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1 - rdXI.Dlt+G PCrtt1IT APPLICATIO14 i••'{ <br />! - Applicant To Complete This -'urm <br />if more than one building is to be contructed, submit a separate permit applica- <br />tion for each building. A separate permit will bu issued for each building. <br />' Ownt:r t �tdll) n^ Building Address <br />-L2 <br />Eddress Z Ir"I ! Lot ! 1310c)- <br />Cit f Subdivirlon (Plat) PARK C' ,T �J <br />Y U r%� E Phone ,,7 f]= _`�.'�''f <br />' Architect/Engineer �� C -rt- __ .�11,:_W�-t .1-••-- --7-- <br />y i city ph, -Ile Hetes L Bounds (UnplaLtal) <br />Cintractor' Scc. Tt"p. ltge <br />t City Phone. Building U :e I[ f 5, () e A%G' <br />Statc License Ih:rabcr of 7_ .�i (h l.r � Describe Work to Be Don(_ TA•K�,.,__ t-+ <br />Be D R00A F-��A <br />t sri cti.on Date. / 4- 7 5 i�TT--- <br />Mot1e ELec� <br />SMITCH PLOT PLT.ft M1,01T t -" . <br />- '•I uANGE�Oo i <br />t Use of Duilt]ing <br />: <br />' 4 ❑New ®Addition flepair/P.emoGel <br />Valuati.on of Construction $ <br />a - PLOT M ti TmQU1Rr-%S::NTS <br />I. Indicate lot: size, name of streets., <br />f 'indi.cate locetion and wicth of <br />alleys, locate proposed and all - <br />exisi:ing buildi.gs, shrew disc>r.ces <br />to ptopurty lines, show distanres <br />t. <br />rjerylD�iFb(Cwccn buildings. <br />I Lot si�.c 75 xS'_Q_,_��. <br />Lot areaa sq. Ft. H <br />Size of BJug. .i So. Ft. <br />�Q � Ilrnabc: of r o �,--�- - - — <br />17ascracvt <br />- „ Signed By <br />eah�-'&J6?L — <br />For l� /,t..tA) <br />,Ucan�r---- Yhoiie-_gam <br />DO *NOT i<a'T': Pr'-n-0 TITIr L]:7P,-F0 CT':':' ll ^, C'71 L7, <br />D.te `:cceived S�'ZL7%'__-� ace ^u,•r. ------ ----- — <br />Plan Creel: aunher"'ifi��"?61+35� <br />t-io❑ .s- - �.�-- Ocr-rrcn:cy (".. r�up--__.___J.- ----• <br />r nti lr,. !iY^'fL� Typ' Of ('c:::::L, u,.:-icn 75% <br />t:(.GITYeOF-EVERE.T -- <br />APPROVED FOR BUILDING PERMIT <br />_ _ gates/Sy I'/-, c <br />