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BUILDING PERMIT APPLICATION <br />Applicant To Complete This Form <br />D �'� <br />If more than on� building is to be constructed, submit a separate permit ap- <br />plication for each building. A separate permit will be issued for each build- <br />ing. , <br />OwnerP�cific Iron h M�[als <br />Address �9602 Everrreen Wav <br />City Everetr Fhone 353-8866 <br />Architect � <br />City Phone <br />Centractor Riverside Roof Co. <br />Address� 1522 Walnut <br />City Everett, Wn. phone z52 7950 <br />Building Address 9602 Evergreen Wav <br />Lot 8 B1k.003 D-01Sec. <br />Intercity Division 1 <br />Twp. Rge. ' <br />Subdivision (Plat) ' <br />Metes & Bounds (Unplatted) -----�___.. <br />Buildiny Use Commercial <br />State License Number 223-02 R�VE�'� j;�'�7�escribe Work to L'e Done _. <br />Expiration Date 10-10-76 �-�2Exti�- ��r_ <br />Use of IIuilding <br />__New .-Addition Repair/F.emodel <br />Valua'_ion of Construction $ 2�7F�.p� <br />PLOT PLI�N <br />Indicate lot size, name of sCreets, <br />indicate location and H�idth of <br />alleys, locate proposed and all. <br />existi.ng Uuildings, show distances <br />to property lines, show distances <br />betcceen buildings. <br />Lot size x. <br />Lot area S.F. <br />Size of Dldg. S.b'. <br />Number of Stories <br />Basement <br />U�e Zone <br />----'-'- --..._ .- -. _ --....__ _.. ._..___.._-- - - <br />Si3ned Dy <br />ior Riversid� noof ( <br />O�mer <br />' �9RITL 3ELOS4 TRIS ? <br />Date�Received �//��%Cn <br />Plan C:�eck Numbe <br />ValuAtion /z J[pQ. C� U <br />PermiC Pce �✓4�, dV <br />Plan Check Fee `— <br />Total L•'ee Due L�,r-, D V <br />Yennit Nwnber <br />Date Issued l /•5 %(�� <br />Fire 2one <br />Type of Co�structior. <br />Occupancy Group <br />Occupant <br />Sprinklers Required ___ <br />AP?ROVED FOR [3UILDIf��� pER�11T <br />Date <br />Q�— ----- <br />