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� � DOILDING PERMIT APPLICATION � � p /��� <br />' , )pplicant To Completc This :arm � /�F�••� <br />i� m.e than one building is to be contructed, submic r..e arate ��/��/J' <br />� p permit applic�- <br />, f:ton ior each 6uildinq. A separate permit will be issuect far each bu.ildina. <br />�' �'ner , Buildin, Address : <br />.� , lP.3resa _ Lot • Hlock � �—^ <br />City Phone Sub3ivision (Plat) � . <br />� � Nohitect/Enyineer � � • .- <br />. _. ":� City �_phone Yetes S Baunds (Un�latted) � <br />� � Contractor ' Sec. <br />. . , -- --- �'. Rge <br />� �ddsess • • . <br />'. CitY Phone Huilding Use =�•;_�' <br />�; �"_ • - <br />��_- �yj ^atate License Na�ber �- -- � �-� Describe hork to Be Done -^��` . <br />~ : � ,I Lr�iration Dat� - " ' � � � � � • <br />'-�' �- � SRETCH PLOT PLALI BELOfJ� • ' ' <br />- ' ' — <br />, ' I . • . <br />IIse of Buildi.ng ' <br />. ; 1 „1 . � <br />� I�., � • . ". _ . . . . - ' �i'.Jew ❑ Addition Q Repair/Remocel - <br />. . , : <br />� � �; � � • � . - � Vuluztion of Construction $ �� � � <br />� . <br />'�`�.� � �. ' �t . � . . _ ` , , 1PIAT PLAN REQUIR&�SE:ITS � . <br />. .'. �- - ' . ' ' - <br />'' - - Indicate lot �ize, name oc streets, <br />� i -� � . . ' � �indicate location and width o: <br />:.� .'. .' I � alleys, locate nronosed and all � .. <br />��'.al existing buildings, show distances <br />• �� 'j' "' � � _ to property lines, show distances <br />� I � betvreen buildinqs. <br />- u, . <br />� � � ' . ' ' , rAt u120 X <br />--' ` � . Lot area Sq. Ft. <br />�• r.. - � ' Sizc of Bldg. � Sa. Ft. <br />' , • Nvmher of Stories <br />• : ; - �asement — <br />.:. <br />� _� Szgned Hy <br />3 <br />' • For <br />� Owner Phone -2.,13 <br />DO NOl^ KZIT� 9:LOi�] TNIS LI:1£-cOR CITY USE qiiLY <br />Date S�ceived [J_� LCj,� :7�'� Dce Zon� ;�_Z <br />—7—r - <br />' Plan C:�eck :rur..ber % S� ZQ( _ Fire Zonc y' <br />Valuation 5C; (�` !%. f �� Occuoancy Group h\ <br />Per�it Fee /�� % Q C� 4ype of Construction <br />V - h-1 <br />�� �' � Oecupant Load <br />. Flan Check Fee / �. �. _ <br />' Sbtal Fee Due Sprinklers Reauired <br />Date ie,sued " ` CITY ��F-[VERETT <br />' ` . . � , � APPP,�VED FOR L3UILDI��G PERhlll <br />' • '. Pato-- �� l_/ 11 E�y }�. C_�_ <br />