot area 4�q. Ft. � <br /> . Size of Bldg. Sq. Ft. , � <br /> • Number of Stories `__ __ � <br /> � � 9ase.^..e.^.t - I <br /> Signe3 8 � '� ^J <br /> For � <br /> • Owncr Pnone _.__ <br /> ^ <br /> i <br /> DO NOT W72TS a� O�J THiS LINE-FOB CITY USE O[ILY � - � <br /> �.•c '-:e:v,? ��G_�� �..._. U_e 2one - — <br /> Plan �.:^c'� )Iur'c__ ^ Fire �one _ � �_. <br /> --- i <br /> � Valuation �J� OO �_ Occuoancy Croup _ <br /> 4emit Fec ���J Type of Construction � I <br /> —'� Occupant Load <br /> Plan Check Fee �_�_ <br /> Total Fee oce __ `�,$� �__.__ , Sprinklers Reqvired _._ ' � <br /> �a�� iss��a �—�-��5 CITY OF EVERETT <br /> APPROVCD :? i:'_C" '^ PE5".^i <br /> J,L.r <br /> oate � �J S By—�IL--- <br />