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<br /> � • StlILDING PERMIT APPLICATZON �/ / / �/ =
<br /> Applicant To Complete This ^orm /�/a 3�� ,�
<br /> If moLe ttan one buildinq is to be contructed, sul�mit a separate permit applica-
<br /> tiort for each buiiding. A separate permit will re issued for each Uuilding.
<br /> Owner. � �u�i��F' ' / . �
<br /> �61 r.7 n Building Address __,�/,� / /�j�,.,,��„/,,rAr
<br /> Address 7l 0 f/���-/.f r,r i)��.i r.ot- z �/,� _ � Bio�x �a.�
<br /> City ��/S�s 77 _ Phone ,�f� - /�f91 sura�vistan criat) �2��-- ���� �
<br /> 1lrchitect/Engineer %�,,�,,,; /)„__�,��t�J r,cf�T Go. S / ;�T �
<br /> City �,i�,c ,tf p:�one �j 1 - 3�c4 t4etes s Hounds (Unplatted)
<br /> Contractor f��t,/LArJJ �i'n��� �c - Sec. TWp. Rge '
<br /> Address � � 9'�j ,�J .
<br /> city = ���� t�{ Phone J �`J- y� 5''/ euilding vse ��N; '
<br /> StAte License Nwnber �,7-? -- L/ — �JSc,; Describe Work to He Done �i f�,., �
<br /> i — .
<br /> Expiration Date _,�Jy v % (. '
<br /> , ,� --1 7 . �� �„�;, d.��.- >�-�, c�A�c
<br /> � SAETCH PLOT PLAt7 DEIAW �i.%Srir� jci�S� /1/bx ' . �/_p'� � � .
<br /> i . ♦ —T—
<br /> � Use of Suilding �'< �a�;ti��� '
<br /> ' �JH��F�� . I�Ne�o ❑ Addition �T Repair/Remodel
<br /> /-
<br /> ' . ' � — - Valuation of C�nstruction $ �
<br /> JT�n�y � • ' pypT PI.1\N REQUIREbSENTS
<br /> U�� .
<br /> � f�� � � � Indicate lot size, name of streets,
<br /> � indicate location and width of
<br /> alle s locate
<br /> e �—� � .---�-�---�-�—i -� � Y , proposed and all -
<br /> �� ��'�S.��FE - I existinq buildings, show distances
<br /> � � . _ � • L-o property lines, show distances
<br /> � , �//r-f�i„f /-0�" , between buildings.
<br /> � � ! ����/f Lot size x
<br /> �, � Lot area
<br /> . I —C�1�r ' Size of Blda. Sq. Ft.
<br /> . .. ' r Number of Sto�ies � ,
<br /> IBaser„ent
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<br /> ! Signed By �� �
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<br /> - T�L _ � � For �u s�f .9?GG� 2S - T,�-1 7) ' 1
<br /> Owner Phone
<br /> _ _ _ �� ._.� — j
<br /> DO rOT WRIT� DELOI� THZS LINE—FOR CSTY USE OfiLY I I
<br /> �ate ^.�ceived /Z /p 75 Uce Zone �
<br /> Plan Chec}: :Junber 7�'" 9¢3 Fire Zone Z � � �
<br /> Valuation 'rJ ��+ SJl Occuoancy Gro!�o ,E3-- ,j �
<br /> Perr.it Fee �rJ - �
<br /> -- �� ��• Type of Construction � ._ � � ,
<br /> Plan Check Fee ��.. ���S � Occupant Load � i
<br /> Total Pee Due Sprinklers Required
<br /> oatc tssued /��23 Z '�� CITY OF.EVERETT � I
<br /> -�--� APPROVED FOR BUILDING PERMIT '
<br /> Aatei/���j ey iL. C i
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<br /> P12J`.J��„�- Ix��a."-�fi;�t�{,G_ �}- r�•�:.cu, P�_tit--1s, �
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