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Date <br />Application For <br />PUBLIC WORICS PERMIT <br />Print or Type Only <br />Plan Check No: C 41079 <br />Applicat.Date: 06/24/93 <br />Owner Job Addreee: 5012 W VIEW DR <br />Owner: SCHILDE KLAUS <br />Te <br />Applicant <br />Oesc�:ha Proposed Work _ <br />��rolect Address (Ii known) <br />Gupl�c Work� Permil � _ <br />BIOp. D�D� • <br />WGtie Worke Fes <br />To1�iFea S <br />� Lau ADnI Fea P��E S <br />B�I�nc� Oue S <br />SEPA <br />Phcne <br />ProposednUee: SINGLE FAMILY RESIDENCE <br />Deec. of Work: <br />336SF FAMILY ROOM ADDN/KITCHEN REMODEL <br />OFFICE SET��JOB SET <br />APPROVED FOR PERMIT: DATE_�_�� BY <br />Attach four (4) copies ot pleris for proposed work • Draw to scale and note the following as applicable: <br />• Property Lines • Centerline ol street <br />• Outline end dimensions of all existing and • Indicate North <br />proposed structures on the lot • • Show any proposed gredtng changes <br />• Existing and proposed utilitias • Show measurements <br />Phone <br />PERMIT CONDITIONS <br />t. All calls for inspectbn shall be made 24 hra in advance • phone 259•8810. <br />2. All work shall be peAortned in accordance wlth this permit end current City ol Everett Desipn and Constructlon <br />Standerda end Specificationa <br />3. Call Lxetion Underground Service 48 hra bafore you dig. TOLI FREE NUMBER 1•800�4245555. <br />PUBLIC WORKS PERMIT <br />NOT REOUIRED <br />BY— � <br />pATE d -ZS�-f'.s <br />Approved lor Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everelt, WA 98201 <br />Phone: 259-8810 <br />ACKI�.OWLEDGEMFNT OF CONDITIONS <br />W <br />H <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />The undersigned owner/applicant here6y agrees to hold and save harm• <br />less the City of Everett Irom any and all claims for damages, costs, <br />expenses, or causes of action lhat may arise because of installation <br />and mainter.ance of the improvement or other right-ot-wey use hereto <br />app�ied for and further agrees to remove same upon notice Irom the <br />City and to replace publir, property damaged thereby. <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS �TO <br />BE DIIIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE C�TY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />