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<br /> _ ' ; ' � BQILDING PERMIT APPLICATION '�t � ' '��
<br /> . : ' , , J1pp11canC To Complete This ^orm I � ] ��':
<br /> ' I! morc than one buildinq is to be contructed, submit a separate per.nit applica- ���
<br /> � � . . tion for each buildin3. �1 separate permit will be issued for each b�ilding.
<br /> " � Ormer ��„�,� .j�_ Suilding Address 2, b� � �y,L,,,_ C....ti./- :
<br /> , 7lddress 24.7 3 ?/,.:,_.. 1��." �t � o Slock 2— •
<br /> # City �k{ Phone�,5p •go �v Subdivision (Plat) � : _ � : (,/-� �
<br /> � � • Lrchitect/Engineer � •
<br /> : _ _ `.':� City Phone Metes i Hounds (Unplatted) �
<br /> . � � � :,� Crntzactor O._,.�.i Sec. 74p. Rge �
<br /> . . ' Ec:dress `—' . •
<br /> ' City Phone �- Buildin7 Use '•;:• �
<br /> t , :.
<br /> � � ��i � State License Nur�ber _ Describe Work to Be Done [�t,.,,,,_�( . ��_ �
<br /> , . . ��-
<br /> : �i Lzpization Dat� � ���. �;;,/ _ (t �,X,���f �,�'
<br /> :� ' � � SI�TCH PLOT PLe1N BELOW� • _��•+���+✓'� -
<br /> . ' ' j . ' • ,
<br /> � IIse of Building
<br /> ' 1 .
<br /> � � . . .' . , . ONew � Addition � Repair/RemoSel
<br /> . ' . ' . . � _ • � 'Valuation of Construction $ �Z pOQ.pO ��
<br /> -....• � � .. � . , • ^ PIAT PLAN REQUZ?i&+IE:ITS .
<br /> + - .
<br /> . •
<br /> � � . ' � � , Zndicate lot size, nane of streats,
<br /> � � ! � • � � �indicate location anc •aidth of .
<br /> � . t � �, ., . • �� . � alleys, locate aroposed a.^.d all � -
<br /> . � `'�1 . . existing buildiags, sho:a 3istances
<br /> . � , ; �'� - . .' � �• -- •� � . ��� _ .. _ . to property lines, show distances
<br /> , • � ' • betwecn buildin3s.
<br /> � • � Lot size x
<br /> f .•- ` , Lot area Sq. Ft.
<br /> ., - . • Size of Bldg. Sq. Ft.
<br /> ' � � • Number of Stories
<br /> . ; . i � , Basement
<br /> :.. • .
<br /> `. '_. Signed By Q< ' - . �.�,,.� _ 259-L43G
<br /> • �. For �:_� �ll�
<br /> � . Owner Phone q p 3- �a 7> •
<br /> ' DO NOT I•:Z?T� H=LOI9 THZS LI:dE-POR CITY USE 02IL'!
<br /> Date �eceived �7 �' Uce 2one
<br /> ' Plan C:icc� ::u.:,Scr � 5� "Z�� ' Fire Zonc y' '
<br /> Valaation � 2.� �'iw � �� Occunancy Grou� i - J �
<br /> (9 L '
<br /> Petnit Fee L��• Type of Construction V. � 1-1•
<br /> C
<br /> Plan Check Fee 3�- � _ Occopant Load '
<br /> . C;C., _
<br /> ' 1bta1 Pce Due �0� SprtnJ:lers Required
<br /> ' Dace �ssued , � � • CITY OF EVERETT
<br /> � . � APPROVED FOR 6UILDING PERMIT
<br /> . o�t�__���_L.�a'__ �Y�_f�S., .
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