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4ax O Residential Building Permit Application <br /> ° Building Department <br /> 4,o P.O. Box 547 Anacortes, WA 98221 <br /> Phone No.: 360-293-1901 FAX: 360.293.1938 <br /> SITE ADDRESS: Ito ei 7-2:-a s <br /> CONTRACTOR G Applicant PROJECT DESCRIPTION <br /> (Lc-aoo t' <br /> Name Slr_"/a tort- /2-c'u Fu..6 _ <br /> y&t'2C1 N et-Ls-t, GCd MN.)S ,Trll f.: YZuc4-Z'rC <br /> Address 441"72- 64/7-• '-rt 1rA 0-41e7/dto tht r13e it Lr( 1, <br /> City/State/Zip y7ilw L../-1 9�232 tN +rrr LL Y=�3e�:.c.-rs) ce.rc'c,c r-Q,.a <br /> t NJ'SCAL q 5 <br /> Phone 44"2-J-t °I CIL' FAX-7ta ' -`E 3S's" <br /> State License#Salem cc'c 9Cte Exp it-cc-o <br /> PARCEL NUMBER <br /> City of Anacortes License P t t"1.; <br /> PROPERTY OWNER ❑Applicant LEGAL DESCRIPTION <br /> Name R o 3 cn 7- MA rzn,5C/- <br /> 1 $t a J vt- Q7esttrc Pt-A-T <br /> (ru S t=7 LcJ I Z <br /> Address I dui 7-27'S r a z, . cc 2-z <br /> City/State/Zip An/-}cv arc i PROJECT VALUATION Co <br /> Phone7"tt Colo 40 47 FAX <br /> Number of Dwelling Units / <br /> E-Mail Address Number of Stories I <br /> Building Area: <br /> ❑Architect 0 Designer 0 Engineer 0 Applicant 1°Floor s.f. 2nd Floor s.f. <br /> Name 3rd Floor s.f. Basement s.f. <br /> Address Garage s.f. Carport s.f. <br /> City/State/Zip Deck s.f. Lot Area s.f. <br /> Phone FAX <br /> E-mail Address <br /> CONTACT VApplicant LENDER <br /> / LENDER INFORMATION MUST BE PROVIDED FOR PROJECTS OVER$5,000 <br /> Name J t A.t C�J t:c-r/ S�0^i(or r/%J)c./+�.�C IN VALUATION PER RCW. <br /> Address (( Name <br /> City/State/Zip Address <br /> Phone &ea(-S Z L f FAX City/State/Zip <br /> E-mail Address Phone No. <br /> CONTINUED ON THE BACK <br /> G7 -°14.3a <br />