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<br /> _ '� � '.: ! ,, ' . ' DOILDING PEItHIT APPLZCRTION � . � � • ,. ,; �.' �%Qt�%',�,��
<br /> r � ]Ipplieant To Completc This :orm ' •. , � T
<br /> .. . ; • • _ : �/r;��
<br /> , • • 2f aore than one buildinq is to be contructed, submit a separate permit applics-
<br /> . : tlon foc each builclin3. .l,separate permit will be issued for each buildinq.
<br /> • � � Ovnu' 1�-�/, l.� L�L�I SnildinqAdd=ess � f�U! /�/�wr`�'
<br /> ,� . . � Mdress 1?0 / l-/cu� ,� ��7.��� " (� Block fp7 �'
<br /> ' � � Mty' _ /-ru cRe'� Pdonc,x53 ' �°7�� Sabdivision (Plat) .
<br /> ' inhitect/Engineer(�y��,q[�r� • .
<br /> •,` . .`_'i City �uc1c � phone `� ��' .Metes i Bounds (Unplatted) ' .
<br /> . ;.' Contractor ����tiJ Sec. 1t�p. ttqe ..
<br /> - i • . .
<br /> _. �. . . .l3dzess �,�� � �C'riv✓, /j � •
<br /> j ,City �ylE'iQ�� phone '��-`�L..[� 'euilding IIse ��l9U C Y@f�1 ' ' • ' �
<br /> :"� `s:•,..
<br /> . {� ,:. . . ,:,.,.•� .:.
<br /> - �'r� � State.License N�ber ���-Oj-/(ed4,� Describe Work to Be .Done /vtW C�utA��)N��,
<br /> � ; '.� 'i �tration Dat� �/26/�� � Aiil� !�1�z�=i��x � e. � • '
<br /> � . . .
<br /> +.�' ' = �SP.ETCI{ pLOT PL�l*I IIELO:i' • '
<br /> , -.� . . . • . . • • Dse of 3uilding . • '
<br /> �•. � j � • .. � .�� � � . ; �New ❑ Addi.ti.on �Repair/Femo:3e1
<br /> . . << .
<br /> '�; . ' � . : , . . • oaluation of Con�truction $ 2� � ��J U ' .
<br /> . .♦ ' . . . . . . . . .
<br /> ' + .. ' . . • , " . , :.PLOT PLAN R=QUIF2:SL'YTS , .
<br /> � � •
<br /> ,• � ' . _ . • ' • ' ' '2ndicate loi size, name of streets,
<br /> i �� '' ' . ' � ' ' " �indicate location and wirirh o:
<br /> • .• ,j ` � i'•;' . . : : • 811Cys� •lOcate proposed a.-.d all '
<br /> ' '' ' ' ' � .existing Luildi:gs, s5ow distances
<br /> . S ,� ' •�•' ' " '- y ' ' •.•'= • . -lo property lines, show distances
<br /> , : � ' .. ., . � , _...between buildings.
<br /> : . - ' • � . .
<br /> . � .. � . . . : •^ • 7.ot size x ' ,
<br /> ..i' � , . � 7nt area Sq: Ft.
<br /> • .;.• = • • • � Sizc of Aldg. Sa. Ft.
<br /> '� , • • " Number of Storics
<br /> • �: • i , . • IIase�aent _
<br /> :. , . , • J �
<br /> -. ; ' • . � Signed Dy �
<br /> i . . . ,
<br /> • � . . • For .
<br /> - �• ' . � Owncr Phone
<br /> ' ' DO �10': Sd:2TTE 92LOS'7 THIS LItvi-20R C'aTY USE OiILY '
<br /> . , , �
<br /> _ Datr �eceived ( • • Uco• Zone
<br /> ' Plan C:�eck :�a:.Scr S�-'�/ ' Fire �one 2_ ' �
<br /> �L2Bt�- °�'
<br /> Yaluation � �� Occuuancy Grou� •3 - 3
<br /> Fernit' Fce �2�• �� T�7re of Construct:ion �! - � 1-�� �
<br /> Flan Check Fec ��- �� � Occup�nL I.oaQ •
<br /> . � '.h�ta). Fcc nue � 9 L� G � Sprinl:lcr_ [�����CIDTY OF EVERETT �MIT
<br /> Pate I::;ucd ' • • ; •
<br /> . . � ----- , • • tiate.�. I�i L`� �" gy � ;�' .
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