Laserfiche WebLink
BUlLDING PERMIT APPLICATION <br />Applicant To Gomplete This Form <br />/ I �-c',�-�l <br />/ <br />If more than one building is to be constructed, submit a separate permit ��.�-' /�y <br />application fot each building, A separate yermit will be issued for each <br />building. � � <br />c+ o (� <br />Owner 'l Building Address e iY1 n Yl i �_)�;�.'-� <br />o '�I , :,�. Y <br />Address � i T, Lot :�i'� �'� Block �, 7. <br />(((��� 0 n� <br />City�Ut�,�,C�� Phone�� �- , Subdiviaion (Plat)���Qy` 1 � ��� . <br />Architect/Engineer ��-'��- l <br />City Phone —�- Metes & Bounds (Unplatted) <br />Contractor(� �_1�l,n{�-Q- A�l.1_�QC�¢h/� Sec. Twp._Range_ <br />� � Q -� � - - v, <br />City L �1Liie� Phone�,�3 �11G,! Building <br />State License Number���-(�/-JJ�/,2;Q Describe �Vork to be Do�e ��� n��� �.�Q�p�_, `� 4 <br />Expiration Date b - �j'�� - � rl y�,(�?i �, , � ,��� , \� F� � 1 e�o �C .."� <br />L � <br />SKETCH PLOT PLAN BLLO�V <br />IIse of Building <br />.Q New ❑ Addition Repair/Remodel <br />�Qq -f . <br />Valuation of Construction $ �� <br />PLOT PLAN R.GQUIREMENTS <br />Indicate lot size, name of streets, <br />indicate location and width of allcys, <br />locate proposed and all e�cis[ing <br />buildings, show distances to prop- <br />erty lines, show dis[ances between <br />buildings. <br />Lot size x <br />Lot area <br />Size of Bldg <br />Number of s[ories <br />Basement <br />Sq. Ft. <br />Sq. Ft. <br />Signed�y Date <br />`/ .-\\ ^�` ln\ �l. _ <br />For f�� � <br />Owncr Phone <br />DO NOT �VRITE AELOW THIS LTNE - <br />Date Received S�'Z {��"7S� <br />Plan Cheek Number �]5 'ZS�i <br />Valuation �i `L(�ry• -�' <br />Permit Fee �"' O � v� <br />Plan Check Fee � 4• �C, <br />Total Fec Due � 2. �� <br />Datc Issued <br />Use Zone <br />Firc Zonc <br />Occupancy Group <br />Y <br />Type o[ Construction �/ - � <br />Occupant Load <br />Sprinklers Required CITY OF EVGRETT <br />PROVED FOR FUILDING PERMIT <br />Date�Z`� � 7_��_13y K—C <br />