10514 243RD PL SW.PDFiiiiiiii lill
4660
10514 243RD PL SW
ADDRESS:
TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE) -
COVENANTS (RECORDED)
CRITICAL AREAS:
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DA
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (
(l e t° G,
m
DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
I � - �)/-198 �#F//
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DA
SEWER LID FEE
SHORT PLAT FILE: LOT:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMITS) #:
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
LID
BLOCK:
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CITY OF EDMONDS
Z°"E NUMBER
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CONSTRUCTION PERMIT APPLICATION
JOB SUITE/APT N
ADDRESS
OWNER NAME/NAME OF BUSINESS
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LEGAL DESCRIPTION CHECK
SUBDIVIS ON NO. LID
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP
Approved ❑
CITY 1 ZIP
TELEPHONE NUMBER
III
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RW
EXISTING REQUIRED DEDICATION Street
Permit Required ❑
Use Permit Req'd ❑
I
PROPOSED Inspection
Required ❑
NAME
Sidewalk
Required ❑
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tr
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
ADDRESS
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YES ❑ NO ❑ 3
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REMARKS Z
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CITY.... - P
TELEPHONE NUMBER •
NAME
CrIADDRESS
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DATED REVIEWED BY
UENGINEERINGtMEW
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CITY ZIP
TELEPHONE NUMBER
ZO
FIRE MEMO DATED REVIEWED BY W
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2
LL
STATE LICENSE NUMBER EXPIRATION DATE
SIGN AREA
SEPA REVIEW
ADS NO.
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ALLOWED PROPOSED
COMPLETE EXEMPT
..�^
Legal Description of Property -include all easements
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SHORELINE N
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VARIANCE OR CU
PLANNING REVIEW BY
DATE
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SETBACKS — FEET
HEIGHT
LOT COVERAGE _
FRONT `^i' SIDE / r REAR .'
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Pro Pe►tY
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Tax Account t} {{`���^y//�'�
Parcel No. �(, t ` t �.., 00 �
REMARKS o
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NEW RESIDENTIAL PLUMBING
ADDITION � �
A 111, r r e� :R l j- t �v�? : t; , .ry 5 ir, �
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COMMERCIAL MECHANICAL
REMODEL APT. BLDG. SIGN
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❑ GRADING FENCE a
CHECKED BY
TYPE OF CONSTRUCTION
CODE
OCCUPANT
GR
REPAIR
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1
WOODSTOVE
DEMOLISH SWIM POOL
INSERT OTTUB/SPA
SPECIAL INSPECTOR
AREA
OCCUPANT
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GARAGE RETAINING WALL/��/�4!
CARPORT
REQUIRED
❑YES
LOAD
MARKS
t7
PROGRESS INSPECTIONS PER UBC 305 Z
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ROCKERY 86NEMIfYI�+
(TYPE OF US�E OR ACTIVITY) EXPLAIN:
�UI'SINESS
57 //��CC�� l JAL+ N (if
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NUMBER NUMBER OF CRITICAL
WO
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OF DWELLING AREAS
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10
STORIES UNITS NUMBER
I
-'
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
CC�✓���/r�>'c �'G '�''"
FINAL INSPECTION
REQUIRED
VALUATION
FEE
PLAN CHECK FEE
BUILDING
HEAT SOURCE:
GLAZING
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 186-Days
Permit Limit:1 Year - Provided Work is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENG. INSPECTION FEE
N
successors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
s
employees, and agents from any and all claims for damages of
iwhatever
nature, arising directly or indirectly from the Issuance
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
modify, waive or reduce any requirement of any city ordinance
°x
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
�l� Z// 6
provision."
II
I hereby acknowledge that I have read this application; that the
Information given is correct; and that I am the owner, or the duly
ATTENTION
APPLICATION APPROVAL
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
state laws regulating construction; and In doing the work authoriz-
AUTHORIZES
This application is not a permit until
ed thereby, no person will be employed in violation of the Labor .
ONLY THE
signed by the Building Official or his/her
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
Deputy; and fees are paid, and receipt is
tion Insurance and RCW 18.27.
INSPECTION
acknowledged in space provided.
SIGNATU E (OWNER OR AGEN�T)q DATE SIGNED
DEPARTMENT
jj'
\, f �03/ J��
�.�'.;.
CITY OF
O F I L' IGNATURE "'� DA G%/�
- /
EDMONDS
! ��i!(�
ATTENT N
CALL FOR
RELEASEdirf.. DATE
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
- . J 0220
'HAS
l
ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY BEEN GRANTED. UBC
CHAPTER 3.
PINK — Owner GOLD — Assessor
ios•eT
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ...................
FOUNDATION:
Footing ....................
Wall.......................
Pier/Porch................
Retaining Wall............
Slab Insulation ............
PLUMBING:
Underground .............
Rough -.In .................
Commercial Final ........
HEATING:
Gas Test ..................
Gas Piping ................
Equipment ................
Commercial Final.........
EXTERIOR SHEATHING
°. NAILING ......................
FRAMING ....................
INSULATION:
Floor Insulation............
Wall Insulation ...........
Ceiling Insulation.........
SHEETROCK NAILING ......
SPECIAL INSPECTION ......
RADON MONITOR AT SITE.
FINAL APPROVAL qtr.
FOR OCCUPANCY.......
TO:
FROM
OWNER
PERMIT#
t
Permit Coordinator, Building Division 'S
a_� FIRE DEPARTMENT
ENGINEERING DIVISION
PLANNING DIVISION
J&,Ro_'�,i �J L,I
ADB#
-ADDRESS zq PL S.).
INSPECTED ON �tU/9�
A field inspection was conducted to determine compliance with approved plans.
Final approval denotes there are no objections. to the granting of:
Occupancy for the building Performance Bonds may be released
Maintenance Bonds may be released Landscaping is approved
Other inspected
PASSED FIRST INSPECTION - CONDITIONS NOTED
2. /c - w aP—E�a l-Luv"�cTE� S.c . -zc i T %'-�' 4a==f� ✓/ �'� u
FAILED 'INSPECTION - OUTSTANDING REQUIREMENTS --RECALL FOR INSPECTION
1. .
2.
:,::•:
3.
4.
OCCUPANCY APPROVAL DATE BY ti:ks"k
FAILED FIRST INSPECTION DATE `
RE -INSPECTED - APPROVED
RE -INSPECTED - FAILED
RE -INSPECTED APPROVED
OCCAPRVL/TXTRECEP/October 13, 1993
DATE
DATE
DATE
FEES
M
RECEIPTn
'CITY CLERIC
• CITY OF EDMONDS
505 BELL STREET
EDMONDS, WA 98020
• �j •
NOTICE OF LIMITATION AND COVENANT
ADULT FAMILY HOME
WHEREAS, the undersigned owners of property located at \CzLy\� a� Cl,.� ,
in Edmonds, Washington legally described below or on the attached Exhibit A, have applied
for a building permit for compliance and/or to remodel a structure located on the site; and
WHEREAS, the applicant has notified the City of the applicant's intention to utilize the
improvements and/or to convert an existing single family structure to an adult family home; and
WHEREAS, under the Uniform Building Code the number of occupants of a structure
trigger certain requirements relating to the fire suppression and exiting requirements; and
WHEREAS, the City has notified the applicant that the permit will be issued conditioned
on limitation of residents to or fewer residents and their caretakers, and
"C
WHEREAS, the City has issued a permit based upon such representations;'
NOW, THEREFORE, the undersigned property owners (hereinafter Owner) in
_
consideration of the issuance of a building permit and in order to confirm the promises upon
which such issuance is based while providing notice to any future owners or mortgagors of the
property does hereby stipulate, covenant and agree as follows:
t
1. Covenant: Limitation on Residence. The owner hereby stipulates and agrees
that occupancy of the structure as an adult family home shall be limited to or
fewer adults and their caretakers as allowed .by applicable provisions of state law. The owner
acknowledges that in the event that the applicant seeks revision of the}applicant's state license.
to operate an adult family home with an occupancy of greater than �Y residents or attempts
to ren , lease or otherwise provide residence for additional residents above
the permitted in the current occupancy classification, the structure shall be vacated and
all residential use ceased until such time as the property is brought into compliance with the
provisions of the State Building -Code, under the edition of the Uniform Building Code then in
effect. The owner further stipulates that this covenant touches and concerns the land so long
t� u
as the present structure and use continues and shall run with the land to all future purchasers .
and assigns.
2. Subiect Tract. The above stipulation and promises shall apply to and run with
the land with respect to a residential structure located at \C)x�,
Edmonds, Washington and legally described as:
. K. 5c1�.r2o � �e�.r 6��-P` ,� /brie s r- �✓.✓ �Lx DC�S J�oc�
a r
3. . Notification to Future Purchasers and Assignees. This notification and covenant
has been recorded in the records of Snohomish County, Washington in order to provide notice
to any and all future owners of the property of the limitation at the current level of improvement
to single families and adult family home residents fewer than in number.
LdTemplFormsV.MT Cov.Doc
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4. Enforcement�n addition to any and other remediesgvil or criminal which the
City may have, the property owner hereby agrees and stipulates that this grant of covenant
shall entitle the City to enforce by injunction the provisions of this code and, in so doing, to
recover its reasonable attorney's fees and costs.
DATED this day of
19
,
c
ACCEPTED BY:
PP LI ANT/PROPERTY OWNER:
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Appl'
J annine L. Graf
Appllcar
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Building Officials
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Owner
/,FlY 5Z /1 g4✓5-1o1 owner
le.X lIi gnCYJ.141 COVENANT AND NOTIFICATION
ACKNOWLEDGED: `
ti ,41.F11.l.IL/•..
MortgagorIA a v,,.,
NOTARY FOR OWNER SIGNATURES •°�c' w� `-
State of Washington),
j ss
County of '.� •��;.�,�,� � .., � ` � -
I certify that I know or have satisfactory evidence that Jt�A�G/✓ • �v�fTU�/ •s],ne iithis•\'.
instrument, on oath stated .that he/she was authorized to execute the ini&uim lhv!and•
.acknowledged it as the (title) of (name of party on
behalf on whom instrument was executed) to be the free and voluntary act of such party for
the uses and purposes m.e tions 'n this instument.Subscribed and sworn to before me
this day of
Notary Public in and for th tate of Washington.
My commission expires // - f - 9 6.
I certify that I know or have satisfactory evidence that _��0�9=- /9 -*47�z,7 signed this
instrument, on oath stated that he/she was authorized to execute the instrument and
acknowledged it as the fk S (title) of (name of party on
behalf on whom instrument was executed) to be the free and voluntary act of such .party for
the uses and purposes mentions in this instument. Subscribed and sworn to before me
this d / day of �L� •� , 19 9
NOTARY PueuC
STATE OF wASHINGTON
DIA BOCK
My Appointment. Expires MAY 30. 1991
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Notary Public in and for the State of Washington.
My commission expires_ >16f* z, 9 9 7
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96080105 25 voL. 3194 PAGE01.26
-Vashington State
7C ����I''ARTMENT H
` SC`t�"'IALf�HEALTH
SERVICES
i •
ufamilyomeLiccn6e.
In compliance with and pursuant to the laws of the State :of Washington and the Minimum Licensing, Requirements
of the Department of Social and Heald Services a license is hereby granted
to
KAREN BUXTON
License Number 52 H 945109
to conduct and maintain at 10514 243RD MACE SW
city Of FDMONDs , zip code —98020 , county Of SNOHOMI A
State of Washington, an Adult Family Home for the care and supervision of adults as follows:
24=hour family care for no more than. - TWO adults
number
This license shall be in force from the 04TH davmf .MARCH ,19 96 to and including
the o4Tu day of MARCH , 19 97 , subject to revocation for due cause..
Special Terms:
LHiG/{.111T
NOTE: This license is not transferable, and is valid only for use bw-the individual(s) to whom it is issued and at the location above
described. Issued by Authority, of Chapter 172, Laws of 1967, and HZCW 70.128.
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STATE OF WASHINGTON
HEALTH PROFESSIONS QUALITY ASSURANCE DIVISION •
THIS CERTIFIES THAT THE PERSON NAMED HEREON IS AUTHORIZED AS PROVIDED BY LAW AS A
NURSING ASSISTANT - REGISTERED
ACTIVE
43
u
41 BUXTON, KAREN L.
10514 243 PL SW
EDMONDS# WA 98020
NUMBER DATE ISSUED EXPIRATION DATE
A 029902 NA00038851 05-21-91 12-13-96
r
DATE
' As AND ADULT SERVICES ADMINISTRATION* _ a
/"FDE A ��
US"
So
FIRE SAFETY EVACUATION PLAN
'I WAC 388-76-20011
An Adult Family Home shall have a poster plan for evacuation to safe areas in event of fire. Draw a diagram of the floor plan
of your home in the space proveded bek.-w. Indicate escape routes and designate where staff and residents should meet
outside the residence. Indicate the location of fire extinguisher(s) and smoke detector(s).
IN5THUGTIUNS: Provide -'Resident
�C.4 to r CWs
U
10.
�tes and posts in a conspicuous iocanon.
,41-1- QED oeM& WfNOow.
9
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nJow
$ Ark p S,AcARNi
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7C r7Vashington State
' " S R CES LOH
LT - T • - .
In compliance with and pursuant to the laws of the State -of Washington and the Minimum Licensing. Requirements
of the Department of Social and Health Services a license is hereby granted
to KAREN BUXTON License Number 52 H 945109
to conduct and maintain at 10 514 2 4 3 R D PLACE SW ,
State of Washington, an Adult Family Home for the care and supervision of adults as follows:
24-hour family care for no mome than TWO adults
number
This license shall be in force from the o4Tx daymf MARCH , 19 96 to and including
the o4TH day of MARCH , 199_, subject to revocation for due cause..
Licensor
1.u;eanyw nuuun uy
NOTE: This license is not transferable, and is valid only for use bw the individual(s) to whom it is issued and at the location above
described. Issued by Authority, of Chapter 172, Laws of 1967, andUtCW 70.128.
usnJ w-173 (Rev. 1/91)
y -CITY CLERK
JCITY OF EDMONDS NOTICE OF LIMITATION AND COVENANT
z 508 BELL STREET
EDMONDS, WA 98020 ADULT FAMILY HOME
WHEREAS, the undersigned owners of property located at \C�S�' �'� aL ad,
in Edmonds, Washington legally described below or on the attached Exhibit A, have applied
for a building permit for compliance and/or to remodel a structure located on the site; and
WHEREAS, the applicant has notified the City of the applicant's intention to utilize the
improvements and/or to convert an existing single family structure to an adult family home; and
WHEREAS, under the Uniform Building Code the number of occupants of a structure
trigger certain requirements relating to the fire suppression and exiting requirements; and
�i
WHEREAS, the City has notified the applicant that the permit will be issued conditioned
on limitation of residents to ` or fewer residents and their caretakers; and
WHEREAS, the City has issued a permit based upon such representations;
NOW, THEREFORE, the undersigned property owners (hereinafter "Owner") in
consideration of the issuance of a building permit and in order to confirm the promises upon
which such issuance is based while providing notice to any future owners or mortgagors of the
property does hereby stipulate, covenant and agree as follows:
1. Covenant: Limitation on Residence. The owner hereby stipulates and agrees
that occupancy of the structure as an adult family home shall be limited to or
fewer adults and their caretakers as allowed by applicable provisions of state law. T e owner
acknowledges that in the event that the applicant seeks revision of,the Iapplicant's state license.
to operate an adult family home with an occupancy of greater than ?� residents or attempts
to ren , lease or otherwise provide residence for additional residents above
the permitted in the current occupancy classification, the structure shall be vacated and
all residential use ceased until such time as the property is brought into compliance with the
provisions of the State Building -Code, under the edition of the Uniform Building Code then in
effect. The owner further stipulates that this covenant touches and concerns the land so long
as the present structure and use continues and shall run with the land to all future purchasers .
and assigns.
2. Subject Tract. The above stipulation and promises shall apply to and run with
the land with respect to a residential structure located at \C)fJ\ S \,1
Edmonds, Washington and legally described as:
✓✓i✓ /�Lt� UIaS OCR
/0 % A0
3. . Notification to Future Purchasers and Assignees. This notification and covenant
has been recorded in the records of Snohomish County, Washington in order to provide notice
to any and all future owners of the property of the limitation at the current level of improvement -
to single families and adult family home residents fewer than in number.
LlTemplFonnslLMT Cov.Doc
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4. Enforcement. In addition to any and other remedies civil or criminal which the
City may have, the property owner hereby agrees and stipulates that this grant of covenant
shall entitle the City to enforce by injunction the provisions of this code and, in so doing, to
recover its reasonable attorney's fees and costs.
DATED this day of
19 ��'
o
Cn `
,
a
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ACCEPTED BY:
PPLI ANT/PROPERTY OWNER:
1
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JdTm/y>
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APPI
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y
3
7 �I! 6 f�
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N
J annine L. Graf
Applicant
N=,
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Building Official
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Owner
IfFlY 5Z 1•/ g4_001
I�1t J
Owner
le"5w�T G%,
{
COVENANT AND NOTIFICATION
ACKNOWLEDGED: "
NOTARY FOR OWNER SIGNATURES
State of Washington )
)ss
ox
County of
I certify that I know or have satisfactory evidence that fi AEG/✓ �yifTJ •sj. ned;this�:
instrument, on oath stated that he/she was authorized to execute the instrument,"arid"
.acknowledged it as the gee (title) of (name of party on
behalf on whom instrument was executed) to be the free and voluntary act of such party for
the uses and purposes me ions 'n this instument.Subscribed and sworn to before me
this '3 / day of
Notary Public in and for thI6 tate of Washington.
My commission expires
Mortgagor
I certify that I know or have satisfactory evidence that as -D/q7 - /3 —47`�Dn signed this
instrument, on oath stated that he/she was authorized to execute the instrument and
acknowledged it as the fro S (title) of (name of party on
behalf on whom instrument was executed) to be the free and voluntary act of such party for
the uses and purposes mentions in this instument. Subscribed and sworn to before me
this Cl day of ,, 19 9 C
J O
Notary Public in and for the State of Washington.
� yNWC My commission expires , / 9 9 7
STATE OF WASHINGTON
DIA BOCK
MV Appointment Expires MAY 30, 1997
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64"801 0525 PAGE 0126
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I ic. 18cj0
July 7, 2006
CITY OF EDMONDS
121 5TH AVENUE NORTH • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771-0221
Website: www.ci.edmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
Planning • Building • Engineering
George E Buxton
10514-243`d Place SW
Edmonds, WA 98020
RE: Sight Distance Obstruction on 1051h Avenue West
Dear Mr. Buxton:
GARY HAAKENSON
MAYOR
Our records indicate that you are the owner of the property at 10514-243`d Place SW. We have
received a complaint that the vegetation on the southwest corner of your property is making it
difficult for drivers on 105th Avenue West to see to the east along 244th Street SW. Specifically,
the pine tree is creating a sight distance problem. City of Edmonds staff lias investigated the
matter and determined that the tree in question does, in fact, create a sight distance hazard per
Edmonds Community Development Code (ECDC), Street Obstructions, Chapter 9.25 (copy
enclosed).
In order to reduce the hazard and enhance public safety, the City of Edmonds directs that you
remove or cut back the tree two feet on the side that faces 244th Street SW. This should create
adequate sight lines for the users of the street to navigate the area more safely.
Please complete the modification and trimming by July 28, 2006. Your cooperation in bringing
your vegetation into compliance is appreciated. Please feel free to call me with any questions at
425-771-0220, Ext. 1328.
Sincerely,
Don Sims
Traffic Engineer
ES/cmc
Enclosure
c: Mike Thies, Code Enforcement Officer
Jim Kammerer, Street Division Manager
S:\ENGR\ED\Letters\Vegetation-SightDist\243 PL SW - 10514+'e fticftorated August 11, 1890 0
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'CITY CLERK �-
i CITY OF EDMONDS
505 BELL STREE NOTIC OF LIMITATION AND COVENANT
T
EDMONDS, WA 98020 ADULT FAMILY HOME
WHEREAS, the undersigned owners of property located at , �
in Edmonds, Washington legally described below or on the attached Exhibit A, have ied
for a building permit for compliance and/or to remodel a structure located on the site; an �
WHEREAS, the applicant has notified the City of the applicant's intention to utiliz'
improvements and/or to convert an existing single family structure to an adult family home;
WHEREAS, under the Uniform Building Code the number of occupants of a structurer�
trigger certain requirements relating to the fire suppression and exiting requirements; and
WHEREAS, the City has notified the applicant that the permit will be issued conditioned
on limitation of residents to or fewer residents and their caretakers; and
WHEREAS, the City has issued a permit based upon such representations;
NOW, THEREFORE, the undersigned property owners (hereinafter "Owner") in
consideration of the issuance of a building permit and in order to confirm the promises upon
which such issuance is based while providing notice to any future owners or mortgagors of the
property does hereby stipulate, covenant and agree as follows:
1. Covenant: Limitation on Residence. The owner hereby stipulates and agrees
that occupancy of the structure as an adult family home shall be limited to or
fewer adults and their caretakers as allowed by applicable provisions of state law. --The owner
acknowledges that in the event that the applicant seeks revision of the applicant's state license.
to operate an adult family home with an occupancy of greater than �Y residents or attempts
to ren , lease or otherwise provide residence for additional residents above
the permitted in the current occupancy classification, the structure shall be vacated and
all residential use ceased until such time as the property is brought into compliance with the
provisions of the State Building -Code, under the edition of the Uniform Building Code then in
effect. The owner further stipulates that this covenant touches and concerns the land so long
as the present structure and use continues and shall run with the land to all future purchasers .
and assigns.
2. Subiect Tract. The above stipulation and promises shall apply to and run with
the land with respect to a residential structure located at \of:>
Edmonds, Washington and legally described as:
>k, se- 14noe &ej 4,00tei7r c2.j-- /;�e s7- r✓Vv /!54it dos 4 oy
Lo r Ga
3. . Notification to Future Purchasers and Assignees. This notification and covenant
has been recorded in the records of Snohomish County, Washington in order to provide notice
to any and all future owners of the property of the limitation at the current level of improvement
to single families and adult family home residents fewer than in number.
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5
vaL. 319 4 nGE H 2 5
4.. EnforcemenAn addition to any and other remedies civil or criminal which the
City may have, the property owner hereby agrees and stipulates that this grant of covenant
shall entitle the City to enforce by injunction the provisions of this code and, in so doing, to
recover its reasonable attorney's fees'and costs.
DATED this day of �� , 19
ACCEPTED BY: PP L1 ANT/PROPERTY OWNER: 'Cn
Appli
z
--44M If IA-7) 7 31f6 -°
J annme L. Graf Applicant
Building Official _
Owner
IfFI-1 5 Z Al ��� �O% Owner
leA41T COVENANT AND NOTIFICATION
ACKNOWLEDGED:
Mortgagor
NOTARY FOR OWNER SIGNATURES" -
State of Washington)
)ss ,
County of
I certify that I know or have satisfactory evidence that /I/ x • ,�rJ�(T�}31/ .,sr` .ne b`this'`:
instrument, on oath stated :that he/she was authorized to execute the instrurne4irid
.acknowledged it as the (title) of (name of party on
behalf on whom instrument was executed) to be the free and voluntary act of such party for
the uses and purposes me �ionn, this instument.Subscribed and sworn to before me
this1 day of
NotaryPublic in and for th tate of Washington.
My commission expires // - y 9 ,�, .
I certify that I know or have satisfactory evidence that as-,D/q7 r3 %cfan signed this
instrument, on oath stated that he/she was authorized to execute the instrument and
acknowledged it as the fro.5 (title) of (name of party on
behalf on whom instrument was executed) to be the free and voluntary act of such party for
the uses and purposes mentions in this instument. Subscribed and sworn to before me
this Cl day of sr=f.! , /], 19 9
�.• ��7 O c'rz_
NOTARY PUBUC
STATE OF WASHINGTON
DIA BOCK
MV Appolntment Wres MAY 30,1997
LlTemplFormsILMT Cov.Doc
bW5
Notary Public in and for the State of Washington.
My commission expiresY�� 9 9 7
608-0 , ®5 25 VOL. 31 9.4PAGE0126