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<br />`� ' � . BUILDING PF.RMIT APPLTCATTON /� �� / / � � ��
<br />. � � - �---. Appli�.�nt To Completi: This Porm ��`i���7� �
<br />If more th�n onr 6uilding is to be contx'ucted, submit :� scp:rrate permit ❑ciolicr
<br />tinn for ca��h bni.ldinq. A separate permit will be issu��d Cor enc� tt���ldinn. l
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<br />Owncr -/�:� � � - . _ . ---- Buildinq Addres� G��� �W�r ,-�G�do�e'�v.
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<br />i]ity �i � � � Phonu -� - � -
<br />nrchitect/Enginecr --��--.�.� +: � � ,
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<br />City: " Phone �,r.0 .� -_..
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<br />C'onk�r�ctot r �,: � ,
<br />ilddress , . �. `
<br />City `_ Phone � �'
<br />State License N�unber ,� �� : .'" �_�'__
<br />1:r.pi.*�:t.i.on Date
<br />SXFTCtI PI.OT PLAN B£LOW
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<br />Lotr��' �� � Block __
<br />Subdivisien (Pl�t) ' ` __ -� � ^
<br />t9etes s ➢ounds (Unplat.t. �d) __
<br />Sec:. .',�- 74^-P, ,__ �ige ti
<br />fluilding tJse _
<br />Descrite Work to �3e Done ,_
<br />-1,�, . � , , .. ---
<br />Ose of Duilding /-�
<br />[}Gew ❑ Addition ❑ Repair/Remodel
<br />Valuation of Construction $ �` ��-��
<br />Pi,OT Pi•nDl HI?pIIT�iI:61F.N9':>
<br />Indicatc lot siac, name of sCreeta,
<br />indicatr Lccition nnd width u[
<br />allcy�, locatc �+ropo,ed and nll
<br />ex3^ti.ng buildinns „show distance�
<br />to property lim�s, show diatar.ces
<br />betwecn b�ildings.
<br />LOt S1Z0 I L� ? X-�
<br />Lot arna � .-> �'`i' Sq. Ft.
<br />Sizc of S13g. ��+'-• Sa. Ft.
<br />Number of .�toFi�-'s ___
<br />Elosemcr.t -,•+.. ..-- -
<br />-1neQ !iy �v._�___— __
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<br />Yar _ _ .
<br />Owncr Phone -'
<br />^,_ DO tJOT lt;:I'�i; f3i'.LOS9 TF!?S T.IiIE-FOR CI'PY tISP 0".7LY
<br />i�atc ^.: c�:ivn,g _ ��I.I��I.15 ------- , Uc.e 7.one --- —
<br />I'lan Cic.:-: N,.;_.,._... %S-L�,7 (P.__ Fire Zonc ,� -
<br />Vals�acion ,3��.�jJ¢• � Occunancy Group �
<br />Femitr. fcc
<br />� � 3 j � Typc of Cun_:truct.ion ��J - �I �
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<br />Plan ChrcL Prc --. �O�'S� �� Occ:upanC l,o.i�t _-. ----,------_--
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<br />Sorini;lcrc �t�_�;ui�-cd
<br />CITY OF EVERETT
<br />APPROVED FOR BUILDING PEP,MIF
<br />Date I� :' ^ ���By—K. C.
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