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` - - <br /> ,- <br />�� ���� <br /> I <br /> i <br /> I <br />� <br /> ' ; � ' HOILDING PERMIT APPLLCATIOM - ' ia� .T <br />' :' ' . , : Applicant To Complete This Form �r�•�� � "3 <br /> _ ���/j3' <br /> , , !f more than one building is to be contructed, submit a separate permit app ica- <br /> . . tion for each buildinq. �1 separate permit will be issued for each building. <br /> . • Orner An/ �NQZR�_ Haildinq Address �A, ,:: j;�fc,'`i.;/:', <br /> � . 1lddress � ,�/Z t"vice2t�.T7- ��C Lot,=�"'./i-� :S.Z Hlock /.-C 7 ' <br /> �- - . <br /> . City �'� Pl�oneeZ,sry-S37 S Subdivision (Piat)eF�.i;�I1P`ff • <br /> ' � azchitect/Enqineer Jp/�✓ �2.�qe•iT • <br /> `"� City Phone Netes G Bounds (Unplatted) <br /> - - "i <br /> :, Contzactor /C ' Sco77� �-J�� , Sec. 1Yap. Rqe � <br /> .. , �ress i'r; jy ? /.>�'� . . <br /> •' �ty �r/.�.���/ Phone ��;��/,�,� guildin Use �,�- '� � � <br /> s � �:,. �7 ii:L .: :�. <br /> ;{ State License Ni:mber ` `.�� , <br /> .i ��9-O� /d?S3 Describe Work to Be Done <br /> . . — � � i " . - <br /> . <br /> � : 'I Lxpiration Dat� /1;;s� �i 7 !J %'r%Y/ � <br /> c :� ' � � � SRETCH PLOT PLAN BELOW' • � <br /> _ � • , � • <br /> ; { . , Qse of Building <br /> ►� �_. � . .� . � ' �, _ . , , . � ❑New ❑ Addition epair/Remo:<el' <br /> ' i. � <br /> " ; , ' • � ' . Valuation of Construction $��.l�ei; � <br /> . ' <br /> .••,,,• . �� � . . ' � - � PLOT PLAN REQU`:tEMENTS � <br /> ,�, . . . . . . . <br /> . . • <br /> �• ; ' " - • Zndicate lot size, name of streets, <br /> . . f . ' ' indicate location anc wi3th of <br /> _ ,. . , alleys, locate pro�osed and all . <br /> II'� � ' . existing buildi:gs, shota distances <br /> . ` : '� • - ' '- '! : - . to property lines, show distances <br /> � 1 ' � ' • between buildings. <br /> � . • - . <br /> � , . ' � bot size x <br /> ••• ` • , Lot area Sq. Ft. <br /> • ,:. - ' Sizc of Blug. Sa. Ft. <br />. ` > •� • Number of pagigs <br /> • ��� � ; . easement� / <br /> :.. <br /> �. '_ � - Signed By C r <br />' • - �For <br /> � Owner Phone • <br /> . ' DO ;705 SSZ?T: 9ELOI9 �F4I5 LI:IE-POR CITY J5� OitL'L <br /> Datc �eceived � Uce� 2on2 <br /> . - �/'7�—--- <br /> ' Flan Check ::u.:.`-.e= 7S - 30O ' Fire zone ' <br /> Valuation Occuaancy Group <br /> 1'emit Fee � � Type of Construction <br /> i?lan Check Fee Occupant Load <br /> . � Total Fee Due ' Sprinklers Required <br /> Cate �ssucd • " ' CITY OF EVERETT �. <br /> ' ' • , ' 'APPROVED FOR E3UILDING FERMIT : • <br /> ' Date C • �J� By ' •�_..--�-� <br />� . • . • � <br />