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i <br />�O•• <br />BUILDING PERMIT APPLICATION <br />/ �O <br />Applicant To Complete <br />This Form <br />If m one building is to be contructed, <br />submit a separate permit applica- <br />t n fo bui ding. A separate permit <br />will be issued for each building <br />d`0/,1zt` <br />e ( <br />Building Address <br />/ / <br />Lot_ Block <br />Ad ress <br />ity Phon 3-2s-6o <br />Sub?ini ion (Plant) <br />Arc tect/Engineer <br />City Phone <br />Metes s dznds (Unplatted) <br />Contractor �.%iiG V _ <br />Sec._ _ Twp. Rge <br />Address <br />City Phone <br />Building Use r <br />State Licenne Number <br />Desc •be Work to Be Done 1' <br />Expiration Date <br />SKETCH PLOT PLAN BELOW <br />Use of Building <br />[]New ❑ Addition ❑ Repair/Remodel <br />Valuation of Construction $ <br />PLOT PLAN REQUIREMENTS <br />Indicate lot size, name of streets, <br />i <br />i \ I <br />indicate location and width of <br />alleys, locate proposed and all <br />9 <br />existing buildings, show distances <br />A <br />to property lines, show distances <br />between buildings. <br />Lot size x <br />Lot area Sq. Ft. <br />Size of Bldg. Sq. Ft. <br />' �4r(0,G, <br />Numb Stories <br />Sa ETCnt <br />ZXb ���P <br />Signe L <br />For _ <br />$e <br />O.te .._ce4cc8 <br />Plan check Nurser <br />Valuation <br />Permit Fee <br />Plan Check Fee <br />Total Fee Due <br />Date Issued <br />U• a Zone <br />Fire Zone <br />Occupancy Group <br />Type of Construction <br />occupant.Load <br />Sprinklers Required <br />CITY OF EVERETT <br />APPROVED FOR QUILDING PEMwPERw,i <br />PAt0 J 13 BY—C <br />I <br />