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_ �, � � � � ` • � ' LOxLDINC PEACSIT APPLICATZON ' � • . •. . •�.'� .
<br /> . _ � Applicant To Complete This :orm � � ���� /' � �
<br /> i � '��s
<br /> , It �ore than onc buildinq is to be eontructed, submit a separate permit a lica-
<br /> . : tlon for each bulldinq. 11 separate permit will bc i.,sued for each building.
<br /> • � .�� �u �e/�•,v � Ri. Te„f;� luilding Addreae ���s �� „/..
<br /> � . ; � JGAress J��s �s .,/.� Lo! Hlock • �
<br /> , . �1 at7 _f.i�/�� Phone �5'2-3/L3 8ubdivision (Plat) : �
<br /> • � � �t'c�Altect/Enqineer �
<br /> - �+', � �=�� �t7I Phone lfetes i Bounds (Unplatted)
<br /> � ' ;,, Contractoz f c1' /`'eN;s�� �e. ,�� . e _
<br /> - . -%. . �� ae9zesa ,311Ly T/./. ,9 � . � �
<br /> ;., � .
<br /> .i atY ,� is Phone .¢/_ 2 - 7y3� laildinq Ose .. t:+
<br /> •:ti� . •Y'' , I . ra:;�•.
<br /> � itate,I.icensa Nmuber ���^Q/-�,�5?, �J p�acribe Work to Be Done C.-,y..�����C �
<br /> , . ,
<br /> ; �;il �piration DatB . ;.
<br /> v1: .' . . � . . ,
<br /> � • :� B�TCH PLOT PLAN BE7ATQ' • =
<br /> •+ � • • (� , _ i
<br /> • Ota o! 8uilding ,,, rj �_� .
<br /> � . • �/ . . . . . ' ' .�eM ❑ Jlddition
<br /> + li . . •• . . . .. . ❑ Repair/�
<br /> . . ••, . . .1 ' � � , . . r, + ' • . �. . .
<br /> ' � � ' - � • • . � • • Vdnation of Constzuction S�`d " '
<br /> � • � � . .(�r �� . , ' . . • ' ' fLOT PLAi7 REQUIR£PfENTS � �r .
<br /> •. �• � � ' I ~�. . . ' '`. . ' • • ' lndicete lot size, name of streets, ., .
<br /> ' , . � � • '� � .. ��:�.. • ' � ' '!ndleate location and width af
<br /> ?'-; = � � aile s
<br /> .; i.� - . ,• • . , ' y , locate pr000sed and all �
<br /> ' �'� ' '\.I, '.�.� ,._. : • ' l7cieting buildinqs, show distances
<br /> • • � ' �� i " �'� � • ' ^��' to property linee, show distances
<br /> ' �. j � ('�� •_! . • � between buildinqs. .
<br /> ... .',. I y� I • • ' Lat rize x
<br /> ..i- ' lJ,� ! �,j�V'4� � •• ,'I. . • Lot area q.
<br /> �! r• ' t ,+ . � i Bize oF elag:— sq. Ft.
<br /> . ' ;: • 4 �NrN I IWmber of Storiea
<br /> ' ,,,•— ' � i G�� d � 4' . Sasement
<br /> r- ,,/
<br /> � y' ' • .. ._: . I iiqned By �fNi�l/++.M2..
<br /> , �
<br /> . . . . . (, • . . x !or
<br /> . � 'j • _ Owner P one
<br /> �,j.J
<br /> � . � . DO NOT S�^.1IT� BELO[�! THIS LI:IE-FOR CITY USE OtiL'l �
<br /> •—, D�te ^eccived �.� � � Dca 2one
<br /> i
<br /> ' . Plta•CSeck `iurber 7S' Fite Zone -
<br /> Valnation '_ L; ! . �^ Ll Occuoancy Grou� �
<br /> femi! Fee ��.� . ' ,
<br /> , _ 'lype of Construction
<br /> . ' ' PUn Check Fee �< <� Occupant Load • �
<br /> . � Sbtal Fee Due �� ' . U C` '
<br /> . , Sprinklers Requited
<br /> , Data Issued ' �. �/ � • • � CITY,OF EVERET.T
<br /> ' , • , —�' . . ' . . ,APPROV�D' FbR•BUILtlING' PERMII' Y
<br /> • : ' , . : � � . • . . . ��=�i-i, - ,��' By�. r_.
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