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, • � - UUILLJ.rvI� rricril�r �u•ra,i�n•�.v�r � , <br />� ' . .'IPp.licant To Compl.eL•e 7.'l�is 1'or.m �f ��� �� ! , <br />/ rp%J�": <br />� K• if n�:e than one bui.ldi.ng i��to be con�iructed, �ubinit a scpar.�ite per.mi.t <br />npPli�•�tion for each building. A sep<iral•e per.mi.L• wi.11 bc i�sneci f:or , 1 <br />building. ' . S'/��� <br />Owner '�.�ri� ��( A� _ IIu•ilding Addres� �.���%U "'�-.j �ve Lf�' <br />�ddr..ss � �o� � r.'c�C'_ Lot � 131oc1: �_ <br />City �yeF{f� rlione�J",'-µ237 Subdivisiws (Plat) ���p �Q�2PS <br />Architect/�ngincer XMPRP55/oN (�P�,v A�� . <br />City Ev[rE'% Phone .5'3 s 3z0U Metes & 13ounds (Unplat-Ced) <br />Contractor fs�a�� ,�n.r�Ps Sec:_ T�.�p, r��., <br />na4�..�s izv GL._ci�� P,v A!/E ' — <br />City ��i p �� � Phone '-?_37-8�l3 D • y , <br />. State License Number 2�3-0 /-/S33 z • <br />Er.pi_ation Date �-3 —7 � ' � <br />e <br />C0;•�_T.�._""_�. FI,6? pLG17 0:1 HES'F,'!�'-,E SII)L <br />0 <br />Do t'ot [•!ri <br />� <br />Duilding Usc _ '�pS ' <br />Describe 19or.1: to Be Done <br />��� NPr,� �e s <br />Tumber oi Stories 'Z <br />Ba�ement �s ' <br />' ec•r Addition .Repai_r./P.emodel' <br />• VaZuation of Con�t�uction $SSoGO== <br />Signed IIY ��/,��.�,v✓f'�"''� <br />. . For {i�a ,�r ��/ o !fY p 5 <br />� Ot+�ner • Phone 33�- 930 <br />9 <br />�lo�•: 'Phi , Li.ne •Fc <br />Datc Seceived �:/2(o�jC,< . . . .. — <br />. <br />1.flanC:eck t�umber 7lo-2/Ti' . <br />Valuation 'S 5 E�D� "� • . <br />Perr:t ree /9�%,. � o <br />Plan Check Fee S� <br />Tnl•al Pee Due �. <br />Aatc Is�ued <br />CiLy Usc <br />Use Sone 5 �i ��,� ,�; S <br />rir<: 7,onc 3 <br />Occtipancy -Group I <br />Type of ConcL•r.uction � •N _� • <br />Occupant Load _� <br />Sprinl:lers Requir.ed <br />CITY OF EVERFTT • <br />' APPROVED �FOR EUIL'LJING PERh11T ' <br />, • �t2 �- ' b BY�—.�.�..� .. <br />: <br />. .. . <br />.. � - . .,.'--- -- <br />� � <br />- �-.. <br />� <br />i <br />