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� . . . � . .. ���.:t <br />1 • DQILDING PERNfZT APFLICATION ��D �:) � �� <br />I • � � lpplicant To Complete This :orm /Tjx ��•'L <br />' Ii more than one buildinq i� to be cantructed, submit a separate permit p¢lica � <br />tlOn for each buildinq. 11 separate permit vill be issued for each building. <br />kx,..1 � � . - _ ,� . . - . <br />Ovner `� i Pc �� c_r , r . Buildinq Address � �>�.' C?< )L'j�i�; �e � � . <br />3ddress to i7oY2 :_z� �/b'2o3 I.ot1,� Block .`J� ' ' <br />� �tyr � ��c � ft Phone Z� 3- `�b' � 3ubdivision (Plat) IS:: 1 i1 L(c / i�� k._ � <br />' nr:; 6 N.�,- . . - <br />, <br />�. Da,_�<<,i <br />� C.ity �� � N o�-; s�• Phone lletes i Hounds (Unplatted) <br />!� Coatractor S i�� o �:., e. � _ Sec. 'h+P• A4e ,~ <br />� • . . . . <br />'' 1lddress Qo Pov z`� -;. -� • ' <br />• ' :. <br />� �ty 1 �•. Phone t; 7• �i o— '� Huildinq Use �.� k'� S� .•:•L i��,...,,- <br />��� w y. �� � . <br />}� State.I.icense Nmnber �, Describe Work to Be Done _ _ <br />, :. <br />�. Lipiration DatE ' � — <br />� � - SEETCEI PLOT PLAN BEIASQ' • . . - .. <br />� ' •: � . � . IIse of Buildinq . <br />__�__, -. _�..__ 1._a ,. , - <br />• • ' . : �: : • �7ew ❑ Addition ❑ Repair/Remociel <br />: . 7 ' i,- . <br />� ' � ' • . . '' • 1:� . ` r • ' Valuation oE Construction S � ' <br />. . . . . ,''. . . � . .:,�: : • ' � . , , PLOT pL11N REQUZREI�SENTS . ' '.: '. <br />• . . , `� ' . . � . . <br />� . ', : � • . � ' . ' Iadicate let size, name of streets, <br />; ' . � '� �indicate location and width of <br />( � . : ;:: • alleys, locate �ronose� and all � <br />`' existing auildiags, show distances <br />.� �'.�, .'-•-..y a-• '� , to property lines, show distances <br />t . ��^ `^ ► : betaeen buildings. <br />� . ' Z�� �`�5Z , . � � . � <br />- bot size x <br />, <br />: <br />� DO NOT Si:2Z <br />Date C�ceived �� �� <br />� �q; i. <br />P1an.Ctieck :7ur.ber 7� <br />Yalnation <br />pemit Fee <br />Plan Check Fec <br />ibta7. Fee Due _ <br />Da[c Issued � <br />Lot area Sq. Ft. <br />Size of Bldg. Sq. Ft. <br />ASumber of Stoties <br />. Basement _ <br />' � �� c.�--� <br />Signed By y�j.`��' ' �� <br />For / ��i., 7-�... <br />Owner Phone 'S J 3 � �f��� <br />THZS LI:IE—POR CITY USE O2iL'L <br />� <br />Dcr Zone <br />Firc Zonc ' � <br />Occunancy Grou� � <br />lype of Construction y -� � _ <br />Oecupant Load <br />Eprinklcrs Required _ <br />. : CITY OF [VERETT . <br />.. � :: APpROVL-D"F.OR'BUILDING PEf2MIT ; <br />, ', '.�Date �.�� 1%:'_+_By,, � �.. <br />.: <br />