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Appliean: •ro cccpiece �:nis .������ <br />� �- �a ;z <br />�/r� � <br />I: more than one buildinq is to be contructed, subnit a separate permit applica- <br />tion for each building. A sepacate crmit il� `c issued for cacl� building. <br />�� v✓�cr��, C�.r�. �r1' ! <br />OwneL i7-� �`j -�v�,�,�_ Building Address ?�ir� � /,�..�t� <br />Address 7�/"' [' �i�+ c� •��� Lot3 �C- 3- Block fi 2. � <br />City / .-Y+-e� T%� Phone <br />Subdivision (Plat�/y oT- � ii,�.-e� 1� <br />Azchitect/Engineer - <br />Czty <br />Phone Metes 5 Counds (Unplatted) <br />Contractor �%� �nv����l Sec. 7Wp• Rge <br />�� � � � y'1 f7-/c= <br />Address ����� / <br />City / �,-�_r7� Phone �?y-S�//n Buildinq Use �r<<'c, o'� � �1 � <br />State License Nunber L"' �`v/-/Lti/�y Describe Work to Be Done �r�f,qnr�.- <br />Expiration Date <br />/� � Nc ofo .,,�� �✓ <br />SKETC}i PLO'P Pi.A:I IIEi.O•4 <br />rOT <br />�'-`-� -="-_":'. <br />��- <br />P!an ..::^cr 'Ic-=-- �— <br />Valuation y <br />i �DD = <br />Pemit Fee <br />� <br />Plan Checl: Fee <br />o� <br />Total Fec Due <br />Datc ;._c�.u��d l��%S .._._--- <br />� <br />�' — <br />Use of Building , <br />❑tiew ❑ Addition (�Repair/Remodel <br />Valuation of Consttuction S/ r7/7 _ <br />PLOT PI.AN REQUIRE?lE:iTS <br />Indicate lot size, name o: strcets, <br />indicate location ind w?dth of <br />alley�, locate propoacd ar.d all <br />existing buildings, shcw 3istances <br />to property lines, show distances <br />betwcen 6uildinys• <br />Lot. size X <br />Lot area Sq. F[. <br />Size of Dldg. Sq. Ft. <br />Nunber of Stories = _ . <br />?.ILC"•C^� _ — — <br />Signcd Dy �� ?`�'n-'-'-�}-- <br />For .�1 � ---�--- <br />O�+ncr Phonc -z 3�s-�Z-i� _ <br />E-FOR CITY USF. O:�[.z <br />U:e �one �___._._ <br />Fire �one <br />Occuoancy Gzoua _ <br />Type of Car.struction <br />Occupant Lo�d ___ <br />Sprinklers Requirc3 <br />CITY OF EVFRETT <br />n��P�ov�p r5� e�.:��-;,����:��� <br />� �10�7 � av � <br />Date _ <br />