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<br /> � � . . . • DOSLDING PERM! p APPLICATIOC: . . . •�. . f .,� �
<br /> �plicant Ta Corz, .lete This .arm � ''��' •?•Yj '
<br /> i ' ° • . . ' . .
<br /> � Y! more hhan one building is to 6e cantructed, ,ubmit a ser,araL•e permit a �
<br /> tion for each buildinq. A separate permit will be issued for each building,ic�- .
<br /> • • ; . �e= -����^� �/�'n �`_ Huildinq Address 9
<br /> ' . a �aaresg ._.L�/ io T�{ ,v,,,: ._; :
<br /> . _�'a, /.:�x � 7- � Lor.�y_ Blxt: .
<br /> • • ; �tY �1C_,Qr— Phone_ .3S'3 -G 5� Subdivision (Plat) � '
<br /> f1��...�r��;
<br /> _ ' ` • 1lzchitect/Engineer � "
<br /> . {/�P�� '� 2 ,,,
<br /> ' :::. .`:'i City Phone _ t4etes 8 9ounds (Unplatr�d?-- .. -
<br /> - .;� Contractor CJ�oi��f/c�o,�,L-"S Sec. ..
<br /> -;. �� Bddress �� " Rge .
<br /> e �O, /��, r � �r � .
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<br /> •. �; `-�tY �-�i1�2 N:� nhone �S� guilding Use � '��. .
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<br /> ..,•.i:.:' ��:.+_a.' '
<br />� : ~. b �itate License Nw�uer - • :: = -
<br /> . � Describe Work to Be Done ."�L �
<br /> : • � ----�.
<br />( : • :I. 1'.�cpiration Dat� rn� 5�(„_ n/�`� , //
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<br /> ,[s.S__!c/%r"�' P-
<br /> ' SRETCfi PLOT PI.AN HELOTJ'
<br /> .•-.. ��;f • � �� . � • ` _ �.
<br /> ' �,: . IIae ti£ Building � ��r,,,c �
<br /> � • `.i � . . .� 8�. ' , . .J��.'_`� ' L`iNew ❑ luiditir�n �] Repair/RemoGel
<br /> , :.
<br /> . j � . � . . `_ � . . Valnation of Construct.ion $ � Qp0 "
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<br /> '-;; I. � . : •�• . . ' � PZAT PLAN REQUIHEb1EttTS � .
<br /> - . . .�� . . . � . . a • . . . .
<br /> • •' � . • . c` :",'. . : . �� i' ' Indicate lot size, name of streets, . '
<br /> '3ndicate location ar.c wi�th of
<br /> • ' ,. ; . . ' � �.::,- -. • .: �' . I
<br /> _ •. G-� - � ,-• . \ :: - xilleys, locate proncsed aad all � I
<br /> !xisting buildinqs, sho�a distances
<br /> � '1 . � _ ��J= - . t . property lines, show distances
<br /> , . : , ! . � ' � betr:e�n buildings.
<br /> a :• a �' . � 7,ot size — . � ,
<br /> " . • � . .�(," • . _ �?� x �S___ �
<br /> ' a: S 9 S , .. � Lot area ?000 Sq. Ft. '
<br /> � ��sj .. . . S3ze of B1ag. /,�9`L__ gq_ pt_
<br /> • � tzum.ber of Stories /_
<br /> '! - 3, .
<br /> .:. • • - . Basement
<br /> , —
<br /> -e '• . " . . � . . .
<br /> �_. ; . Signed &y �� / �
<br /> , � � : � . . . . • �-� '� -
<br /> . ' ' . . . For C/F��� � �� � —
<br /> , vcaner ghone 3S�_l,S or�
<br /> �� , � DO NO': SyZZTE ?_:,0:9 TNZ� LI:1c-FOR CITZ USr^. OtIL'1 .
<br /> ---� --. Date ':eceived ' i ' —
<br /> _ . IIce Zone
<br /> ' , Plan.Chec;; :7ur.,ber , Fire Zone -
<br /> Valn:.;:ion � Occunancy Grou� � '.
<br /> . � Pe.r�3t Fee � Type of Construction ��� P�-� I . •
<br /> ' ' $lan Check Fee Occupant Load
<br /> . : Total Fee Due � gprinklers Required
<br /> Date Issued ' _ ' AP��O,��DITY Of EVERETT --_ '
<br /> • • • . . . FOR BUILDIN� PERMdT : '
<br /> . .' ' , . . . Date '_ ' � ',• • .
<br /> . —.:-�.� r �;.. i.; �.
<br /> . . . . -;--By.=_�_
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