Laserfiche WebLink
�� i3UlLUlNli YP:HMAT Al'YL1CATIM4 ' <br />Applicant To Complete This Furm <br />if tore than one building is'to be constructed, submit a separ.aLc permit <br />application for each building. A separate permit will he issued for each <br />building. ` '9 <br />Owner _-p� S&l �oasoj Building T�dress 2/Dy <br />Address _Fo• 150x rn Lot riloc): <br />City i f ILMlooD Phone 77_fo-1Z�^i Subdivijion (Plat) <br />Architect/Engineer <br />City Phone Metes & Bounds (Unplatted) <br />Contractor gn.- VE Sec. Twp. _ _ RgC. <br />Rddrss -- <br />City Phone Ago hi!�w qt� -- <br />RtatE License Number 723-nt-6A51 - <br />TRACT. 5: <br />Lots 11 and 12, the North 2.0 feet of Lot 10 and that <br />portion of Lot 13 Block 453 lying withi:i the Plat of <br />Garfield, as platted and recorded in Volume y , -age�7 , <br />Records of Snohomish County, Washington. <br />CO •P', .. PLOT PUN Oil REVERSE SM <br />Do rot write Bclow <br />Date Received <br />Yslan Check Numbcr <br />Valuation <br />Pewit Fce <br />'Plan check Fee <br />Total Fee Due <br />Date Issued <br />Number of Stories <br />'Basement <br />New Addition Repair./rCm0dcL <br />Valuation of Construction $ <br />�l8 Q5r7 <br />Signed ny <br />For <br />Owner. Phone <br />y , <br />This Lino -For City Use Oni.y <br />Use Sonc <br />FirQ. Zone <br />' I <br />Occupancy -Group <br />Type of Construction <br />occupant Load <br />�I <br />Spri.nklcrs Required <br />