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;7/3 /17✓ <br />t"•pplicantyT'o Complete <br />This Form i <br />' <br />if more than anc building is to be contrurted,'submit <br />a separate permit applica•- <br />Urin for each building. A separate permit will be issued for each building. <br />. <br />a:mCr iV f.``'_.'�, Ott �a.::�( ---K.�/- <br />Building Address v9''���r. <br />£::dress ?/4 - �� G l.r.. w/• <br />Lot <br />city Fhonew��.��`- <br />— <br />Surr i.vision 2W <br />F .. 7 _ <br />(Plat) <br />s <br />xxChitect/Engineer — /' <c: .��P.+n � •� <br />1 __ ' <br />- <br />City;., .,,��.. Phone;�'�,-_���3bietes <br />- <br />& Bounds (Unj.lattcd) <br />C ) <br />.. <br />C.antractor y74%:y''. -_r.• <br />sec. Twp._t y 12ge-VE_U-:/4, <br />.i� <br />... ! <br />'.City <br />Building Use. .6 J,.J •. ... i <br />re ) <br />state. License Z:u:aber <br />Describe Work to Be -Done' <br />,1 <br />ltz•iration Date <br />.�' <br />S7XTCH PLOT PLi,17 BELOW <br />/.,._. _,'1y�s``�r. <br />, <br />7 `n� <br />Use of Building na.• r� z�! <br />z <br />;•tb'''-:= <br />p Addition ❑ P.epair/Rer..e5el <br />4 <br />Valuation of Construction $ 4,T. <br />. <br />-LOT PLAN REUUT3`.'•'?.:TS <br />i <br />'reet:s, <br />Sndicate lot size, name of. .. <br />•, <br />i^dicate location and :aiahor <br />alloys, `locate zroposed a..d all <br />eristing bcildiags, shoe: distances <br />3 <br />ro property lines, show distances <br />_ <br />bctwccn builcngs. <br />-Lot size _[G 0 x /G 0 <br />.... <br />_ <br />Lot area O [ O (/ So. Ft_ <br />site of Blcg. SR. Xt. . <br />of Stcries <br />_ <br />Darenciit <br />Signed By!G C • /c1 %c t" Lu ,7iL z6L <br />.- <br />•' <br />For"- 7' <br />U or.?none <br />•,���"•' <br />�, DO NOT SQ : Z P.=LO:. L'HIS LINE -Foil CITY USE C':'L•L <br />�—� <br />Date rcr�c ved� z123� %S� <br />me Zone <br />_:u.-bye_ 7`eJs 'JCS <br />Fire: zone 3 <br />_ <br />_ <br />t'a_r.ation �26J7i �_ <br />Occupancy Group <br />rve rtit Fee 3Z. <br />aype of Construction <br />Chcek FCC /4- � y <br />occupant Load <br />dAO_ <br />kc.�. _er- Du:. �$! ._.__ <br />'•;o*-_..,c1.•7+•., Required <br />+. <br />,..CITY OF.EVERETT <br />APPROVED FOR BUILDING PERMIT <br />Date d �_sa1/-1�By {L _ [ . <br />ra <br />