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CITY OF EVFRETT <br />DEPARTMENT OF COMMUNITY DEVELOPMENT <br />•BUILDING PEP14IT APPLICATION <br />DATE -7 ICJ ` Je/ <br />PERMIT NO. <br />VALUATION ��— <br />PERMIT FEES_ <br />ADDRESS OF CONSTRUCTION WORK 1/ai d; °JL' eY�y� <br />LEGAL DESCRIPTION: LOT -.'o BLOCK _aO/ PLAT <br />UNPLATTED DESCRIPTION <br />BUILDING DESCRIPTION: NEW ADDITION OR' —fit —PAIR <br />A OF UNITS OCCUPANCY OR USE STORIES <br />IS THIS A CHANGE OF BUILDING OCCUPANCY: YES NO <br />CONTRACTOR` p u . w. r- �t`Ji r++Yriv.,vl o <br />MAILING �J✓s j�/>d�so.v <br />ADDRESS <br />4 <br />PHONE NUMBER ,$t` 9z>L <br />SIGNATURE <br />S LICENSE NUMBER <br />0 <br />OWNER v / �. d.4•ce <br />MAILING <br />ADDRESS 11 !r G 3' L=ya 11 <br />PHONE NUMBER . <br />e <br />NOTE: THE APPLICANT SHALL FILL IN ALL ABOVE BLANKS COMPLETELY INCLUDING <br />THE PLOT PLAN SKETCH ON REAR OF THIS SHEET. THE APPLICANT IS RESPONSIBLE <br />FOR ALL INFORMATION WHICH IS FURNISHED ON THE APPLICATION. ANY CHANGES <br />INFORMATION,IN THE TPLAN OR BUILDING SHALL ESUBMITTED <br />INSPECTION DIVISION FOR APPROVAL BEFOREPROCEEDINGWITHTIiECONSTRUCTIONE <br />WORK. <br />APPROVAL: <br />1. PLANNING DATE <br />2. ENGINEERING <br />TRAFFIC DIVISION <br />WATER SERVICE <br />SEWER SERVICE <br />PUBLIC SERVICE SECTION <br />7. INSPECTION DEPARTMENT <br />4. FIRE MARSHAL <br />NOTE: All CONSTRUCTION WORK SHALL COMPLY WITH APPLICABLE CODES, NOTES <br />ON DRAWINGS, AND INSPECTIONS <br />