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� . . �. <br />• DUILDING PIiRMIT APPLICI�TION • i' 7� • <br />, • �1�' _ <br />•� • • ]1��1ic�lnt• To Compl.eLe 'rhi , 1 orm 3G7 i�, <br />If moze than one bui.lding is'to be construct�ed, submit a separ.ate �j,�.er.m�t <br />applicat•ion for eacli Uuilding. A separaL•e liei�uiL• �•�i.11 he is�ued fo.r, eacli <br />buil�ing. <br />OMmer �!� l'_- �ti-flH ��-�.�. �O�If.uilding Addi•css 1/E� .S� �G�/ S� �f�. <br />�-�1�� <br />CA <br />naar��s .; �i ; 3 ,���-c����,��- �. Lot ,� 5� _ I31oc1: <br />City C"�cr-r�'' Phw�e ,�9=/.2�� Subd'vision (Plat) • <br />Archi�ect/Enr,ineer �,�v. f,��,�--�� l�f�����.,.�-1 • <br />City '.'hone Metes & Bow�ds (Unplattecl) <br />Contr�ct•o � �,�. �,,, ��'��-� _ Sec. � � Tcap. �_ Rg�. J .. <br />Address <br />City Phone <br />State License humber�;s'�;�-d/ -/N�?/ <br />Er.pis�tion Date ��S'�7� _ <br />Building Usc '' ��• <br />Describe T•:or}: to Be Done <br />COIFT�__ PI.OT PLAY1 0� REV�RSE SIDu <br />Number of Stories r.--,�� <br />• ' Basement liJ�.�/ <br />' . ' ' ' " eh� Addition .Repaxr./Rer,�adel' <br />. � . Valuation of Construct•ion $ <br />d <br />• - S:igned By� "��� ��r «�✓ ��- <br />/ <br />. FUr i �o�,— �—% �—_-�7'i� — <br />Owner _'J Phof�e�S �i �,�� �. <br />�• Do rot S�;rite Uelo�a Thie Li.nc -I'or City Use Only � <br />` Date Receivcd �Z v � ' ' ' ' � ' " �� Use Sone ` • <br />Islan C�ecl: Number '% �-._/7� ' • Firc: 2one � <br />Valuetion � ' • Occupancy•Group — <br />Pernit Fee • . Type of Co�lsi:ruction �- i-, ' <br />Plan Check Fee ' � • Occupant Load <br />Total Pec lluc i Sprinlcicrs Required <br />Datc Issued • , <br />� , . CITY QF EVEREI'T <br />' � , ' . APPROVED FOR 6UILDING P�ftPAIT <br />, . . . • � � <br />, • bnte >'; � / ..By ` ` . . � <br />