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• <br />DILDII7G PEIL•1IT <br />U <br />APPLICATION <br />Applicant To Complete <br />This Form �•Li•` •y <br />' <br />If tore then one building is to be contracted, <br />submit a separate permit applica- <br />tion for each bU11d121g. A separate permit <br />will be issued for cacti building. <br />• owner %' c• c oz wo rrQ n <br />Building Address /Cf D J� Cc','/ <br />jddress / r{ a-,- toe / n <br />Lot /.io..d /`/ Block �c/ S . <br />•. • ' <br />city Phone :15`7-'.5 �9 <br />Subdi4ision (Plat) 5ci .,7 a S NI'C x/a... <br />Architect/Engineer <br />i �._e% i <br />I <br />• 1• -.r, <br />City Phone <br />Hates L Bounds (Unplattcd) <br />- <br />`' ' <br />•*'k-H. CONSTRUCI,...•• <br />Contractor <br />Sec. Twp• Rge <br />i• <br />Eddzess F.•Ln'tt•WAON-' <br />;.:. <br />l <br />City Phone 3 3w 3Cj 2 <br />�e <br />.'• <br />Building Use-77 <br />i <br />1 �3-0/- l/-�( Co- <br />�V.'i C/ <br />r Describe[work to Bc Done <br />ri <br />State, License 11=ber <br />:) <br />grpiration Date <br />t,1: <br />SKETCH PLOT PL�1 BELOW* <br />J ` " -`n`y <br />_• <br />•• <br />Use of Building <br />- <br />• ❑New ❑ Addition 0 Repair/Remo- <br />Valuation of Construction <br />•�' <br />.. •. •. I <br />PLOT PLA.*7 REQUZP.y�'�NTS <br />y <br />' <br />IDdieatc lot size, name of .tracts. <br />•-i <br />- •' . <br />- •indicate location and width of <br />I.Y• <br />alleys, locate procosed and all <br />existing buildings, shew distarc� <br />l.; <br />.: `�CJ :�'i• ••�! % <br />to property lines, show distances <br />_ <br />between buildings. <br />Lot size X <br />• . <br />1 �j � ). ! ► <br />Sq. Ft. <br />- <br />•�; �.v. iJJ <br />. Lot area <br />Sq. Ft. <br />.=.t. <br />- r1;,c-�^ <br />r ... p '�';, , , s. +�• ' <br />Size of Bldg. _ <br />Number of Stories <br />Basement <br />EVERETT' <br />CITY OF <br />BUILDING .PERMIT <br />Signed By�n���" <br />APPROVED FOR <br />; <br />1: <br />•,' <br />BY <br />For C r<<� 4�rr P.n <br />Ocr r Phone <br />pate <br />• <br />DO NOT IMITL' SE1.00 THIS <br />LINE-F03 CITY USE Oi7LY ` <br />Data=eeived _ <br />Ula•Zone <br />Plan Check ,N=ber <br />Fire Zone <br />Valuation <br />Occupancy Group <br />Peron Fee <br />Type of Construction <br />• <br />Plan Check Fee <br />Occupant Load <br />Total Fee Due <br />Sprinklers Required <br />Date Issued <br />