Laserfiche WebLink
pw 'A FVERETT PERMIT NO. <br />;AATMTMEIJ'J' OF COMDIU'!ITY .DEVELOPMENT - <br />!LDING PERMIT APPLICATION VALUATION �—L <br />DATEI ., �J �li�l PERMIT FEE ' 3 7Q— <br />ADDRESS OF CONSTRUCTION WORK y�� y.�~o9 <br />LEGAL DESCRIPTION: LOT �2_ BLOCK PLAT <br />UNPLATTED DESCRIPTION <br />BUILDING DESCRIPTION: NEW Cl-� ADDITION REMODEL <br />—' OR REPAIR <br />A OF UNITS OCCUPANCY OR USE �'cC�STORIES <br />IS THIS A CHANGE OF BUILDING OCCUPANCY: YES — NO <br />CONTRACTOR C{jE�O/! /N ���)//�-f' OWNER SA_ _.�±E MAILING MAILING ADDRESS �'C/ '-p3 ex ADDRESS <br />r4 /,//-y <br />PHONE NUMBER 35 "fin {'CJC PHONE NUMBER <br />CONTRACTOR'S LLIIICCENSSEE NUMBER _ �(� L' I - oi o cr Lq <br />SIGNATURE <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 />IN THE INFORMATION, PLOT PLAN OR BUILDING PLANS SHALL BE SUBMITTED TO THE <br />INSPECTION DIVISION FOR APPROVAL BEFORE PROCEEDING WITH THE CONSTRUCTION <br />WORK. <br />APPROVAL. �. <br />1. PLANNING f,.� DATE <br />2. ENGINEERIN`'`9��I I <br />TRAFFI h1Of a <br />WATER SERVICE �-_ y <br />SEWER SERVICE <br />PUBLIC SERVICE SE <br />CT jl <br />'. INSPECT N PARTMENT / �n• <br />�74 _ <br />4. TIRE MARSHAL <br />NOTE: ALI, CONSTRUCTION WORK SHALL COMPLY WITH APPLICABLE CODES, NOTES <br />ON DRAWINGS, AND INSPECTIONS <br />