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I <br />BUILDING PERMIT APPLICATION <br />Applicant To Complete This ?orm/� <br />If more than one building is to be contructed, submit a seoarate permit appl-za— <br />tion for each building. A separate permit 9 will be issued for each building. <br />Owner �IrLL I AP.A K Z (Fh R _ Building Address <br />Address 7r;/7 F'_ � a� Lot ') ice,/� Block <br />City CVECF-'" PhoneR$ <br />/� Subdivision (Plat) r <br />'y�Q"�S <br />r <br />Architect/Engineer 130LG,!7 li J ;iLH Ca. / r <br />City /GnrPhone Sol Metes s Bounds (Unplatted) <br />Contractor M G'. rr of L Cwr: sT• Sec. Twp. Rge <br />Address <br />City %'�,. :cr_ C�.nr Phone r)9R1-7VF3 Building Use <br />State License Number - ,1 3-6 ' • '? �/ .'_ Describe work to Be Done <br />Expiration Date <br />SKETCH PLOT PLAN BELOW <br />q id \A/A t_ <br />I <br />O <br />G <br />N, <br />I <br />NCk+ IUN/1 <br />7 L yIj? <br />I <br />i <br />PHRk�^r�' <br />C'ND'!R <br />Use of Building I/ <br />(-L1New ❑ Addition ❑ Repair/Remodel. <br />Valuation of Construction $ 7.1 t <br />I <br />PLOT PLAN REQUIREMENTS <br />• Indicate lot size, name of streets, <br />indicate location and width of <br />alleys, locate proposed and all <br />existing buildings, show distances <br />to property lines, show distances <br />• between buildings. <br />Lot size 90 _x_ % % _ <br />Lot area �_ / 6 O Sq. Ft. <br />Size of Bldg. /. / ? Sq. Ft. <br />Number of Stogies / <br />EX�Basemont P� jO'X 7' <br />I �S7" C'- <br />G <br />Signed BY <br />For I <br />Owner Phone V 91/- 98 d <br />DO NOT 61TE BELOW THIS LINE -FOR CITY USE ONLY <br />Date Ycceived &) — Uc.e Zone c::: J— Y✓f �7 L_ <br />Plan Check :lumber % y-/•_ Z Fire Zone �!r <br />r <br />Valuation 4, �7) <br />Permit Fee �)✓ <br />Plan Check Fee <br />Total Fee Due <br />Date Issued <br />Occupancy Group <br />Type of Construction 'I V- <br />Occupant Load <br />Sprinklers Required v G <br />CITY OF EVERETI: <br />APPROVED FOR BUILDING PERMIT <br />Date 1 *4-- 13`l --4 t — <br />