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.. <br />� - � HIIILDINC P£RMIT APPLICATION � /} ' , <br />t <br />- � , Applieant To Complete This ^•orm / / � oc`;� <br />� 2f more ihan one buildinq is to be contructed, submit a separate permit appl����/� � <br />.. tion for each building. �l separe.te permit will be issued for each 5uilding. <br />� j _ �. �., <br />. . Owner �.. � �i i� _ Buildinq Address ' � ' � ' `� <br />hddress � 7 ���' �� Lot Block � <br />City / "� Phone =?� r,6�j5�� Subdivision (Plat) • <br />Architect/Engineer ��,��r//�,(�. _ <br />City Phone Hetes 6 Bounds (Unplatted) � <br />�-s — <br />Contractor _ }�.'"���' ,��� Sec. Twp. Rge � <br />� • <br />Address <br />� <br />� <br />City Phone _ Buildinq Use � •;.��. <br />SWte. License Number ,_���7.-(��—�PS�Describe Work t� Be Done �`� , <br />f � <br />Expiration Dat� � ;.�''�7 --7C ' �tCa'� / (fi✓� 4� �Ctf'� <br />• SRETCH PLOT PLe1N B£LOW <br />, ' i <br />�...- �' � � Y'�� <br />. !� -- <br />� ` - <br />. .' .i' ��I_ - <br />'1 3•.1 \ I .. . <br />, 1 . :l ' ,-0 r - �! <br />� , �i <br />Date received <br />� IIse of ➢uilding � <br />�„ •. . ,� BNew ❑ Addition ❑ Repair/Remdel <br />. . � " Valuation of Construction $ �� � Lr`£C-' �� <br />, ' �^ � , P7AT PL11N REQUZ?tES1ENTS . - . <br />� � <br />Plan c:�eck :tur.,bcr. 7'�'-25�J ' <br />valuation 'Z �'� DC�!0 • 6� <br />Pernit�Fee � � �� � <br />Plan Check Fce lDC"i• � �� <br />. Yotal Fee Due <br />/�/• � <br />. Date Issued ._. __•(D �_lc'� <br />�— <br />Indicate lot size, name of stzeets, <br />indicate location ar.d width of <br />a7.leys, locatc pro?osed a:d all <br />existing buildi:as, sho�.� distances <br />to property lines, siow distances <br />betxeen 6uildings. <br />Lot size x_ <br />Lot area <br />Size of 91cg. <br />Numbcr ot Sto ies� <br />Basement <br />Signed By + <br />F7 <br />For <br />Ocaner Phone <br />;-POR CITY OSo Oi7L7 <br />Ucc� 2one /�J'—� <br />Fire Zonc <br />Occuoancy Gzou� <br />Sq. Ft. <br />Sa. Ft. <br />Type of Construction \j_ I-_� . <br />Occupaut Load <br />�prinY,ldr� Req�ired <br />� ` CITY OF EVEf2ETT <br />APPROVED fOR BUILDING PERPoiI T <br />D,�tc . - �= -- �`% '-�-_ � _ <br />