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�7�� . <br />. . EOZLDZNG PEAMIT APPLICATION �' . • . �� ,: �,•.•'. �'•?'•+ <br />'. � . . ' . ,.-.,� <br />�pplieant To Complete This -a=m %"' <br />_,'�:;. -: <br />. . j , <br />' fi �ore than one buildinq ie to be contrueted. submit a separate perniit applica- <br />rn <br />� tlpn for each buildinq. ]1 separate permit will be issued for each building. <br />" �; -%''%� lnildinq Address S 7=2r; � r/h.rr� <br />: • � �� �� -�a i, l r.'iF �. - <br />. � . <br />` . ' �Esess ,�-�-��� �,/��ir�vr�- Lo! •�� Elock 00"3 <br />a . <br />; • «� � 4hone..35.5'�5'yCnZ. Subdivision (Plat) � <br />'' �rchitect/Enqineer -S� � � <br />, , �r .a,f ��� � rPhone lletes i Bounds (Unplattedl : <br />- � "i . • . . <br />• . s • Elc. �P• �° <br />:.' Coctzactor . . . • ' , : <br />.., • <br />-. :• , �� lddzess � • ; • s. . <br />� � a� J <br />Phone Lnildinq IIse ' (� �`( _ �lu�i�-�'�!:Q�`•" <br />.' j. ' Desczibe Work to Be Done �' %� g/� �,y� <br />�y� tttte.License Number A ;, <br />.,r r�,��.f-� _7'_l'Lqx t/'i��_ . <br />. . :� . Ltpiration Dat� _ <br />z1: ' � .: �CH PLOT PLAN BEIAW' . • . • ; . <br />'• '.: �• a ti'AdHCMt J7 . 3/��c i � Q�a of Buildinq . <br />/ <br />' . • ONer � 1lddition ❑ Repair/RemoGel� . <br />� i . ' . , �: G�p�,� . <br />, . .,i' - • . . . . . , . • 7alaation of Construction 5 ! Vv�' <br />.` _ . : <br />� • • • ' .. lLOT PLAN REQUIBFStENTS - r; <br />.,.• .: , � . � <br />� ,� ' • ' , .. • • =pdicate lot size, nane of streets, <br />'.'( � • . ' � . .. • , •istdicate location and width of � <br />' •� . alleys, locate pr000sed and all <br />- ' .��. " ' _ ' � .. ' _ = existinq buildings, show distances <br />•�' �' :�,. to property lines, show distances <br />. 1'•� • ..:�.` �'.-•�.+ � -- - . . between buildings. - • ' <br />. . . ! . -- . <br />. . : • . , ' . L�trsize �x �5 U f X 7S �,•, S.E, <br />� � . ro.. ie .�o <br />. a' . ,. � . � Lot area 9S � 54. Ft. <br />..i- . . . ' Size of B�. � �'� " nss�_ 5q. Ft. <br />r; - :'� 8umber of Stories 7 <br />• � ... , . . . Easement <br />�:.., � � . • . �Dv l'� <br />, Y'.:�- Siqned By . <br />�� ;._ : . � � � ror � C-CCC�r.t i�v�ti � <br />. . : , � � . . . . Wner Phone 3 � ��_ b 9°� �, <br />_� .� DO NO'" S�ZITS H�LOt9 THIS LI:7E-FOR CITY USE ORL�! - <br />�. — Date �eceived S � � ' U='e Zone . � <br />' Plan.CSeck :7urber �' "Z7'� Fire Zone <br />Yalnation � �� � Occuoancy Grou� <br />� Type of Construction <br />: , Pemit Fee 4�T, � � - • <br />• ' Z Occupant Load <br />� ' ll�n Check Fee , <br />� Sbtal Fee Due Z' `` Sprinklers Required ' <br />' �' • � CITY OF ,[VERETT • <br />• Date Issued ' � . '; APPRUVED FOf� �U4LDINQ PGRMIT: : ' ,. <br />"• � �,���' .. ' . ', •i_W�r_ , _,Ry'. ---•-'_ . .-� <br />