18416 88TH AVE W.PDF111111 lill 11
8343
18416 88TH AVE W
6? 9 0 - 1 9 9 -
City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
EET FILEPERMIT Permit Number:
Issue Date:
A. Address or Vicinity of Construction: - 18416 88 Avenue West
B. Type of Work (be specific): Install New Service
C. Contractor: Washington Nat'l. Gas Co.
Mailing Address: 815 Mercer St-§eattle,Wn
Y0111
State License #:
D. Building Permit # (if applicable):
Contact: Frank Swan
Phone: 224-2278
Liability Insurance:
Bond: $
Side Sewer Permit # (if applicable):
E. F� Commercial Subdivision El City Project a Utility (PUD, GTE, WNG, CABLE, WATER)
F� Multi-Fan-ffly 0 SingleFan-ffly F� Other
INSPECTOR: INSPECTOR: VA(�'-M
F. Pavement or Concrete Cut Yes E]No G. Size of Cut:*-(f )2 x 4 fWaterl-I. Charge $
APPLICANT TO READ (AND'SIGN
INDEMNITY. Applicant understands and by his signature to this application, agrees&d the City of Edmonds hatmle'iW,� �y&e.')damages, or
claims of any kind or description whatsoever, foreseen or unforeen, that may be made ajaIZ-i thelCiry of Edmonds, or any ofVts departments or employ-
ees, including or not limited to the defense of any legal proceedings including defe�se4`o s�'Lsj,ai�d afttorneyfees by reason of grqn'ti-ng' Ais p"errhit.
THE CONTRA CTOR IS RESPONSIBLE FOR WORKMANSHIP A ArD MA TERIALS FOR A PERIOD OF ONE YEAR FOLLO WNG THE FINAL INSPEC77ON
AND ACCEPTANCE OF THE WORK ES77MA TED RESTORA 77ON FEES WILL BE-,�ELQ
-VN77L THE FINAL S77ZEET PATCH IS COMPLETED By
C17Y FORCES, A T WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUAkE TO THE APPLJCANf�-
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Department- 72MIM.
Work is to be inspected during progress and at completion. 721-OcPd�o
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regblations as required by the City Engineo�t-
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above statements and understand the p it will be available
�op:mil requirements and the pink copy of the perm
on site at all timesfor inspection purposes.
Signature: Date: Dec. 21, 1992
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
TOT
..... ..... — ........... I ........
......... ................ -DATE::-:: ---- ...... ASSUED BY::
............. . .......
..... .......... ............ ..........
... ................
.............. ............ -
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Engrg. Div. 1991
FIELD INSPECTION NOTES (Fund I I I - Route copy to Street Dept.)
Comments:
01
11 Diagram:
, if-t-i -.
CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Addendum to C,-ity Of Edmonds
Righ� of Way
permit Application
submitted by: ing Aide
Engineer Natural Gas
'Washington
622-6767 x2761
pager
water main u=ij,-,,
unknown
/Z if gas main
r
-9- gas
-ss- sewer.
-e- water hydrant
0 water valve
-6767
815 Mercer St. (P.O. Box Ig6q), SeRWC, WA q&I 11 (206) 622
STREET F11 F
MEMO TO: Devon Drake
FROM: Jeannine L. Gra f��,
DATE: September 1, 1987
RE: Refund
A right of way constructi'on permit (87-255) was issued in error to
JoAnn Major7,—,18.4,'l;-,6-9,8,tli—Av-6n—u---e--We--s-t-,--E-dMonds—.-- -Please refund the
$30.00.
Copy permit 87-255 and receipt #7245 enclosed.
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CITY OF EDMONDS
COMMUNITY SERVICES DEPARTMENT
RIGHT. -OF -WAY CONSTRUCTION PERMIT
e Address or Vicinity of Construction:
Type of Work to be
Permit
Issue" Date'-
B. Contractor:
City�,,,,,�, State Zip
State License Number Telephone Number
Work in Connection With: 0 Sub or Plat 96ingle Family 0 City Projects
Pavement Cut: 0 Y YN 0 Commercial 0 Multifamily 0 utility
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, forseen or unforseen, that may
be made against the City of Edmonds, or any of its departments or employees, including or not limited to the defense
of any legal proceedings including defense costs, court costs, and attorney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE
YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed
by City forces, at which time a debit or credit will be processed for issuance to the applicant. .
• A 24 hour notice is required for inspection; Please call Public Works: 771-3202
• Work is to be inspected during progress and at completion.
• Restoration 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 this permit must be available at the job site for inspection purposes at all times.
1 -7
Signature:C�n rkA 02—owri-, Date:
V Owner or Cordractor
This Permit Must Be Posted at the Job Site For Inspection Purposes
Call DIAL -DIG Prior To Beginning Work
>. ISSUED BY:
0-4
Z Time Authorized: Void after ays.
0
W Special Conditions:
Amendments:,
U
04 k
0
PERMIT FEE:
Security Deposit:
Receipt No.:
Fund 111 Fee:
Street Cut Dimensions:
X
TO BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. July 1985
r-,, / I
City of Edmto..ds INT? C 7 2 4 5
Community Services
Date: -7 ti�-7
'�JQ AT� k'.l
Received of: C*-
Check Cash $ �tn.
Meter
-Water
Water Connection
Street Cut
Sewer Permit/Repair
Trunk Charge
Sewer Connection
Fence Permit
R/W Invasion
Street Restoration Deposit (620 fund)
Street Use Permit
Building Permit: (Type)
Plan Check/Plat Inspection
Specs & Plans Deposit
Zoning Applications
Shoreline Permits
S.E.P.A. Review
Recording Fee
Maps/Books
Photostating
State Surcharge
Energy Code Fee
Permit# F-T--
Date of Hearing: Time:
By-
I
00
Date:
To:
1UV 1040 UO I 11F.,
May 28, 2002
Carla Raymond
From: Jeanie McConnell
C>ff
Subject: Ramirez, 18416 88th Ave W, Complaint file EE-02-78
I have reviewed this complaint file for the following items:
9 Removal of trees within City right-of-way
In order to remove trees within City right-of-way, an individual would be
required to have an approved right-of-way permit. The trees mentioned were
removed from City right-of-way without an approved right-of-way permit.
9 Possible second access
It does not appear as though the owners intend to have a second access. The gate
is barely 8' wide and no access improvements have been done to create a
permanent access point off of 88th. Please see the attached photos.
* Possible fence encroachment
At this time there is not a fence located within City right-of-way. The letter in the
street file states the fence " . . . is located 18" from the edge of pavement". Both
fences for this property are located on private property, a distance mu ch greater
than 18" from the edge of pavement.
City of Edmonds
IV- �
Community Services Department
Engineering Division
9F
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:,f:l Fil I FFFA = MOPPAYMPI:
AN zt.
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STREET FILE
M E M 0 R A N D U M
August 27, 1987
TO: Jeannine Graf
FROM: Bobby R. Mills
SUBJECT: Fence in Right -Of -Way
I have inspected and took pictures of the fence installed at 18416-88th
Ave. W.
I feel the fence was placed improperly. It should have been placed on
the property line. It now is located 18 inches from the edge of the
payment. Once the fence is located back, additional planting could be
allowed outside the fence. Part of the existing fence is 6 feet high
and�-lpart is 4 feet. I question the 6 feet being legal. I must,
therefore, inform you that I will not issue a permit for this fence as
it exists now.
Also, I would like to mentioh that 18416 also has a satellite dish. Is
this legal?
If you have any additional questions, please call.
BRM/mo
FENCE/TXTMB061
R
FOR 96
DATE.
M CAM Ao
OF- /9,
PHONE 77
AREA CODE
NUMBER EXTENSION
TELEPHONED
PLEASE CALL
CAME TO SEE YOU
WILL CALL AGAIN
WANTS TO SEE YOU
RUSH
RETURNED YOUR CALL
SPECIAL ATTENTION
MESSAGE
SIGNED -
.S.A.
LITHO IN U
TOPSIV FORM3002P
C I T Y 0 F E D M 0 N D S
- PU13LIC IVOUS DEPARTMENT— 3-77
HErET FILE
Routing o Building Permit, Plat, or Subdivision Applications
Proposed Property Address: 18416 - 88th Avenue West
DEPARTIvENT
CONMENTS
1,N r —rhk L
& DATE
IVA T E R
S E W E R
S T R E E T
B U I L D I N G
0 R
P L A N N I N G
ADDITIONAL INFORMATION:
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10/11/76
IV, MIT
BUILDINt -DOARTMENT Applicant Fill Sm.ZONE NUMBER
ff -REC'Fl
PERMIT APPLICATION Inside Heavy Lines 9 Ou
NJ 1*'- 07 iXF R 1
ADDRESS /0// 1
NAME JOR NAME OF BUSINESS)
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ADDR'ESS
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CITY ONE NUMBER
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I C 77 1 P�. (i u —V--'V--
,JHEIGHT
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VARIANCE OR COND. USE NO.
A
W ADDRESS
u rELEPH.
M CITY ONENUMBER
NAME
0 -TDDRESS
U 8 o 3 k- d
M CITY TELEPHONE NUMBER
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0
U STATE LICENSE: NUMBhH CITY LICENSE NUMBE
Legal Description of Property, (Show Below or Attach Four Copies
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PROPOSED YARDS
A5,-FRONT SIDE A!5%EAR
SIGN AREA ENVIRONMENTAL REVIEW -
ALLOWED PROPOSED C..PL. T
D COMPLETE 0ExEmP
REMARKS
PLANNING DEPT. APPROVAL . DATE
LEGAL LOT
El YES ED NO
STREET R/W
EXISTING STREET R/W
COMP. PLAN ST. R/W
FT. DEFICIENCY THIS PROPERTY
FT. FT.,
CHECKED B
R
STREET ANCl/OR UTILITY ED
REQ*D. El Y ES
L-i
10
UNDERGROUND'
WIRING REQ'D. YES NO
TYPE CONNECTION.
SANITARY SEWER'
YES
0 NO'
0
'VERIFIED By
SEPTIC SYSTEM
APPVD BY CITY ENG.
YES
NO
PERMIT NUMBER
REMARKS
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REMAhKS
NEW
ADD
ALTER
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REPAIR
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RESIDENTIAL,
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EXCAVATE.
OR FILL
PRE -MOVE
INSP.
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SIGN
RETAINING
WALL
FENCE.
X _FT)
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swim
POOL
FIRE ZONE
TYPE OF CONSTRUCTION
ODE
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—]L-AD
SPEC AL INSPECTOR
REQUIREC
YES�,
AREA
OCCUPANCY
GROUP .
OCC UPAN1
PLAN CHECKED By THIS SITE IS Lb-CATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
NUMBER 0
+
TORIES
NU MBER OF
DWELLING
UNITS.
NATURE OF WORK TO BE DONE
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01PROPOSED USE
PLOT PLAN JINDICATE BUILDING 5
ABUTTING STREETS)
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PLAN CHECK
NO.
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WA LL
SWIMMI NG P06L
VALUATION FEE
LEGAL DESCRIPTION FOR SAUERLAND SHORT SUBDIVISION
PARCEL A
All that portion of the north half of Tract 34, Edmonds Sea View Te6cts,
according to the plat thereof recorded In Volume 3 of Plats, on page 76
records of Snohomish County, Washington.; more- part I c'ularl y described aso
follows:
Beginning at a point of the west,line of said Tract'34, said point being''-
115.00,feet south 6f- the northwest corner of said Tract 340.as* measured
along the West lipe theireof; thence.S89c)41154"E., along a line drawn
.parallel with the.north line of said Tract 34,. a distance of '152-50 feet to
�the True Point of Beginninq'of the tract herein described; thence contin-
Ung S89')41'5411E.
a distance of 90.00 feet to -an intersection with the
east line of said Tract 34; thence S003812011W, along,said east line a�
distance of 178.94 feet, to an intersection with
a line drawn pb ral lei
with and.lying 28.0 -fee't north of the south line of said north half;
,thence N89042'59"W, along said paral lei I ine a dis.tance of 49-33'.feet I
thence N25026148'!W, a distance of 92.49 feet; thence N0038120"E, a
tance of 95.64 feet, to the True Po d I
int of Beql'nning.
.EXCEPT the east-10 feet thereof deeded to the City of Edmonds.*under
Snohomish County.Auditor's File No. 2078774.
t7
-"--S-4WT SUBDIVISIM FOR JU,.,,Pl P. SAUERLAIJD
184th. St ree.t S. W. EX.$
N 89* 4 1 '1544W
20' 20'
P T
N69*41 154"W 232.50
1-52.50' a .04001, .30.1 1
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40 N.89*421594'w 2 3 2.3 8' -17
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SOU4H LINE Or NORTH HALF OF TRACT 34
LEGAL DESCRIPTION
0
APPLICATION
for
The City of Edmonds
SIDE SEWER PERMIT EASEMENT NO - ---------------------------------------
NEW CONSTRUCTION 0 REPAIRS F� LID NO . .... 1� ....... . ASMT. NO - ------------------
OWNER .... ......... V-A�=- ................................ CONTRACTOR -e F
----- �--�;> ----- .................................... PERMIT NO.
JOB ADDRESS ---- --------------- LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - -------------------------------------
.................
... T.N ....................................................... .......... - ------------- I ........
NAMEOF ADDITION ------------------------------------------------------------------- -------------------------------------- ------------
... ;17 ......... By
E
APPLICATION
The!'City of Edmonds for EASEMENT NO - --------------------------------------------
SIDE SEWER PERMIT
NO - ----- ----------
NEW CONSTRUCTION gj�— REPAIRS F� LID NO.
OWNER --- ............ ei�114� 2�f --------------------------------- .......... CONTRACTOR ----- 1'74 --------------------------------------------- PERMIT NO. :�,� -----------------
JOB ADDRESS ................. 6v, ---------------------- LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------
Se el
---------------------------------------- ----------------- l6q.h.4W — ------------------------------------------------------------------------------
NAMEOF ADDITION -------------------------- --------------------------------------------------------------------------------------------
7
S- L� 41�-e% 6ell-
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Pat
Approved:
DATE........................................... � By --------------------------------------------------- i . U�w
1011
DESCRIPTJL
4�
All that portion of the north half of Tract 34t Edmonds Sea View Tracts,
according to the plat thereof recorded in Volume 3 of Plats, on page 76,
records of Snohomish County, Washington; more particularly described as
follows:
Beginning at a point of the west -line of said Tract 34, said point being
115.00 feet south of the northwest'*c'or*ner of said Tract 34, as measured
along the west line thereof; thence S89'41'54"E, along a line drawn
parallel with the north line of said Tract 34, a distance of 152.50 feet to
the True Point of Beginning of the tract herein' described; thence contin-
ing S83*41'54"E, a distance of 90.00 feet to an intersection with the
east line of said Tract 34; thence SO"38'20"W, along said east Une a
distance of 178-34 feet, to an intersection with a line drawn parallel.
with and lying 28.0 feet north of the south line of said north half; ."
thence N89'42'59'lw, along said parallel line a distance o . f 49-33 feet;
thence N25*26'4811W, a distance of 92.49 feet; thence N0038120"E, a dis-
tance of 95.64 feet, to the True Point of Beginning.
EXCEPT the east 10 feet thereof deeded to the City of -Edmonds *under
Snohomish County Auditor's File No. 2078774.
NOTICE:
N'o ... W`a r-ra
The information shown on the attached
oiled for use by the CitY Of
map(s) was coMl
Edmonds/ its Employees and Consultants.
Th-e QtY of Ecirn.onds does not. warrant the
et forth on these
accuracy of anything s
entity -requesting a
Map(�-). Any person or
copy should conduct an independent
-ation shown on
inquiry regarding the inform
-t-He -map(s)/ including, but not limited to, -h
th . e location of any sewer stub shown. Suc
sewer stubs may or may, not exist. and may
hown.
or may not exist at the location s. . .
Nei-ther the r'ity of Edmoind's nor its
%_1
emp'fo-yee-s o-r office-rs -sh-a-I'l be 11a-b-'Fe for the
this map(5), nor for
information g ven on
any one representation provided based
upon*said map(s),
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
Z�
PERMIT
Call 77 -2525 for side sewer inspections BEFORE covering any Portion of the construction.1
Inspecti5on will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspections.)
ADDRESS LOCATION OF CONSTRUCTION .......... U&U
PROPERTY LEGAL DESCRIPTION ----------- S22 attached
....... - -------------------- j C =� ------------------------------ OWNER AND/OR BUILDER ......... Sile _Rellz!�,Tmn.
........................ . .......................................................
CONTRACTOR'S NAME & ADDRESS ........ AUAn - -------
- --- --- ------
Permission is granted ---------- KeY ------ 19-7-7 --------- 1 19-77, for repair and/or connection of a side sewer to the city sanitary sewer
sv-'-sn in accordance with Clty7 of Edmonds ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. 1—The owners of the Property may obtain a Permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct
side sewer in street area. Do not cover any Portion of sewer before it has been inspected.
NOTE No. 2—All work performed in city right-of-way requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office.
NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property line and 12 Inches inside property line; minimum grade of 2%. No bends in grade
sharper.than % will be permitted.
NOTE No. 5--Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper
work which may develop within one year of completion.
NOTE) No. 6—It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the main sewer or its appurtenances except to in-
sert the pipe into the wye.
DISAPPROVED E] Date ... . .... ............................ By ................ Date
APPROVED Date... .......... By --------_------ Date ............... . ................... By ................
W ------------------------
BY --- - ---- 4 0 . . . .. . ..........................
Remarks: ...... . ...... . ...................................................................
'100 ----------------- . ....................................... ...................................................................
...................................................................... . ........................................................................................ . .................................. . .. ....................................................
— BOTH Permit Copies MUST Be Signed By Owner of Firm j?erforming Construction PRIOR To Request For Inspection
r I
........................................................... .... hereby certify that the side sewer installation constructed under this permit
(6wner 'of Contracting FIrm Performing construction)
was installed in accordance with all governing ordinances of the City of Edmonds.
Datedthis ....... ........ day of ................................... ........................
2!�
V V Check BEFORE you dig for: Water 0, Gas E], Telephone Ej, Power E], Sewer Other Ej -V _V
,e I
5.,;. Do
10:20
FROM -OLD REPUBLIC TITLE EVERTT
+4Z5-258-48Z5
T-854 P. 03/03 F-UT
ft: il
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Ag vo porpm of am Nom W of Tram(3) 34� EDMON05 3EA vWW TPACT3, K=am m a" am mm
romdW in VoWm 3 of PWM Peg*Q 78- mm(ft Of %Wwffth CWW- wmft"Pwr Nve PWVGLMM 00"rg"
65 Wows:
saia Tmo 34. as mowxW a" �V*
114ENCF SOM W41"W Ea6t SWQ 4 kW onpWn RMW WMLOW
Nonn Sro of w4 Tram 34. a downce of 15150
ANK 113 am T" PON aevwmg of vw vw r"m
THENCE =nomwV S"7W41ldC Ea% a *pmw of 90.00 fect jo an kowwomoft wan Q* Eant km Of W4 Traor
34:
THENCE SwjM V3rjT IA� own $w Eag Lm a cap= ol 178.94 fect. to an wMwvoMm vvm a Im Grawn
pumm *lm ww " 2&Q w No"" Qf me som Im & aa-4 Nam Hwt,
THE14CE MOM W4ZW VA15k al"V "0 PwWW Lrw a dhonc* Of 419 33 ftM
THEN" Nwgi 25-M4W V*K 8 6418fm Of SZ49 *Qt
THENCE Nix u 0,3r= EaSL a comwo of 95 64 brut to gne Tpw Pw9 d ftgoPM.
rzXCEPT ina Earst 10 bet vwuO daeacC W Inc CRY Of EQmom3.unW Snowm$h CmAly Au=Ws Fag No
2078T74
(ALSO KNOWN AS Par= A of Vw Cay of EwTm od& Swa Plw No 5-3-T7 r.wwdw t=xw ROW"*V ?*x
77==14.)
SMATE in Vw Cowty cd Snor4n'4h. State ot washaigion.
SW903
4
END OF EXHIBIT"A'
200107020175
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ul
EXHIBIT "A"
Ali that portion of the North half of Tract(s) 34, EDMONDS SEA VIEW TRACTS, according to the pl6t thereof
recorded In Volume 3 of Plats. page(s) 76, records of Snohomish County, Washington; more particularly described
as follows:
'0)
Beginning at a point of the West line of said Tract 34, saIdPoint being 115.00 feet South of the Northwest comer of
said Tract 34, as measured along the West line thereof.
THENCE South 89041'W East along a line dravvn parallel with the North line of said Tract 34, a distance of 152.50
feet to the True Point of Beginning of the tract herein described;
THENCE continuing South'89041'64" East a distance of 90.00 feet to an intersection with the East line of said Tract
5
34;
THENCE South 01387ir West, along said East Line a distance of 178.94 feet to an intersection with a line drawn
parallel with and lying 2&0 feet North of the South line of said North Halt
THENCE North 89042'59"West along said Parallel Line a distance of 49.33 feet
THENCE North 26026!41r West a distance of 92.49 feet
THENCE North V382T EaA a distance of 95.64 feet to the True Point of Beginning.
EXCEPT the East 10 feet thereof deeded to the City of Edmonds under Snohomish County Auditor's File No.
2078M.
(ALSO KNOWN AS Parcel A of the City of Edmonds, Short Plat No. S-3-77 recorded under Recording No.
7702080218.)
SITUATE In the County of Snohomish, State of Washington.
END OF EXHIBIT "A"
REcEIVED
SEP 1, 0 2004
la
tv
RETURN ADDRESS:
City of Edmonds, City Clerk
12 1 - 5 th Avenue North
Edmonds, WA 98020
DEVELOPMENT rERMES GTR.
C,:TY OF EDMONDS
W107020i?5- 200107020175 1 Snohomish
07/02/2001 11:16 AV
P.o005 REcoRDED County
RECORDER�S NOTE:
PORTIONS OF THIS DOCUMENt
ARE POOR OUALITY FOR SCANNING.
NOTICE OF LIMITATION AND COVENANT
ADULT FAMILY HOME
Reference #: 001-o49
. Grantor(s): (1) 9*�/VR t� 164M
J* 0 Additional on pg. A
Grantee(s): C11y of Edmonds
Legal Description (abbreviated): Seiz--Twn---------Rng Qtr
OR Lot Block lat
Assessor's Tax Parcel ED#(s): (2)
--Assessor's Tax Parcel ID# not yet assigned
AUTHORIZED FOR RECORDING
City of Edmonds
By: ljzfi Date: 412'r1ol
Page / of
V i Co ST4
WJjEREA§, the undersigned owners of property located at
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 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 ap licant 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:
RE:r,S IVE D
JUL 3 1 2001
EDMOND$ CITY CLERK
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.- 4 residents or attempts to rent, lease or
otherw se . provide residence for additional residents above * the
,4- 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. Sub - ject Tract. The above stipulation and promises shall apply to and
run with the land with respect to a residential structure located at �00ql(� 1�t'�_
Edmonds, Washington and legally described . as:
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 .5- in number.
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.
AUTHORIZED FOR RECORDING
City of Edmonds
B y: �.w Date:- 411CV101
]?age of __I�
1) U I AU 7 011 2 011 7 5
DATED this day of
ACCEPTED BY:
OWNER:
A1,21 /10/
Jeannine L. Graf
Building Official
NOTIFICATION
NOTARY FOR OWNER SIGNATURES
State of Washington )
)ss
County of 51Dhom(4)-)
APPLICANT/PROPERTY
Ap�licant
Applicant
0 Vine, r
Owner
COVENANT AND
ACKNOWLEDGED:
Mortgagor
I certify that I know or have satisfactory evidence that 17 14t I er— a - X�q/77/
signed this instrument, on oath stated that he/&was authorized to execute the
instrument and acknowledged it as the (title) of leW,14
X
(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 men�jgu&b4'this
instrument. Subscribed and sworn to before me this 71�,5
4-9���2OO
Y PM
04 s0TAR
UC
PVotary Public im"d for the State of Washi
My commission expires 9
I certify that I know or have satisfactory evidence that (-"4&�2
signed this instrument, on oath stated that he/she was autgorized to execute the
instrument and acknowledged it as the (title) of
OW� 9W, (-J - (name of party on behalf on whom instrument was executed) to be th e
free and voluntary act of such party for the uses a nd purposes mentions in this
instrument. Subscribed and sworn to before me this day of
492-0-,)/
VA 'j.
01
kp It
U-) 1,
Notafr/y Public in and the State of Washington. 4
: 0 N OTAr?),
Mye.ommission expires �2-/2-03 :0
;4 M,
0
00
XORDING
AUTHORIZED FOR RE "Oil
C't of Edmonds
By:—'�w Date: 41,09101
Page -3 of
L:\TEMP�BUILDING\FORMSXADF—COV.DOC
20107.020175
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS
0. 0.11. P
MAILING ADDRESS ev
7
CITY ZIP TELEPHONE NUMBER
QP0
ADDRESS
NAME
__ A/
ZDDRESS
CITY ZIP I TELEPHON
STATE LICENSE NUMBER EXPIRATION DATE
Legal DesItion of Property - include all Basements
=unt
��q�00003#000-1
Parcel No.
PLUMBINGIMECH
NEW
RESIDENTIAL
r ' 0
OMPLI;NC R
I§
L�a
ADDITION
COMMERCIAL
SE
ETREMODEL
APT. BLDG.
E]
SIGN
GRADING
E]
FENCE
REPAIR
CYDS.
X_ FT)
ODEMOLISH
WOODSTOVE
INSERT
SWIMPOOL
HOT TUB/SPA
GARAGE RETAINING WALL/
RENEWAL
CARPORT
ROCKERY
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
VLA
NUMBER
NUMBER OF
CRITICAL..
OF
DWELLING
AREAS
INUMBER
STORIES
UNITS
DE RIBE W 0 BE DONE (ATTACH PLOT PLAN)
/I
I . fe / T-
Yvlt,
lqdu)
k. r-A1,11 It 1%iq
01i
USE MIN
ZONE PERMIT
NUMBER q q,
�j
JOB SUITE/APT
ADDRESS
A ty.
PUBLIC RIGHT OF WAY PE R OFFICIAL STREET MAP.
TESCP Approved
0
,
RW Permit Required
0
EXISTING REOUI I RED DEDICATION —
Street Use Permit Req'd
0
Inspection Required
0
PROPOSED
Sidewalk Required
0
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
I
YES 13 NO 13
ENGINEERING MEMO
SEPA ENIE W
C NPLETE I 17T
,P
EXP
LOT COjGRAGE
N4�ED PM;��[
< DB #
A�b�SIGN N
I R OSED
EOND SETBACKS (FT.)
FRONN, SIDE REAR
REVIEWED BY
UR SIDE REAR
1\h7i \/Aur� W1 i_x
W 1
osru
,(J,-1rl'li& r;1,4 7
OHECKED BY TYPE OF CONSTRUCTION
CODE
oCCuPW
_9N
G 0
SPECIAL INSPECTOR
AREA
REQUIRED 0 YES
LOAD4
REMARKS
PROGRESS INSPECTIONS PER USC 108
Z
FINAL INSPECTION REQUIRED
VALUATION
FEE
PLAN CHECK FEE
.1—avviz BUILDING
HEAT SCiUROE:,,: GLAZING
% PLUMBING
Plan Check No.
MECHANICAL
GRADINGIFILL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewelks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: I 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
successors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance
PLAN CHECK DEPO SIT
of this permit. Issuance of this permit shall not be deemed to
�j
modify, waive or reduce any requirement of any city ordinance
0
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision."
I hereby acknowledge that I have read this application; that the
ATTENTION
APPLICATION APPROVAL
information -given is correct; and that I am the owner, or this duly
authorized agent of the owner. I agree to comply with city and
state laws regulating construction; and in doing the work authoriz-
THIS PERMIT
AUTHORIZES
This application is not a permit u ntil
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 recei ' pt is
tion Insura250!9 RCW 18.27.
INSPECTION
acknowledged in space pro.yided.
SIGNATtJRE1�QYWt&,B0OR AGENT) DATE SIGNED
DEPARTMENT
/)0
CITY OF
OFFICI SIGLRE
6� V'k
EDMONDS
CALL FOR
RELE 'S9 BY:
DATE
ATTENTION
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771-0220
ORIGINAL — File YELLOW — Inspector
.A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
SECTION 109
PINK — Owner GOLD — Assessor
10247