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_• - - ,G_1�DILDING PERMIT APPLICATI&, <br />�npPlicant To Complete This ?o41 ,•d <br />If more than one building is to be contructed, submit a separate is <br />tion for each building.P Permit building. <br />a - <br />A separate permit will be issued for each building. <br />Owner (} (� h��J Building Address Y- i 2 J - (,mot. 1Fw [i2 <br />n <br />Block O e) r e r <br />City f�,iPQL.o7'1—Phone ( - IF51subdivision (Plat) <br />Architect/Engineer ' <br />City ----Phone Metes a Bounds (Unplatted) <br />Contractor Qa-i JLJ02Y A',er, ff;' Sec.__ Twp. Rge <br />Address 6 //u - ) <br />city d Phone Building Use <br />State License Number .�_� 7 Q J 'jd[. O Describe Work to Be Done •' <br />Expiration Date <br />SKI <br />T7 <br />• <br />1. <br />PLOT PLAN BELOW <br />Use of Building ,f o <br />�7New ❑ Addition ❑ Repair/Remodel <br />Valuation of Construction $ , e �-- <br />o` <br />PLOT PLAN REQUIREMENT$ <br />Indicate lot size, name of streets, <br />indicate lo-ation 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 x <br />Lot area Sq. Ft. <br />Size of Bldg. So. Ft. <br />Number o£ Stories <br />Basement <br />fl Signed jjBy t/q A.(�f! <br />For nE Ste{ hone �7 •t/ <br />DO NOT WRITE BELOW THIS LINE -FOR CITY USE ONLY <br />Date Received U-e Zone <br />P1an.Check :lumber Fire Zone <br />Valuation Occupancy Group <br />Permit Fee Type of Constructions_ <br />Plan Check Fee Occupant Load ILM <br />Total Fee Due Sprinklers Required <br />Date Issued CITY OF EVERETT <br />Inspection Dept., <br />