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' � � . ' AUILDING pERMIT APPJ.7CATION � <br /> • ' �j Applicant To CompleCc 7'hi❑ Form ' /p/�� Q <br /> '� / / <br /> � If more than one buildinq is to be construcCed, ��nmit a ceparate permit np- 7/��/7.> <br /> plication Lor each building. A separace permit will Le iacued far e:ich build- <br /> iny. <br /> . UanerfG-��l/(ll' �� 7��/'�i��/� /y� E-���'� Duildinq Ac'.dress�s Z c/ � - ���� S f"�' k (� <br /> Ad�ress .?'�y4 J��� �'�t�p S tYU-� LoZ�'���Ulk. '.� Sec. <br /> Cir.y�/�-e�� /-r Phone 9Wp.__ Rge. � <br /> ArchitecL ' Subdivi.nion (Plal) ��!;�/.i {�UGg �S j. �U ' <br /> City Phone Metes & Dounds (Unplatted) <br /> Contractor�/nt✓N'SYe »,:,d�r/e��,Y <br /> Address�7'S� �i ��7+, (r-, � <br /> ctcYF_ :i�¢;. �rr � Phone2 � '�317 Duilding Usc�/Jf: <br /> g a / <br /> � � Stnte Licence Number�z 7-��-�7��J Describc Work to 13c Dene�� „���,yP p/�d. I <br /> ` Exp�rntion Datc �///�/ � J yQ/'t�'n� I.ind�_LP.�71t�Tre..w.r..+iovrfJf/62`S <br /> � .�• � <br /> . � � �Ca�-nf� df_���� .G �.C'�aY�a:�[YYI-r F/cn� I <br /> ���. �N ,U�'t -rTrf-j•�'e i.,y' � /�i ia /Sl�• <br /> • . . .. . . U O I3Uilding�s+-/' /'�.�n •e�.. r.f <br /> , � � � '-New =. Addition epair/Fenod <br /> - � � Vuluation of Constrvcti�on f �� p O - <br /> � � � . . ' P7AT PL7�,N . <br /> ' . • . ' Indicate ]ot size, name of streelc, <br /> . ' . - . indicate ).ocation and aidth •of <br /> � � .� • . � alleye, locahc propose.l and all <br /> ' • � � � �. � •• � � _ eKicCi.ng buildings, chuw dietances <br /> - to property linec, sho�v �istances <br /> beto�cen buildings. <br /> , Lot- cizc x <br /> . � - � Lot .urca S.�F. � ' <br /> , � � Sizc of ll]dg. S,F. � ' <br /> . . - Numbcr of Storicc ' <br /> � - bacemcnt � <br /> Ucc %one <br /> , Signecl Dy ���,�^ � <br /> T`_—' <br /> ' For I <br /> � .. � Owner I <br /> DO NV7` W1i77'C IILiAiP TIIIS I.ING-POR CITY USE ONLY I <br /> .Onte heceived �j 7. 5 Pire Zonc ; <br /> Plan Check Numbcr � _S'-1�1 Typc oE Construction rj- �..1 � <br /> Vnluati�n �� .F��Y�• �'s` Occupancy Group T <br /> � Permit Fee �� Z• �� Oc upant I.oad <br /> Plnn Check Pce i(r- c�L Sprinklera ReyuJred <br /> • Total Fce Duc ¢E_+-�� CITY OF EVERETT <br /> Pcrmit Numbcr_ ' APPROVED f"OR QUILDING PERMIT <br /> VA�L' IE6UC(� . �il�C��_�QY \. .�.. <br /> nrrRovrn rorr r�ui�niNc r�RMir ' � <br /> o,,i�._.. .. <br /> �� <br />