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21825 95TH AVE W.PDFiiiiiiiiiiii 9294 21825'95TH AVE W Z 0 W 0 �J. IrV OF EDMONDS "REET FILE COMMUNITY SERVICES DEPARTMW RIGHT-OF-WAY CONSTRUCTION PERMIT A. 9 Owner: ame > Mailing Address, q `P_� C,�!" \,\ n"'Nz�� I City State Zip B. * Contractor: Permit No. — q D - L4 Z I Issue Date 9- IZ-9c) Mailing Address City State Zip State License Number Telephone Number Type of Work to be Done: I _") 4- - V'7-> \011' 1-Diz 0 2iN �5 - Zn - D. 0 Work in Connection With: El Sub or Plae... 0 Single Family 0 City Projects 0 Commercial 0_34�plijbBily- 90 Utility E. * Pavement Cut: El Y F. Size of Cut: X APPLICANT TO READ AND SIGN INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from any injuries, damages, or claims of any.kind or description whatsoever, forseien or unforseen, that may be made against the City of Edmonds or any of its departm."entg-*or,,pmployees,'Iiiicl,dding 6f hot limited to the defense of any legal proceedings including defense costs, court costs, ana attorney fees by reason of granting this permic. k THE CONTRACTOR IS RESPONSIBLE FqR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC1IbN/A-Nb/ACCEPTANCE OF THE WORK. Estimated res toration fees'will be held until final street.patch is completed by City forces, at which time a debit or credit will be processed for issuance to the applicant."—' 0 .e A 24 hour notice is required for inspection; Please call Engineering: 771-3202 • Work is to be inspected during progress and at completion. RVV • Restoratio�n to be in accordance with City Code. • Street to"be kept clean at all times. • Traffic Control to be in accordance with City regulations. • All street -cut ditches must, -be patched with asphalt or City approved material.prior to end of working day; NO EXCEPTIONS. I understand the above and that thi§�,permit m rst'be available at the job site for inspection purposes at all times. Signature: D t a e: Owner or mi t Must be Posted at the Job Site For Inspection Purposes Call. DIAL -A -DIG Prior to Beginning Work APPROVED BY: F?VS/ Time Authorized: Void after I YJFAf� days. Special Conditions: PERMIT FEE: $ 3n' 7M - PU;; P-1 i 1 2- Restoration Fee: Receipt No.: r4r1!1nTr_n Fund I'l I Fee: KIAIF I LLJ Street Cut Dimensions: x RELEASED BY: C Date!311211d INSPECTED BY NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE Date rng. Div. Much 1989 FIELD INSPECTION NOTES 7 . % (Fund I I I - Route copy to Street Dept.) .� -�- Comments: Diagram: CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO Partial Work Inspection by P. W.: Work Disapproved By: — FINAL APPROVAL BY: Date: Eng. Div. July 1985 0 IC L�m AL-,g P 0 A. L-r w A.-I-Ej?- 3"'Ta 6LI WATEV- ww " LOVEL PACKZO M6*7 U13 D I 7� 9 13 .5 rz-W EZ Z-01 ow Catlf,12- END-------------- UMIS7. FLUS W MOUNT FIMO i .RF-FL&C-F- w/-Tv-�&D Z-1 S 2-1 ZI azs- cp-&6jL- Milli, BUILDING D E P A R1% E N T Applicant Fill dSE PERMIT ZONE -NUMBER PERMIT APPL1Cfff1Qj:jn!e ;lff Fes JOB ADDR S NAME (OR NAME OF BUS`ML`S9)!*�" . LEGAL. ......................... LOT AREA J.,SSUBDIVISIZON jr jlnl�l ONO �7NO� y 1:!!:; W I�IAILING ADDRESS z 3: STREET R/W EXISTING STREET R/W FT. DEFICIENCY THIS PROPERTY 0 41 Lot CITY TELEPHONE NUMBER COMP. PLAN ST. R/W FT.' FT. `7 7 NAME REMAR KS U W ADDRESS I- CH;ECKEQ_j3_Y U 0: CITY TELEPHONE NU . MBER STREET AND/OR UTILITY WORK R/W PERMIT REQUIRED REQ'D. C3 YES' YES �gNo NAME UNDERGROUND WIRING R I EQ'D. YES '&rN 0 0: 6W Ad Al 0 ADDRESS TYPE CONNECT 0 YES VERI BYa ION SANITARY. SEWER ONO U TELEPHONE NUMBER P SEPTIC SYSTEM YE S 814MIT NUMBER APPV*O BY CITY ENG. C3 NO ZjCiTY 0 UMBER ICITY LICENSE NUMBER REMAF�KS_ Below or Attach Four Copi BUILDING SUPPLY SIZE A 9F REMARKS z 2 SIGN AREA ENV. REVIEW ALLOWED PROPOSED COMPLETE EXEMPT U W REMARKS W J VARIANCE OR CU PLANN ING REVIEW BY YARDS LO' FRONT SIDE REARF F� NEW FIRESIDENTIAL 0 GAS LINE FIRE ZONE TYPE OF CONSTRUCTION ICODE NON-RESIDENTIAL M SIGN ADD E] DEMOLISH RETAINING WA LL SPECIAL, INSPECTOR REQUIRED ALTER EXCAVATE OR FILL FENCE I— X—FT) ED YES E NO PLAN CHECKED By REPAIR PRE -MOVE INSP. swim POOL REMARKS NUMBER OF STORIES NUMBER.OF DWELLING UNITS NATURE OF WORK TO BE DONE z PRO I POSED USE PLAN CHE . CK 0 NO. PLOT PLAN (INDICATE BUILDING ' SETBACKS. ABUTTING STREETS) BUILDING U I&I PLUMBING 0 HEAT & GAS LINE FENCE SIGN RETAINING WALL SWIMMING,POOL I hereby acknowledge that I have read this application; that the in- TOTAL. A . MOUNT DUE formation given is correct; and that I am the owner, or the duly.author- ized agent of the owner. I agree to comply with ciiy and state laws regu- lading construction; and in doing the work authorizod thereby, no person ATTENTION will be employed in vio lation of the Labor Code of the State of Washington THIS PERM.'IT elating to Wo,kmen', Comperfsalion Insurance. AUTHORIZES NOTE: Permit Limit One Year(Except DEMOLITIONS and FILL ONLY THE PERMITS without conditional use permit, which shall be completed in 90 WORK NOTED. days; MOVED -IN BUILDINGS shall be completed in six months.) St NATU E (O�NE7 AGE DATYIG;N7E N�,r;)d ... ... ECTION DEPARTMENT - CITY OF EDMONDS NOTE: AKPlicAt Subject to Plan Check Fee 775-25 25. This Permit covers work to be done on private property ONLY. Any construction on the public domain.icurbs, sidewalks, driveways, marquees,,etc.) will require separate permission. ADB NO. COVERAGE k OCCUPANCY OCCUPANT GROUP LOAD THIS SITE IS LOCATED IN THE CITY OF EDMONDS. LOCAL SALES TAX SHOULD BE CODED 31.04. VALUATION I FEE APPLICATION APPROVAL This application is not a permit until signed by the Building Official or his Deputy; and * fees are paid, and receipt is acknowledged in space pro- vided. DIRECTOR*S SIGNATURE ORIGINAL - File YELLOW Inspector GOLD - Assessor PINK Owner 0 z W ziL7 11: 1 W F. 4 :1 I- z a: W z W 0 W z 0 .Ehevron Chev ron U.S.A. Inc. 515 Market Street, San Francisco, CA 94105 Mail Address: P.O. Box 7643, San Fran6isco, CA 94120 Land Department A u�g us t 12 1977 Western Region - Encroachment Agreement Everett., Washington Refinery Pt. Wells Pipeline Right of Way Snohomish County, Washington R/W 78021 Mr. and Mrs. Richard L. Lapinski 21825 - 95th W. Edmonds, Washington 98020. D'ear Mr,. and Mrs. Lapinski: Attached, in duplicate, is an encroachment agreement which.is for the purpose of allowing you to construct a garage and driveway on a portion of our 33-foot-wide easement. The garageand driveway should riot extend past a line 25 feet measured at right angles to the westerly boundary'of our 33-foot-wide easement. This should provide sufficient s�ace_for.your proposed construction. This agreement should be signedby both of you exactly as your nanies appear before a'notary public so that your signatures my be ackriowledged on both copies. - Men this has been completed, you should then return both copies of the agreement -to me at the above-iridicated address. As soon as I receive them, I will arrange -to secure execution on behalf of Chevron U.S.A. Inc. and ' have the signatures acknowledged. I will then return the duplicate copy to you and havei.the original placed of record. As soon aCs I have the full - . recording information, I will forward it to.you. I would.have proceeded to secure the signature for Chevron U.S.A. Inc. However, I did not have time to arrange for this and. still get this in. the nail to you by Friday, August 12., In the event you have any questions concerning the form or if you wish to discuss any of.the items, please do not hesitate -to let me k1101-T. Very truly yours., W. F. Brady WFB: fw Enclosures 0 I rill "1,. 0 � Arl `Jf t :41 Aft jt -pe `41 -hip 0-.t NOTICE:, VA ... o r-aauc-u- -r-*-.a7u-Y--' - - - - I - The-infor mation *shown on the attached piled for use by the City 01 map(s) was com * Edmonds/ its Employees and Consultants. Th,.e City ofEdm.onds does - n ot. warrant the accuracy of anything set for,th on t ' hese Map(s). An . V person or entity -requesting a copy should conduct an independent orm'ation shown-c inquiry regarding the infi tTi�� a p (s), including, but not Jimited to, n of any sewer stub shown. SU( the lociatio sewer stubs may or may- not exist and ma�, t the location shown. or may not exist a Neltheir the City of Ec',m0*n%d4S/ nor its e m pl-o-yee-s 0-r off rcers'shal] be 1--ia-b-1--e for th i . nformation given on this map(5), nor for t* Ided based any one represe-nta ion prov upon said map(s'. 0 -A APPLICATION The City of Edmonds for EASEMENT NO - ------------------------------------- ...... SIDE SEWER PERMIT NEW CONSTRUCTION REPAIRS LID NO . ................ .- ASMT. NO . .................. F-L-- OWNER........ L.--V ---.5 .......................................................... CONTRACTOP - ------------------ ----------------------------------------------------------------- PERMIT NO - -------------------- JOB ADDRESS .......... LEGAL DESCRIPTION: LOT NO - --------------- 77. -------------------- BLOCK NO - ------------------- ---------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------- NAME OF ADDITION ----- ------- LTa C-4 i 12i Approved: DATE ... . By ...................... I IY75 . A IF r. -EDWO, NO' 0 S S11D.Ev-�.MVIE MENT VVATEWSEWER,, DEPART N P RUIT 'Y E -M 'pectionis BEFORE covering� -any Portion of the� construction. Cail'11754525 for side sewer ns - s after requst. NO,�Sat­ Sun-, 'or holiday. inspections.' 24"hour (Inspection, will be provided, within % .................... . ........ ........... ......................... ....... ..-...:7 ............. 'OF CONSTRUCTION .......... 1'iAbDRESS, ................... .... ..... 'L�DF -PTION ......... .. ............... ........ XG�k SCRI ]�RoPE,RTV,4L ........................... ..................... ............ ....................................... ................... ............... L ..... ................... ................ ....... 7 ..... ... . ......... 7Y ............ f .,,OW ERAND/OR-BU ELDER ............ . .......... ............. N ... . ... .............................. ................................ .................. ............ . ....... . �CoyjRA&ijWswAME�,& ADDRESS ............ 0 y. sewer, city sanitar 9 of a side sewer 'to th ......... . .......... 1 ifo—r repair and/or connection In W aceblrdhnc4ew JtfirCJity of Edmonds ordinances., ­N� 'I . ��CA,i�CF,D,-TO,-,TH'-E,'�FOLLOWING: need, Side sewer contractor. must be emplbyedl.to, construct,, ;jhsi,�r8peity may.�obtaln a permit to, c �struct sewer insIde.property,,line. A lice "sewer. before it has beenAruipected. *N�: �I—T ofo T_ tqarei.' Do not cover any portion -Engineer's office* -Way Permit o6tainable from the City' Invasion of rUght-of .4NOTE )No. 2t,='All�,,%�torki,pe�frjrl�ed-,in city right-Of,-WELY requires aw 't;, 'Y"'. ­';­ C rmit. �; ' tion,*rcgarding ordinance- 11.16 030 and Regulations governing side sewers when you get pe !I—Obtiiij,�full�ihfdrim�. 'n6hes inside -property line: minimum grade of 2%. No bends�jn 'grade e iop, oi;sir';ewerl least 30 inches -coverage at pro�cky ]in and' 11 1 'NOTE!No 4` e must, have at " '! proper i/� will be� permitted. tors shall be responsible for failure due, to m NOTE'No. 5.,�-Trenches' imsLree� must be water settled and, surface of street . restored to original. conditiom Contra . c ��6rk*,".,�hich�,ryiELY,develoP- Within one year of completi n,. cept to in mIt, or to, do'. any work on the maAn sewer or Its appurten nees ex t'0',,aIter,or*do�*any other work than is provided for, in the per 4U :,�.-sert'th�,.',pipe,!into,jthc wye. j3Y ................ ........ Ry ....... ..... .. Date; ................................... S Date-, .'By.... ......... . Date - 'Ea �&P ............ ................................................ my ....... ...... ........................ . -4 --- ------------- - - I A41PROVEb' .. n ..... ............................... X ............. ............................. ...................... M ............ ................. ar S., ......................... Rein k ................ ......... ...................... ................................ .......... ................. ......... ......................................... ............................... ................ est For, Inspection -To Requ. 0 er. of'Firm P�rf orming-, Construction PRIOR, op, es: M, y,,Be Signed By WII _e, latiori: constrdcted:, under thi's permit I hereby�,certif ythat the, side sewer instal . ......... rier.;;o;f,i,�6o'nt'i;PL.,i�,gl� p irm.- e F rm ng Construction, ce ' t ds" " . 1" 0 - C a I ordin:6=6s f.the Nt� of,'Edmon wi e 0 ............... ............... 4ay Dated this..*. f..% e Other� Power; Sew r er -TOPOone El 'Check BEFORE Y,(�u-dlglor Wa't The City of Edmonds APPLICATION for SIDE SEWER PERMIT EASEMENT NO - --------------------- ..................... NEW CONSTRUCTION RE PAIRS LID NO. ------- : ---------- OWNER ..... 40. e 421 ------- CONTRACTC --------- ... .. - - - ---------------------------------- PERMIT NO.�F--±f�.A 4� JOB ADDRESS -------------------- n - - ------ ...... LEGAL DESCRIPTION: LOT NO. -7 ----------------------------- BLOCK NO - ------------------------------------- E ........................... ------------------------------------------------------------------------ ......................................................... VED NAME OF ADDITION,, -------------------- ------------------- Ap ft 7 971 WAS VOL DATE............................................... By ............... .............. .................. YUYE.