Laserfiche WebLink
g• �• <br />, • DUILDING PERMIT APPI,ICI�TION • . ��o �-� / " � • <br />' nPP�icanL• To Compl.etc 7`his Por.m ��k ' ��/�� <br />If moze than on^_ bu'_lding i,'to be const.rucl;cd, submit• a separ.it•e rer.mi.t <br />applicaL•ion fur cacli building. A separstc perntiL• aii.11 be i�: ucd for. cach • <br />building. , , <br />"� v1� <br />Owner .: ;;'�'r l'G��w � ry�,.,�- ��ti�.c. . IIuilding Address '�'3 5 j5 � l�L .-`�� <br />naar��s ,;< i J f �c�r.i!��,�--�j_:�. Lot �;C O I31oc1; <br />City ����fa`' c�-,-,. Phone ,;� ,5�; - ila=� SubQiyision (Plat) • <br />Architcct/Engineer „-��t �u��-r� C�1���%.�-�.<-/ '. <br />City Phone Metes & IIounds (UnplatL•�cl) <br />Contr�etor .��y�,c, c-.. �t-l�=,-c-�- See. � C� Ta�p. ��_ 12ge. cf .•. <br />Addr�ss <br />City Phone <br />State License 13umber �;L��_!r;'-�� �67/ <br />Er.piration Date r/"<'/y� <br />.. —T ' � <br />COhP"�== PLOT PLAid O:r' RFV�RSE SID;. <br />� <br />�ll1�.C�111� USC � � � <br />Describz t•Tor}: to e llone <br />Number of Stories �r-,�-c� <br />� Basement <br />. . .. �— <br />21 a Addition Repa�r./12er�odel' <br />Valuation of Con�t-�uclion $ <br />Signed IIy / . /i,'�� - (' �.-� <br />/J T ' �, <br />. • F'Ol' � <br />. / i �%�—r.�� � � ��a�if9 <br />OWn�i <br />PhOI � y �� ` `" <br />Do rot T•:ritc Below Thi.s Linc -F'or Ci <br />Datc Reccived <br />l�.an C�ec}: Number <br />Valu�tion � <br />Perr�it Fee <br />Plan C]iecK I'ee <br />Tot�l 1'ec llue <br />4 <br />Date IJJ��e� <br />z, 7 y...... _ <br />7 �v-- %7/ ' • <br />�� Use Sone <br />Firr. 2one <br />Use Onl <br />Occupancy •Group ,1- <br />Typc of Construction u- �-f ' <br />Occupant Load <br />Sprinl:lers Required <br />CITY OF [VERETT <br />• : APPROVED F�CJR GUILUING PERMIT <br />Dato��/ Z� gy I�, ;_ <br />