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- .' . � . ,. .— .. . . , • � DOILDING PERMI; RPPLICATION , • ' ' .. �� .: .• '- . •*,;�
<br />•�pplicant To Complete This :orm '��p1 j j9'��
<br />.. � . � . f
<br />� If nore thar. ane buildinq is to be contructed, submit a se arate
<br />�. •. tion for each buildin 11 se arate P Petmit applica-
<br />, 4• p permit will bc issued for each building.
<br />. .�'p�� J�RRo�D K. •�..�qNN Huildinq Address 14�5 W1o.dronq '
<br />�. b� ldP.ress I�IS MAD(ipNA Let 3'�- elock ' �
<br />• '.,. .. City EUCFZE�- phone�52-421io 3ubdivision (Plat) Pv�FpLE 1-EEV'NT'S •
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<br />_ � � � Aschitect/Engineer _ DW N EFZ � .
<br />_�i�:•..:� �itY ' . Phone Metes L Hounds (Unplatted) �
<br />- : . . .
<br />:,' Coatsactor ��e � Sec. �p, ' gy� .
<br />.� ,
<br />�. .;•.�•:i, iddsess � �� ' . � '
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<br />•! �i' Phone Bnilding Ose '� '"
<br />� � ;� .�::.: . - '`.�",�,-4L.',�=.,,r.::
<br />_ � y � State. Licer.se Nin¢ber Describe Work to Be Done Gn�r STRU�T° �`•
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<br />.;1 Pspization Dat� •_pELK RE RD_ O E :
<br />� �1 : ,ti. . . � � • � • . .
<br />� • SRETCFS PLOT PLAN SELOW' • � � - •�
<br />�, i • •
<br />� ...',• � . . . .•:. ' o . . — .
<br />Dse of Building *
<br />� •. � �.. � �.'. .� DHew ❑ Addition Repair/Remofiel
<br />. . '•� , . . . . � • , � i.' .
<br />- � � • - . ` � - ' Valnation oE Construction 5 Sd 0 °�°- " .
<br />�• , . ... .
<br />.�... .. . • . • . ' . � , , PI.OT PLAN PEQUI?2EttENTS � � ' .
<br />� . ,,..� � • _ '`' .. . , , C ri .
<br />�. •qoih ' •' ' Indicace lot size, name of streets,
<br />' / . .QS��.�' •indicate location and width of
<br />� ` ! ` � '' � illeys, locate proposed and zll
<br />' ' :�� � • • ' ' �. `� ' ` existing buildings, show distances �
<br />• ' �t � �� . .'�' � �� "'�! : : ' ^ 'Y " � . . to pzoperty lines, show distznces
<br />' � � . � : : betaeen buildings.
<br />.. , . • . � Iot size X - .
<br />' • ' . ' ' ' bot area Sq. Ft.
<br />. �.�i �• " � ' . .. . , .� . Size of Blu4r 5 Ft_
<br />� ' • . DTumUer of Stories 4
<br />. � �. i . • . Baseme
<br />r .. •
<br />'-• -� ' . . � SignQd B�
<br />• +. � . . . .
<br />• . . . . For '
<br />.. . ; . � � . , �Ow��r Phon � .
<br />. . . . . • . . �� . . . . .
<br />. . � u� ivu�. �c:<i'ri: H�LU�7 TNZS LI:IE-FOR CITY USc 027L'I � �� '
<br />— . —' Date Seceived � Q/7, � � Dce Zone "ti _
<br />�.. � , P1an.CSec� :1ur,ber ' Fire Zone � - ' � � .
<br />Valnation _ ` (�, �� Occunancp Grou� � �
<br />. Pemit' Fee -l"j , � ' Type of Constructian _� - ti� • ,
<br />' Ylan Check Fee Occupant' Load • ��
<br />. �. Total Fee Due S- �� b�rinklers Required ' , ''
<br />� Datc Issued ' � S 7J'- •: .• � CITY OF EVERETT
<br />• .• —�� .: . �.. 'APf��iOV�D FOF"El11LDI�G PERh11P .
<br />, . , .. , , ., . ., , � . . . ,
<br />•. : . . .. . .. ,•D����=�—flyaY=�------- .
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