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Applica�[ 'ro c;c-picce �ir.i� :u��o �(� / <br />/ 9�a� <br />If cere than one bvilding is ao be contrucced, submit a separate permit applica- 73 �' <br />tion for each tuilding. n s�,parate permit will be issucd for each buildinq. ! <br />Owner �-r�.P.�� � H, �( �'e��. �P,� / Buildinq nddress /,2 /S /%'I J <br />/ 4 Gi�(e <br />Address /'J_ /S /y,i,Ti ��� ��� Lot f;37 B1ock <br />City ��-,-� , f-U�iPhone �Sr% 5�f/6 Subdivision (Plat) �� <br />Architect/Engineer n.r-z � py ��; � <br />City F„�,_.,. �' Phone 3.iS-3�o�c� Metes 6 Eounds (Unpl,itted) � <br />Contractor -�Z��. Sec. RWp. Rqe <br />: " Address <br />City Phone Buildinq �sc ,�p �� ��,,�/�/ � <br />State License Number Describe Wor;c to Be Donc ��L%��:i�lLc-l1 <br />Expiration Date �Ve.Y 2.X �_ 's/;� +iia,�4c�F'_ <br />SRETCH PLOT PLA)7 BEiOIJ <br />WZI <br />]_`_C . :=n:.2a <br />P?:n C..ec% )ic-`.._ 7�—��%i <br />Valuation 1C:�9�- �� <br />Pemit Fee 2L�•p� <br />Plan Checi: Fee l0• � � � <br />Total Fee Due ��• �� <br />Datc Is�uad <br />Use of Duilding <br />❑New � Addition ❑ Repair/Remodel <br />Valuation of Construction 5 <br />PIfJT PLAt7 REQUIREt�L:7T5 <br />tndica[e lot size, name of s:re�:s, <br />indicatc location and wi2�h of <br />alleys, locate proposed �nd all <br />existing buildinqs, sno:� 3ista�c�s <br />Lu property lines, show distances <br />betWeen buildings. <br />Lot size x <br />Lot are� Sq. Ft. <br />Size of Sldg. Sq. Ft. <br />Number of Stories <br />Paccr.,.r.t � <br />Sig:,c3 By <br />For <br />thancr Phone <br />E-FOR CITY USF. 0:7LY <br />U_e Zone �,-L - — <br />Fire :.onc <br />Occuoancy Group ___ I <br />Typc of Conctructi,n q- N <br />Occup�nt Lo�d <br />SprinY.lers Required <br />CITY OF EVERETI <br />AFPROV[D FOR 6U;I.DItiG PERNIIT <br />� �.0 <br />Da,e 3/z�-/-t> gy_ <br />