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' LDILDINC PERMIT APPL2CATSON '�
<br />. � ' � � • �pplicant To Complete This =arm • . ' ',�•�� ��'�
<br />+ ' 2! eore than one buildinq ia to be contructed, submit a separate permit applica�/��
<br />� �.•; tion for each buildinq. A separate permit vill bc issued'for each building.
<br />•.: O�mea� �/G U.c1,c� Cj�p�c�w / Dnildinq Addzess ��G S z Z �/?A� y;; ..
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<br />',�� �EEress 2'S LZ C��ni�,� Lot ��/�G� Block 558 '
<br />�� City �.J(� Phone ��Z—'2?9'S" 3ubdivision (Plat) � -�-`���:T •
<br />, i
<br />• �� � 3ichitect/Enqineer � •�
<br />,• ti�: ....`_'� City • Phone lletes z Bounds (Unplatted) '
<br />_ . ..� , . _
<br />;�' Coatractor ����� Sec. 1rrp. ' gqa .
<br />.� - . .
<br />• ;. . �• �ddress • • � ' ' .
<br />- �j ,�7. • s. . '
<br />• �; City Phone BnLlding Use .[df� � ' .':. .
<br />-"d.',.;-�.
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<br />`�� State�License Nwnber � Describe Work to Be Done •�`
<br />. ir .
<br />• . � .1. L:piration Datt ' �O D �OD� L ttu � i Ta `
<br />: : ; . . l �
<br />j % SI�TCR PLOT PLAN BELOW' �1ST�� 4�.1"= ��CTU�� .�
<br />. • .. : 1 . . . � ' . , . .. . .' e . . ' '_�-.a � U 1...) l l`�„ .
<br />.'•• • .. ' . te bE Buil ing •
<br />♦ ' i � . ' ' , , , . , • �liew ❑ Addition LK xPpair/Remociel
<br />, i� �,,/; ..
<br />- :.�.i� . . , • .
<br />. j . ' '. • • . �.- • �Valnation of Construction $ �`/� "�' •
<br />�• . . . ; ... _
<br />r.. . , . ' PIAT PLAN REQUZBE"fENTS - ' �
<br />�. . , - � . . . , • ::
<br />� '.� • . ' - .. ' � •. ' ' Indicate lot size, name of streets, �
<br />y. • ' • '' •indicate location and width of
<br />• ' .��. ' � ; y�•� ' _ `•" • illeys, locate pronosed and all �
<br />. . ' ':'t . �' ' • - � . • e�cisting buildinqs, shoca distances
<br />_ -. i'f ' -•�"''`""�`! : � ' •`'� � • • !o property lines, show distznces
<br />; , , , , • betxeen buildings.
<br />. . i � • ' ' . • ' ' . � . . , . .
<br />� ' , ' � •• ' Eot size x
<br />. ,�. ',, .
<br />..i- � . .' ' . � Lot area Sq. Ft.
<br />� . : �; = � � � �• '. . .� . Size oE IIldq. Sq. Ft.
<br />_ ' i , ' . �Tumbe�t of Stories �
<br />'. j•• . • . . . 8asemer.t
<br />�r... .
<br />'� ': � . ' ' . Signed By
<br />_ . i � . ; , . . : � FO�'�? <-/L% � �v �/w,�,�,D _ `�'
<br />: : '. '. ' � �� ' . � . Owner Phone � .
<br />—• — Date Seceived �" � �G� Dce Zone Y - �
<br />' P1an.CSeck :7urber �.4`� ' Z�v Fire 2one ' '
<br />Valnation � 'S���l, ��' Occunaacy Grou� {�
<br />: . Petni£ Fee ��p• � „' Type of Construction \t -I�l ' .
<br />� .' ' Plan Check Fee �� �� � Oecupant Load • '
<br />' ibtal Fee Due S/�+ '��
<br />, , • Sprinklers Required �_ �.-.
<br />' Datc Issued /���jQ /�j — � , , • ; CITY OF EVERETT ,
<br />, � 'APPROVCp �=11R f3UILDING PERf�IIT' �
<br />• ,. , ' . . . : •.. , �' • Date,�i;%1:� ;gy i� r .
<br />. ' . ,• ' ' , . . .' , . . , -►
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