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� ;�.� S.1 <br /> I�U2LI77NG PF:IUtIT APVf,ICATION t' <br /> ; Applicint To Comp.letc This Form �)�3�3� <br /> If tnoze than one building ia to bc consCrucCed, submit a sepnrntc ;crmit ap- <br /> plicetion f.or cach bui].ding. A Ecparatc permit wi:l bc issued foz cach 6uild- <br /> ing. , <br /> Owner ��p,.;f'i ti � �/ 'J�,� IIuilding Addrese �`'�t'� � , j �� /,� ' r . <br /> � � <br /> Address�`�n? •%/-��U.Jd�� �tri!'�' Lot_� rilk. `.'s Sec. <br /> � / - <br /> Cit:y,t='l��t'�i�/GN� Phone '>S.3 �S%�: Twp. Rge. � <br /> Architect • _ Subdivision (Flat).f j��FA 71j/ �� <br /> 9MF•: <br /> City Phone��S Mete.^, 6 Dounds (Unplatted) <br /> Contractor C/�T/�C' C .e„� •.;7T'��;� � -i � — <br /> �e.✓ <br /> Addrecs � > i���N, t� .�i�� - <br /> CitY `�-�,.t=�,'F.;j Phone .>�: vZ.�. IIuilPiny Usc /�"f_":r'D�L' - �x' F �p.i,�;� <br /> State License Number' �.Z.i�-n�/-(�'�/pT Deocribe I9orY, to De D�ne--� <br /> Eapi.ration Date`�7 '-�� -7(� �i'[ r1'_�/C�._,/`.�Gti/F-_ <br /> �O� � <br /> Usc of riu�.ldincy',�,�;,_;«� f,e.•K�- �t�5' <br /> . <br /> . �New . AddiCion Repair/P.emodcl <br /> Valuati-on of Constructi,on $��� <br /> - � P1AT PLNJ <br /> � <br /> � ' Indicutc lot cizc, namc of strects, <br /> �'�y � indicatc locaCion and �eidth o[ <br /> � nlleys, locaCe proposed and all <br /> - - eKietin9 Uuildings, show distences <br /> to property lines, ehun� distnnces <br /> ' i betu:cen buildinqs. <br /> S-� - u't... <br /> •]rn� ,nr.n I `i�h' .'m:u LoC siZC�Y. ?) �'7 <br /> � Lot arca 2�� ��nn 5.1�. _ � �- - <br /> Size of Rldy• �31D u:.r�iGwruci: S.t'. ; _.-- <br /> f/5 qry,,,r Numbcr of Stortes � <br /> . � - — basement • — ' <br /> �+ �� <br /> ,/���j� � , <br /> 7S' Signed ' _ . c V / ` -�,.z ., � <br /> 7 <br /> ` /';.;n.[' J'SOi°.,-� Por �'i:t%'LS � �it-/i T/� <br /> Owncr � <br /> UO NO'P {�HI1'C I31:IAlJ 7'IIIS 7,7Nr.-}'OR CITY USC ONLY ! <br /> Uatc Reccived 1'ire 7.onc g � <br /> Plan Check Numbar � Type of Con::iruction �� i <br /> �C " <br /> Valuatiw� Occupuncy Group �j � <br /> Permit Tue OccupanC Load - <br /> Ylan Check Pee Sprinklerc Required -- <br /> motal E•ee nuc CITY OF fVERETT <br /> }�crmit ;au�t,c,� ' _ APFROVEU FOR l3UILDING PERM11 <br /> une� i:,;v�-a � <br /> _ D,ile'L�i�i�.---- By_�. � . <br /> Af'PROV[D f OR DUILDING PCRMIT <br /> Dalc_ _ <br />