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0 <br />0 <br />BUILUZNG PEAMIT APPLICATION � J v�'� j� <br />/ I <br />Applzcant To Comp:cte This ^orm <br />If nore chan one building is to be contructed, submit a separate permit applica 3/�`�S <br />tion for each buildir.g. A separate permit will be issueu for each building. I <br />Owner /�y) ✓Sb �{ , [3�'AND ✓oL G Baildinq Addr• �ss . I <br />Address f: J• L'� [!' /i .J fP Lot _ Block - I <br />City /r�%rrl�F� Fhone 3SS-//3s'- Subdivision (Plat) li <br />Architect%Enqineer _ � <br />City Phone <br />Contiactor .S /3 r " � <br />Address <br />City •-� Phone _-- <br />State License r,.nber aa3-o/- /a,'/a <br />Expiration Date � - /— 7S <br />F <br />SRETCH PLOi PLAN IIfiLOW <br />- - -�-----,—ixv.9� <br />. IQ�y�iia <br />I 2q� � <br />a ¢�_/ .i J <br />.,"J , '°'. p � <br />° � ' �� a <br />_ y� # ' Q <br />�-� <br />� <br />• � ; j� <br />. 1 �I <br />_ _ . _---. _- . . .-- <br />SS,Q/ . <br />IIELOIP THIS <br />r <br />Datc 2�ceicca <br />Plan C`�ecY. tiunber 75 "�Z <br />Valuatio� <br />Pernit Fee <br />Plan Checl: Fee <br />Total Fee Due <br />Date Issucd ____ <br />Metes 5 Bounds (Unplatted) <br />Sec. 8 _�'P• ?9 nl. Rge 5` r-, J, M. <br />Building Use ,5'rr/G!< <rN• 0.��!(7-✓C� <br />Describe Work to Le Done ' <br />io��.fr.,- � n,�r,.i �curc^ . <br />% � <br />tlse of Building �i c • ,�-. �•.• ,' <br />�idew C7 Addition ❑ Repair/Aemodel <br />Valuation of Construction $ <br />RIAT PLAN REQUIRF.FSENTS <br />Indicate loc size, name of streets, <br />andicate location and width of <br />alleys, locate proposed and all <br />existing buildings,.shou� distances <br />to property lines, show distances <br />bcl:ween buildings. <br />Lot size � � x /<%_'.� <br />Lot area �/� �I� Sq. Ft. <br />Size of Sldg. / d Sq. Ft. <br />Numbcr of Stories, � T <br />Basemer.tr� � O,�Z% <br />Signed By S�i� , �. ,f� �,�� i i, . .�i ' �i� <br />For <br />Owner Phone �}-�� ii_.�� <br />0:7LY <br />� <br />il_e 3one <T R<<.,nfi-�rt <br />Fire 2onc 3 " <br />Occuoancy Group � _ <br />Type of Construction ;,L - �r� � _ <br />Occupant Load _ <br />Sprinklers Required <br />CITY OF �\�ERETT <br />nr-rr���: ::� ; ci; �.���!_.,�r�� r��r�Mir <br />/ <br />D:,�, �Jz�_�1l_._By—�_, � <br />r <br />e <br />0 <br />