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, = <br /> BUILDING PERMIT APPLIC�TION �• �'j <br /> ' Applicant To Complete This ^orm � <br /> If more than one building is to be contructed, submit a separate permit applica- <br /> tion for each building. A separate permit will be issued for each building. <br /> Owner �J- �GN e y� C'��,5 e.v Building Address ��/O ���fic, <br /> Address �.�//(% /b/.v�. LotaS�G;y7 Slock ��.�� <br /> City ,r„Q,.�7J Phone Subdivision (Plat) �y;vives7�+ Ndc�. � <br /> Architect/Engineer <br /> City Phone Metes S Bounds (Unplatted) <br /> Contractor �Sj�///< /-/erfe �.t-jN�uverfero�" See. '1Wp. Rge <br /> Address �,3dS /�'!/Id/SO/L' <br /> t <br /> Citiy F�ei�Ty Phone ,3SJ- 927p' Building Use S�/� <br /> State License Number 3 �U/-9GGS�" Describe Work to Be Done � <br /> Expiration Date ,�" -/- 7SJ Ceiycti� l3Lcc/C Fo��iTir/rr7io,y <br /> SRETCH PLOT PLAN BELOW . <br /> Use of Building <br /> . �� ��'" _ ❑New ❑ Addition ❑ Repair/Remodel <br /> � �° <br /> � �..y �[p � ' Valuation of Construction $ 3 0�� <br /> �.1-- <br /> � i� -. P2AT PLF1N REQUIBEh1ENTS : <br /> �/�i t <br /> Q� X1 G���� Indicate lot si2e, name of streets, <br /> � �Ii 7 _ ```'''///���... indicate location and width of <br /> b{�j•�Y�.�w alleys, locate pr000sed and all <br /> � `�.Q�� ��5 existing buildings, .show distances <br /> to property lines, show distances <br /> \ / s�i' �ti Q•C . between buildings. <br /> .� <br /> � � Lot size X <br /> ��O.G � Lot area Sq. Ft. � <br /> ' . � ��Z Si�e of Bldg. Sq. Ft. ' <br /> � �.. � <br /> Number of Stories <br /> ,i� ����'�� ���� Basement � <br /> . ! � e <br /> n � � <br /> � � �� �o c� y Signed By �w/� � 1, � <br /> � I Z —# �a� S'k''or �ncr Phone i <br /> � 11r b � I <br /> DO N T 4'2IT6 BELOIJ THIS LNE-FOR CITY USE OflLY � <br /> Dzte .^._cci�•ed �0 --Z.. S- � �7 U:.e �one <br /> i <br /> • .; Fire 2one � � <br /> P1an Chec}. ue:bez , <br /> Valuation Occuoancy Group � <br /> Pemit Fee ��7.�--�� Type of Construction <br /> Plan Check Fee Occupant Load . � <br /> Total Fee Due Sprinklers Required � <br /> �atc rs_��a CITY Oi� EVERET�" � <br /> APPROV D FO^ �UILDIfdG PGR�AIT <br /> o,tcl�/'?�;(�—_ � ��--- � <br />