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.. ____'__ '., ..,..�,�.ic.�c ili1S [oLRI � � ✓ � � � <br />���� �� ��; � <br />If more than one buildinq is to be rontructed, submit a separate permit aoplics- <br />tion for each buildiny. A separate oermit will be issued for each building. <br />Owner � �-� Building Address �,y�%� � <br />Address _ Lot � Alack <br />City _ Phone_ Subdivision (Plat) i - <br />Architect/Engii:eer � , <br />City Phonc <br />Contractor <br />Address <br />City <br />State License Number <br />Expiration Dat� <br />Metes 6 Bounds (UnplatY.ed) <br />Sec. '1Wp. �� Rge <br />Phone Building Use - � - - <br />— �e�cribe t;hos;c co ae Done <br />i <br />SKETCH PLOT ?'LA:I BELOhJ <br />IIse of Building . ' <br />❑ New ❑ Addition ❑ Repair/Remodel <br />Valuation of Constzuction 5 � � <br />PLOT PLAN REQUIBE:fE^ITS <br />Indicate lot size, n�m� of streets, <br />indicatc location and width o= <br />alleys, locate oroposed an3 a11 <br />existing buildings, sno;o dista;cos <br />to pronert_: lines, show distances <br />between buildings. <br />Lot size X <br />Lot area �� Sq. Ft. <br />Size o£ Bldc,. i� �- Sa. Ft. <br />Number of Steries i - <br />Basement <br />Signcd =_ _ .. , <br />�'Or <br />, � owner anor.e — <br />DO ::C. '. - .--`� _� - =-=0� ' •'� li.�',' 0`:LZ <br />J�t" c___cc� _ Oce �or.e �_ i <br />_. �..__.. .._...,_. %'� - `ri-�C_ <br />,._._--_�: 2�'s-,s�c� �" <br />Perni t Fee �'Z �_ , �C� <br />� � <br />PLan Checl; Fee �L-� L�G <br />' �n p <br />Total L•'ee Due g (�j <br />Datc Issuad <br />Fira Zo::c <br />o��:,��:,�y c�o�� i <br />Type of Construction \� � ��. <br />Occup�nt Load <br />Sprinklers Required <br />CITY OF EVERETT <br />fiPPR04ED FOR BUILDING F'cRMIT <br />D�te �.� `-f -� �. �Y �'_ c <br />