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.... � , b . i�.iL <br />� ' � BOILDING PERMIT APPLICATION � � � ' � .. /i �/�;�C� <br />, : 7�pplicant To Complete This ?orm ' � ( � . , � <br />, !f more than onc buii.dinq is to be contructed, submit a separate permit applica- �/ <br />-� tion for each buildinq. .1 separate permit will be issued for each building. �?S ' <br />�� Ovner �� D V,G� 'i� � l h• ;} Y Buildinq Address �,�! i> '� - <br />e <br />* . .. <br />.; <br />•:. •: <br />. -- <br />� •: <br />. y <br />0 <br />Ilddress % �� � ,'� �.- i / ' <br />_ ) ��� ��.� Lot�� �I�� _ Hlock . <br />City � �t �� �� (; ;�• '�^ Phone ?,Ss¢7l�/ Subdivision (Plat) � '� . <br />Architect/Engineer � j- - .�_/ �,� � n �I_ � . <br />� ; r ��; . -� '. i . <br />City Phone Metes 6 Bounds (Unplatted) <br />Coutractor _ ��-� � _ Sec. 1tep. gye .. <br />Bddress . . <br />�tY _,___ Phone <br />State.Lirense Nuvber <br />Ezpiratioa Dat� <br />, � SRETCH PLOT PLACI BELOW' • <br />' • <br />�j , ��n✓/�l„ l'��, •Nf;;:'~�✓_"l� . <br />-., �/c�-�'�C ��c /: <br />��,�-�,c� ,,2D�� . . • ; : <br />� <br />...-. �• r. .a . <br />e <br />0 <br />r, <br />Bc3lding Use !! ,:, r,%.> p � �a ' <br />, -�; <br />Describe Work to Be Oone p,'�/ � � �`��' � <br />�r'urr�/h:� ��rr��<lin � 41' 1(�f-"r �� <br />. • , �-�� <br />l= i/FI" !�h =wit-;='i+ r, �:,�� 1�tJly�'!� <br />� , � � .i <br />IIse of Building ,(�.(_�c� � -' ,i�� <. ' <br />�New � Addition ❑ Repair/Remofiel <br />'Valuation of Construction $ S d`d,"-`'� <br />. . PIAT PLAN REQUI?2E?tE.ITS <br />T_ndicate lot size, na�e of streets, <br />�indicate locaticn and width of <br />alleys, locate proocsed and al'1 <br />� Existing buildings, show distances <br />• to property lines, show distar.ces <br />betaeen buildings. <br />Lot size /Z '_x � % ;') . <br />•, Lot azea �� CJ /j � Sq. Ft. <br />Size of Bldq. /�^— Sq. Ft. <br />ISumber of Stories <br />Basement / <br />Signed By <br />/ "�— <br />�Gr % .�N/rr'J � /n /1 ' �7iil/%-�G'(! <br />�wner + Phone 3;; ,,_ y7��' <br />� DO NOT F:2ZT� BELOt�I iHIS LI:7E-FOR CITY USE Oi7L'L <br />Date �eceived S�'7/']S� � Ute Zonc <br />� _ <br />P1an�Check :lur.,ber 75 -/L'ZI Fize zone ' - <br />Valuation j� '9 v � <br />�-` ���d Occuoancy Group _� <br />Feznit Fee —J `� �� � --� <br />� 5�-• Type ef Construction _1 - i-; _ <br />�Plan Check Fee 2� � Occupant Load <br />1bta1 Fee Due �CJ. �`� Sprinklers Required <br />Date issued 5�/Z�7� '... . CITY OF EVFkETT <br />. . . � ..: APP.iZOVED..FOR F3UILDINfa P[RMIT, <br />Date--- ';' __--�y_i— _�_ - <br />