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*.,-.p1:c:'= :�o c%-p:,,cc ::::. .uc��� ' J ��"'. <br />� � �� /v //��.� <br />If rccre thnn one tuilding is to be cuntructed, ,ubmit a separate permit applica- <br />tion for each building. A separate permtt will be issued _`or eacli buil�ing. <br />c�.�ncr r ? � �1'`S� ��'%� Build' Add � <br />Address �uc•'.-er c`• C;�7 i.i or2 ia <br />City '''�e-et t Phone �5°�� � �"' <br />Architect/Engineer � <br />�ity ?hone <br />Contractor Joe Dore <br />2%-', 2 1.'n yt . <br />7,.3dress �sverotf� �;, <br />City Phone 2r'' ��p 7 �' <br />�State License Nunber <br />Expiration Date <br />sxsTcta PLo,^ eru�s aeLo:a <br />inq re..s r_ %�2 i,r�t ,d nA <br />U�r�sh.erlri ?0 ft <br />Lot ?%, 18� Zc- glock ��� <br />conz>�o�iri�Ti�own as 27?2 L�oyt Aue <br />SuL�ivision (Plat) <br />Metes a Bound:: (Unplattc3) <br />Sec. '[top. Rge <br />Buildinq Use 7'�Zloi �.o <br />Describe Wor;c to Be Done <br />-�ut i� petition , i�:st¢11 <br />ar� ,or� facilities <br />Use Af Huilding <br />❑New ❑ Addition �Repair/Renodel <br />Valuation of Construction $ 1� 00.00 <br />PLOT PLnN RPQUIRESlE::TS <br />Indicate lot size, nane of streets, <br />indicate location a�d wi�th of <br />ollcys, lacate nro�osed and n11 <br />existing buildinqs, show 3istances <br />to property lines, show distances <br />betcrecn buildings. <br />Lot size x <br />Lot area Sq. F <br />Size of Dldg. Sq. F:. <br />Nur„ber of Stor��es <br />'ascr.crt • -- <br />. � -�cd ByJ` ,'Q- �_ <br />: c: <br />ncr Pnone <br />--_-'----�- :�.)"." t:3i':'.'-----.. __�;5 L;;:E-FOR CITY USE O:1LY <br />�.tc :c�:.a' -�Z -/ - %G/ — U_c �one - — <br />?!an �..�c:: `, .-_ -_ Fire �onc � <br />Valuatian T ,��� �'' <br />Pemit Fcc <br />Plan Checi: Fee <br />Tot3: Fee Dc^ <br />Occuoancy Group <br />Type of Canstruction <br />Occup�nt Lo�d <br />___ Srrinklers Requircd <br />_ CITY OF EVERETT <br />APPROV�D FC�R f,'!;'_L;;I�:i; i,._, , <br />n.,t�— i, <br />0 <br />i <br />