|
� . I � � � � � - ' BDZLDING PERMIT APPLICATION . !. �/��7`•/ . � . .� �
<br />� S • 1lpplicant To Complete This 'orm " ' � •'�
<br />•' I! more than one building is to be contructed, submit a separate permit appl���,
<br />.. tion for each building. .1 separate permit will be issued for each building.
<br />, " ' Ouner ��,, i , � l � � :.-, ��1 Buildinq Address � ( ( 1�p`�T
<br />' : J3dress % / % — / iJ G�� % , Lot � i �/ Block 1.� % -
<br />� � ' �� �
<br />� � City �s�'Jij� � /� Phone Subdivision (Plat) ��t^/��ti� �'� �= t-�-' •
<br />= � ' Jschitect/Engineer � �� I I il_/ ��i: i- , ��! f-.r /%� � �
<br />'`'� City Phone Metes s Rounds (Unplatted)
<br />_ -�
<br />c, _., _._ _ �
<br />. � ;,� Contractor��ilii�i� r� �; /�/- i �. �/-� , l
<br />. .., _
<br />:' � Eddress ���', ���„ � r`�C3 �
<br />. : t; CitY � i'; VP � Phone �r�;��- / •�/%
<br />-,: ,.;:.�.
<br />� ���:� � State. License Number _J 1 %� -(' � - � ii %�
<br />� � � ;� expiration nat� (, (. < J - 7 j ^
<br />�� ' - � � SRETCH PLOT PL71N BELOTQ � '
<br />.. i � • .
<br />. 1 • �S . . .
<br />i . . ...
<br />..,, . • , II : . -L _. -
<br />�
<br />...- . - --.'ro ' '.
<br />0
<br />Date Seceived S
<br />Sec. Twp. lt4e
<br />� �
<br />Buildinq Use (:. � ��Q L ' ,�-�^'„
<br />Describe Work to Be Done 1-i � i.�l��/tTii �/'� �
<br />' �! -� ri�i�..,i.v; -ti T-1 - 'I ��� ,1:._.-� �
<br />. �1r �
<br /><h_�� %�u,.lii f� f i',^n� Y' �i"/'/�liq br.i !'✓�:�Ji ;�
<br />�--i—'�--�--IT- t
<br />IIse of Building
<br />❑New ❑ Addition Q Repair/F.emotiel
<br />�' ;-�. .
<br />Valuation of Construction S�� J l_,' j; .�('�;
<br />. . PLOT PLAN REQUIR�'IENTS . ..
<br />t•:ZITL B�:.Ot! THIS
<br />. •T
<br />Plan. Cyeck :Iur.,Ser '
<br />Valuation
<br />� ti ��F�-- B6
<br />Pemit Fee
<br />2�� �
<br />Plan Check Fee �_
<br />�'otal Fee Due ��,'
<br />Datc Issued
<br />c
<br />Indicate lot size, name of streets,
<br />indicate location and width of .
<br />alleys, locate ar000sed and all �
<br />fxistinq buildi:gs, show distance�
<br />to pronerty lines, show distances
<br />betWeen buildings.
<br />Z.ot size �) �� x i� t,'
<br />Lot area Sq. Ft.
<br />Size of Bldg. Sq. Ft.
<br />1lumber of Stories
<br />easement
<br />;�
<br />/ �
<br />Signed By-� I�i `� �, ., -t �% if r.���i P� ����,..i 1.i .
<br />,
<br />For
<br />Qwner Phone
<br />Uce Zonc �Z � � .
<br />Fire 2onc .� '
<br />Occuoancy Grou� .T
<br />Type of Construction �(^_�_
<br />Occupant Load
<br />Sprinklezs Requi.red
<br />, CITY OF EVERETT
<br />•ARPRO�ED FOR. BUILDING PERNitC
<br />Date � ,� � ,� By �C ' __—
<br />, � ,. � _. _..,, � � `.., . .. ..
<br />�... .. �•.��. "�" e�:�M.�a.:.�:'�o...�.-� ' •• - ` ..�.• ' . . . � �...\jrirhid�s:'n:x:�xreael'unsssiE.G �''1�wi8�rNmi�du�ire�-aiSuFisn .�i��YiYi'w
<br />
|