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. . _ . . ,. _ . . � - ._. . _..�_ <br /> ' • � /' ' ..1 <br /> , ' ! � ' . ' BOILOIpC PE1L'1IT APPLICATION � , � � ;�� `�,�i•�1'�'je�, ,i,� <br /> s , , �• Appllcant.To ComplcCc This :orm � •.�y;/�/j�� <br /> .. . � � � <br /> , � • � Tf aore than one building is to be contzucted, sul�mit a separate permit applica- <br /> . � tion Eor caeh building. .1 sepur�tc permit will bc issucd for cach buildinq. <br /> ' � Omcr Pl:blic iJti�it,y Distiict ;� l. Huilding Address � ?37.5 California ^L. ' � <br /> . � . <br /> � <br /> ,� . aearess r. o. aox iio�� Lot r2��� ^3 Dlock 63� <br /> ' � CSty • �verett phone Sub3ivision (Plat) � I'l�t of 2;vere':t ' ; <br /> � • �ichitect/Engineer SelC � llivision '' 1 " ' � � . <br /> 'L `:'� City Phone Netes & Dounls (Unplatted) <br /> • � <br /> �. .. <br /> ;,•, Cantractor ' Sec. ?� Tap. ?') itqe 5 � <br /> � . . . - <br /> - ' , . '' �l:.dzess . . , <br /> 1 ,City Phone 'fluilding Usc Yarking Lot • � • � <br /> � �'�� � State.License Ni..^iher Describe Work to Dr_ Done Blocktop^,a `'�F'� <br /> ' : �:� �i LYpiration Date i�u�ement, conc. curU. t'< landscnpe ' ' <br /> :� ' �� = SP.ETCIt PLOT PI.T��1 DEI,OW' • � <br /> . :.� , . . • • IIce of ]3uilding •None ' <br /> � ' SPE AT`fAGHLD.'F'RIIJT ' <br /> L' i PARKIidQ, LOT •-(.IIG 37•) . - : �NeN ❑ Addit:on ❑ Repair/F.ca�o_cl <br /> . � ` � . ' •� . . • � Valuation of Con�t_uction 5 3,500 " <br /> . •� � ' . . . • � . :,PLO� PI.]llJ R?QUI3;E.'•S�NTS • <br /> y . , . � . . <br /> ' '• J � • ' � ' indicate lut �ize, nar.e of s,rects, <br /> . � � _ • � ' •indicate loca:ion �r.d wiflr.h o: <br /> . : ,, ' _ � �;, . . . • alley„ •locatc aropoe.eci and all . <br /> ' '' � .exiuting buildi:as, shc:v di:;taaces <br /> , 1 ?I ' ... - -• "! ; •.,''� . . .to pr nerty lines, show dist.ances <br /> , 1 . _� . _ betui n buildings. <br /> . . . .. . , <br /> � . � , •- Lot size 3� x_115 <br /> ••L' � ' • i�t- area Sq. Ft. <br /> • r..- - . • � � Size oL A aI� g:�— Sq. Pt. <br /> '� , • • NumUcr of SLorie�— <br /> • � �•; • j � , . ' IIasenent 0 _ <br /> .:. - . - � � ' — . <br /> -.. ,'•� Signecl P� � —' . <br /> y • . <br /> • For P. U. D. No. 1 oi' Suohomish Count � <br /> ' • Owncr Phonc 59-97 +9 <br /> ' DO NO'" :�ZIT� �3EL0[! TH75 LItlF.-FOR CS1`Y USE O;Ii.Y <br /> Datc �eccived • • U�o Zone <br /> ' Pltn C:mc;: :Jur..Scr ' ' Fire Zonc ' <br /> \'aluation � Occupancy Crou� • _ <br /> Fc.miC Fcc � •1'ypc of Constructi.on _ <br /> Tlaa Cbec1; Fec ' Qccup�nC I.o�il ^ ,_ . <br /> , � Yota) I'cc tiu� _ _ �Prinl:lc•�:^ RcquJred _ <br /> : . Pcte I:::ucd �_ ---- . . ' . . <br />