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<br /> „ . . ` . , • . . nOILDING PERMIT APPLICATION , ��"_ / ,J�� ^;�• �:.1
<br /> : xpplieant To Complete This :orm � j �J ,/ •:;r'
<br /> " .. . i � • . �� ' /��j�G=
<br /> . • ' if more than one buildinq is to he c<<itructed, submit n sepazate permit applica-
<br /> � , , tiop for each huildin3. �l separate permit will be issued for each building.
<br /> , � " ' Qrpc.�:r c �, fOC14T19�CTI0N INC. _ Stlildinq Address
<br /> �JdJll� ��`. 3 ��I•zW�_9i`,�
<br /> ' . iddrese PO E�X 2157 �. Lot t� B2ock
<br /> � �� EveretC, wasl�. phone �5� ��r'�'�' Subdi4ision (Platj �,r�mada Seav{ew Estr;Ces ,� .
<br /> - ' • �rehiteet/Engineez SR Freal Co_ ' � �
<br /> • �, "� City r��F.RF.TT • Phcne ?5' 3500 Kebes i Bounds {Unplatted) _, _
<br /> _ . .�f . � Tnr. � SQC. �• j�0 . .
<br /> � . .t' (�.011tIdCtOI R S' T !` - r r;nn . . . . .
<br /> �..j . . .
<br /> -• , eddzess PO Box 2157
<br /> �
<br /> • 252 6uGG Suilding Use �esidr_ntial . ''`;•;:g�;:..,.,.
<br /> •� �tY Evcrert Phone , . �;
<br /> •li . .. . . . ..:.F r•
<br /> �'r� State,License Ncmber ?� nl tn�i5'i Describe Work to Be Done
<br /> � . -� "� gipiration Da�.r _
<br /> �� � � ' � • SRETCkl 1LOT PLA.H BELOS�T' ' �� . , • � �
<br /> ' : , , : j • ���__� ���/. • ... .., , � Dsx of Building .
<br /> . ---�_�_ ' -
<br /> � - - • . -��: � �New ❑ Additi on ❑ Repair/Remo�el
<br /> �• : ._ , '- ;' ..
<br /> ,i • �, �• ' paluation of Constr��ction $45,000.00
<br /> . . . � ,. ,� . � � . . .
<br /> 's � • • � � ' . � . PI.OT P:.AN REQUI?t&�IENTS :
<br /> . .
<br /> .. • F-. ` . .
<br /> ,�,.• . ! � . �.... . � �
<br /> ...
<br /> . � �(� ' . . Sndica`_e let =i�e, nar..e of street�.
<br /> , i . . _
<br /> .• � � •indi.cate locat�on anfl width of
<br /> � ! � . _ ._ ;'. � ,- _ ' ,- � alleys, locate pr000sed ar.d all
<br /> . � ;. •• . y��' . existing buildiags, sho:a distances
<br /> : � _ ._ y . : �. .,�+� . . to property lines, show distances
<br /> . , . ; .1 betveen buildings. .
<br /> . _ ; . - . j . _. G; �
<br /> ' .L • , ;' yot size 81.30x1�i[+.02x86.O1x10�.98
<br /> - �f j � _—. .' . . � ��.f . . .
<br /> . Lot atea /�/''"�' � Sa. Ft.
<br /> . • '`: `j� �-- . �- ____ � /'� \ � Size of Bldq. 1580
<br /> .sr. � - � Number of Stories t
<br /> :. , ' J 1' . Basement � --
<br /> .
<br /> • • '•: � •_i� � ,.� � • � � � � -
<br /> . . � , _ - V� r Signed By --. . ,. . i ,,.
<br /> '� � � . . . . � � F ,c� �
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<br /> s ri , For ;�� J7S�' -%/"�✓
<br /> . _ ry`
<br /> � '-'--'Owner Phone � +__ �-_GL�C^T;
<br /> , _ _. . ._ ..�/ �J . --� - ,__ � . . :
<br /> • DO :IOT tiZ?Tfi 9=L0['I iHI� LZ:dE-POR CITY JSE OiIL'1 '
<br /> . " . — ' . , . II�e Zone �� 5 �«.iry�,;A/� �� , .
<br /> Date Seceived � �''
<br /> ' Plan C:�eck, :7i:rber 7�!"�%`�_ ' Fire Zonc �� �
<br /> , ";�
<br /> Valnation '����i�'-� � ' � Occuoancy Grou�
<br /> ' `�" Type of Construction � '
<br /> Pexnit Fee < <i�• ' --- .
<br /> <,-L�:
<br /> Ylan Check Fee ��� '` _ �cupant Load
<br /> � Sbtal Fee Due Sprinklers Reqaired • _
<br /> � , . . '.;;i 1' �J;= E'J�R�TT .
<br /> Datc Issucd , F,f�,^-RJ:''i•D•FOf� GU'CI?I'�G PERMIT .
<br /> . . .. ' � Date!---3y `-=r-=�---- -
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