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• , � • IsU�tLDzt�c rr•.nrti�r nrrLrcn��zoia � � ': <br />. , _ , . . . Applicant To Compl.ei:c '�lii.s T'orm � , . . <br />If tn�:e than one bui.ldi:ng i.^,'L•u be constructed, �ubmit a�separ.at•e rer.nii.� <br />' application for cach buildin�Y. A �eparate p��r.miL• wi.l� bc issucd Por cach <br />buil�ing. . . <br />' Owncr `�� �.Luloasal _' '••-. .Duilding Address f%;-3 `�r'o S�� Sy` • <br />naaZo�S �o. -�x rrZ , s.ot <br />731ocr <br />r.ity LY}iuwoo� Phone 77(e-1Z�X. Subdiyision (Plat) • � <br />Azahitect/Engincer . , , <br />City Phone Mef:e� & I3ounds (OnplatLecl) <br />Contzacl•or Q��Z Sec. � T��.p• ):gr. - <br />Rddr:-ss ' <br />City Phone '. •hL� brrey�{5p <br />.State Licease Number � �i � <br />. �Z3-o1-685J . <br />• Er.pin_tion Date 3- �-'7(0 <br />TRACT 4: • - <br />Lot 9, the North 14.0 feet nf Lut 8 and Lhe South 23.0 � <br />feet of Lot 10 Block h53 Gai•field Second Addition to <br />Everett, as ;�latted aiid recoi•ded in Vo]umeS o[' Plats, � <br />Page� l, Records of Snohouii:;h Coiu�ty, Washington. � <br />� - . � . . � . . � �vUmaer c�i aLur1�5 "I <br />, � • _ . •Basement: ' <br />� : . : � "` • Net•� ' Addition .RepaS.r./P.emodel' <br />',. . • • • <br />• • - . - , ' . Valuatiou of Construction $ ' <br />�. . .. � �38,25a -� <br />� _ ' . ; ' Signed DY ��.-�v �l�s��in��..�� <br />.'' . For � � ' <br />. � ' � . . Owner. • Phone � <br />��i'. • . :' . . :.� .. ' ' , .. . <br />' ' Do ?�ot S•7ritc IIelow 'Phi . Line •For City Use Only ' <br />; �Datc Received " " ' • . ' Use Sone ' • <br />;� lslan Check Number ' • � . Firi: Zone <br />�..Yaluation � ' • Occupancy •Group � • <br />. Pemit I'ee • . Type of Conctruction ' <br />' 'I'lan Check F'ee Occupant Lo.�d <br />Totsl Fee Aue Sprinlcicrs Required <br />. Datc Ts�ucd • ' ' '. <br />.Y • , . • ... ' , .� .. ,� , .' . . :,, <br />