18717 88TH AVE W.PDF111111111111
8363
18717 88TH AVE W
-4/�
STREET FILE
INSPECTION RECORD
CITY OF EDMONDS, PUBLIC WRKS DEPARTMENT
DATE: PROJECT:
2
Q
I / 7 8 1 v
,Y:
11
CITY CLERK
CiVIC CENTER sTfi
EDMONDS. WA 98020 JAN 14 1994
NOTICE OF LIMITATION AND COVENANT
WHEREAS, the undersigned owners of property located at 1-1717 A61r- A/ in
E%s Edmonds, Washington, legally described on the attached Exhibit A, have applied for a building
permit 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 to co . nvert an existing single family structure to an adult family home; and
WHEREAS, under the Uniform Bu ' ilding 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 4� 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:
I . Covenant: Limitation on Residence. The owner hereby sti Ulates and agrees that
occupancy of the structure as an adult family home shall be limited to I or fewer adult P�!f5alv
and their caretakers as allowed by applicable provisions of state law. Ile 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 residents or attempts to
rent, lease or otherwise 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 effecL 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 /157/E WWPe PKS—r I Edmonds,
Washington and legally described as:
Anw-'ely 7,v- 0!-
zow be.4ekI )wAe7--r Zu-� 00OP-03--Ze6 _VW -Me
EM
A r 5 ZI 97. -16 4 i P - 7,.? o*Zo
/ Se7
M -W1- V 7,
5,o 5 4,ve 1?4. loq- 7,9 In& 4,ce w IN4- 6�y a- 6,eAvvw-t xe -c mo 2 oj 9,s 6 2—
Scpt=bcr 13, M
WSSM9.IX/0006.040.010
lga6 'a1t11j1zW
VOL. 2857PAO&32
3. Notification to Future Purchasers and Assienees. 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 ad ' dition. 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 t day of 3 ?,h t-,,:,-'Y J , lgg/;(
-J
ACCEF.rED BY:
4��Wo;
JeAnine Graf, Acting BuMing
Official
SqA=bcr 13, 1993
WSS56089.IX/0006.040.010
940.12001 70
2
APPLICANT/PROPERTY OWNER:
COVENANT AND NOTIFICATION
ACKNOWLEDGED:
Mortgagor
CZ)
VOL. 2857PA6E2833
9401200 -1 711
C> STREET FILE MEMO
t�- co-P)f- JAN 141994
NOTICE OF LIMITATION AND COVENANT
teldWiffild
ft -f*/1ft
WHEREAS, the undersigned owners of property loca 1*, 1 , in
Edmonds, Washington, legally described on the attached Exhibit A, have applied for a building
0 permit 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 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 4- 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:
I . 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 adult M---1;9/15
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 otherwise 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. Subject Tract. The above stipulation and promises shall apply to and run with the
land with respect to a residential structure located at /15717' 66�40,e &2�S--r , Edmonds,
Washington and legally described as:
Py VV
-1?6 kqe4/ 7.,�4 cz:r 6 cx oev P-o-nr- A:rec7 vw ca c,-*ja
20 e Az4 W z1v -73- claxrr 7,xl Sg,? &4W 13 E Ar 5 Zlt- / �7 71,'12- *-7 j3
1-?,6. /0,0':r 729 XOd- 4�PCe W lWac- 6,71 OF C-01*10vVY Xe -C lyz> 2 03 9-'�'b Z—
Septrmber 13, 1993
WSS56089.IXJ0006.040.010
'Iuai� "91t1alav
3. Notification to Future Purchasers and Assilzriees. 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.
DATED this day of
ACCEPTED BY: APPLICANUPROPERTY OWNER:
6&� d��
Je4�nine Graf, Acting BuWng
Official
Scptember 13, 1993
WSS56089.IX/0006.040.010
0�
COVENANT AND NOTIFICATION
ACKNOWLEDGED;
Mortgagor 9
asolington late
r7D OF
0 -T
7 PD,.',if:".A,,R.T� t.E�NA LT H
SERVICES
Adult famil-Y Home! Liccn6c'
In compliance �vith 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 PAUL TROMBLEY License Number 52 H 477868
to conduct and maintain at 18717 88TH AVE WEST
city of EDMONDS , zip code 98026 _, county of SNOROM:ESH
State of Washington, an Adult Family Home for the care and supenision of adults as follows:
24-hour family care for no more than six adults
number
This license shall be in force from the 03PD da of JWIE 19 95, to and including
V
the 0 2ND day of
Special Terms:
Licensor
JUNE
1 19 96 , Subject to revocation for due cause.
Ltcen-5't119.411th0r1tY-
NOTE: This license is not transferable, and is valid only for use by the indi%idual(s) to whom it is issued and at the location above
described. Issued by Authority of Chapter 172, Laws of 1967, and RM 70.128.
�Zi V 9 y-M
CITY OF EDMONDS
.DEPARTMENT OF BUILDINGS
CERTIFICATE OF OCCUPANCY
UNIFORM BUILDING CODE SECTION 307
At 18717 88th Avenue West
Occupancy established by this certificate:
R-3
40111 rM, I
No. Stories
Basement
4 Clients
Floor Load signs in place (per Sec. 13o8 U.B.C.) — Capacity signs 1 Suprv. — posted (per Sec. 3302(c) U.B.C.)
Owner of Building
Building Permit Number
No. Units
Type Const. V-N
Floor load and room capacity signs, when required, must remain posted at all times.
Paul Trombley
Address
5714 95th Dr. SE, Snohomish
THE NEW BEGINNINGS ADULT FAMILY HOME HAS BEEN INSPECTED AND APPROVED AS COMPLYING WITH
THE REQUIREMENTS OF THE UNIFORM BUILDING CODE AS ADOPTED BY THE CITY 1991 EDITION, FOR THE
GROUP AND DIVISION OF OCCUPANCY AND THE USE FOR WHICH THE PROPOSED OCCUPANCY IS C LASSIFIED.
Issued this 3rd —day of March 19 94
CHIEF BUILDING OFFICIAL By 1/1�
V
This certificate shall be posted in a conspicuous public area and shall not be removed, mutilated or obscured and shall be main-
tained in legible condition at all times. Any change of occupancy requires a new certificate.
Vashington State
saP)
DE 'AR EN F
fflATUSH
D, A T
oc, L
sER CES
Adult family Home License.,
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 Paul W. Trombley License Number 52 H 477868
to conduct and maintain at
18717 - 88th Avenue West
city of, Edmonds , zip code 98026_, county of
I
Snohomish
State of Washington, an Adult Family Home for the care and supervision of adults as follows:
24-hour family care for no more than 4 adults
nunOer
This license shall be in force from the 8th day of June —) 19 93 , to and including
the 8th day of. June
19 94_, subject to revocation for due cause.
NOTE: This license is not transferable, and is valid only for use by the individual(s) to whom it is issued and at the location above
described. Issued by Authority of Chapter 172, Laws of 1967, and RCW 70.128.
CITY CLERK MIMI - NO
CMC CENTER
41994
EOMONDS. WA 98020 JAN I
NOTICE OF LEWITATION AND COVENANT
WHEREAS, the undersigned owners of property located at 1,671-7 A644 A/ , in
Edmonds, Washington, legally described on the attached Exhibit A, have applied for a building
permit 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 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
WHEREASY 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 sti lates and agrees that
to -7u
occupancy of the structure as an adult family home shall be limited or fewer adult ofn��-Ivs
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 -, -jesidents or attempts to
rent, 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 /25717- W,Ille K4�S--r , Edmonds,
Washington and legally described as:
)axe
,,vy 7.#-x
ziy-W
zp-
myvyar Xzg yte&V ;7&9 cZ:r d6 tte- OeV P-03-- , e6 - 64,e )WA, /W /Y 0 *-T3
'2045 AL6 W Z/v 7-5:10,ocr 7N S99 f4w 13,E A�- 5 Z"V, A
17. ZL�� .5&V.*26
50 5
SW=b" 13. 1993
WSS56089.IX/0006.040.010
lga6 ,�Pmjlzw
VOL. 2857PA6E2832
J%
3. Notification to Future Purchasers and Assignees. This nodfication 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.
DATED this t day of lqq/�(
ACCEPTED BY:
4��� d/-J-41S
JeMnine Graf, Acting BdWing
Official
SqAcmber 13, 1993
WSS56089.IXA)006.040.010
940,1200170'
9401200-1 7a
2
APPLICANTIPROPERTY OWNER:
COVENANT AND NOTIFICATION
ACKNOWLEDGED:
Mortgagor
cAai
C)
VOL. 2857PA6E283-3
At7'Shington State
DEPART
LVENT OF
f7a I
1.4
SOCIAL HEALTH
S1
SERVICES
Adult.. family. Home Licen6e..
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 Paul W. Trombley License Number 52 H 477868
to conduct and maintain at 18717 - 88th Avenue West
city of Edmonds zip code 98026 county of Snohomish
State of Washington, an Adult Family Home for the care and supervision of 'adults as follows:
24-hour family care for no more than 4 adults
nun0er
This license shall be in force from the 8th day of June 19 93 , to and including
the 8th day of June 19 94
--- I , subject to revocation for due cause.
Special Terms:
(�J Licewing AuWrity
NOTE: This license is not transferable, and is valid only for use by the individual(s) to whom it is issued and at the location above
described. Issued by Authority of Chapter 172, Laws of 1967, and RCW 70.128.
I
DSHS 10- 171 (Rp.v- I /A 1)
STREETfILE
USE
ZONE gS_6 PERMIT
CITY OF EDMONDS NUMBER 9_304E4 �77
CONSTRUCTION PERMIT APPLICATIOINjos JITEjAP
0
ADDRESS -7 b0l" AVE, VV eD?*/IONJr�,� .1-7 1Z
FOWNE'R NAME/NAME OF BUSINESS
Oil) r-r'/k It; NAY 1,2,r /,I I 1A Jlkj/ LEGAL DESCRIPTION CHECKI SUBDIVISION NO. LID NO.
M ''WAANESS
AILIN
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3:
0 67
CITY.
NAME
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ADDRESS
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CITY
NAME
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ADDRESS
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0
STATE LICEIsJSd NUMBER
IS P I E_tll _* I
1 1. E-,
Z115 TELEPHONE NUMBER
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dA ?10 61 2 7 _7 -7 1 . .
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ZIP TELEPHONE NUMBER
alx)4 im&
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
TESCP Approved
0
RW Permit Required
0
EXISTING —REQUIRED DEDICATION —
1
Street Use Permit Req . d
0
Inspection Required
0
PROPOSED
.
Sidewalk Required
0
fiPal 7"17" 14 Y /X0/?t& //4W,4e_
# 5-2,
6101A
ENGINEERING MEMO DATED REVIEW BY
METER SIZE BUILDING SUPPLY SIZE NO. OF FIXTURES*
ZIP TELEPHONE NUMBER
L�j�j 7 1 06(p -7 k34- - 05- REMARKS
EXPIERATION DATIE SIGN AREA SEPA REVIEW
tS ALLOWED PROPOSED COMPLETE 1EXEMPT
erty - include all easements I I
Property
Tax Account
Parcel No. 0)
1:1 NEW
WRESIDENTIAL
0 PLUMBING
ADDITION
COMMERCIAL
MECHANICAL
WREMODEL
El APT.BLDG.
SIGN
GRADING
FENCE
E]
REPAIR
— CYDS.
I x _FT)
DEMOLISH
WOODSTOVE
INSERT
SWIM POOL
HOT TUB/SPA
GARAGE
RETAINING WALL/
c
ROCKERY
RENEWAL
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
Api)L��:
-'5:r I L-f (A
NUMBER
NUMBER OF
CRITICAL
OF
STORIES _21
DWELLING
UNIT,
UNITS a e—
AREAS
NUMBER MR
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
I!, I �E: 1
(411 IE r-- '::,X 1 -4:1 k IL-4
P"r- n;-, (42M
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VARIANCE OR CU P7��EVIEW BY TE
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SETBACKS — FEE T HEIGHT I LOT COVERAGE
I FRONT SIDE REAR I
31
Z
Z
P4 V
e�)y_
eX2
Gl J?(w 76� ,Z;7
CHECKED BY
TYPE OF CONSTRUCTION
CODE
HEIGHT
�PECIAL INSPECTOR
AREA
"
OCCU
REQUIRED
JOCCUPANCY
GROUP
LOAOFVT4_14�
YES
NEMARKS
PROGRESS INSPECTIONS PER UBC 305
Z
0
_j
_Z�YSIII_ 10e,4 lqll WSC,
FINAL INSPECTION REOUIRED
VALUATION FE!
r)r,rr_, p
P_,E_DFvb�,1 I N6T-A 3 M 4-F— Oeq-�ecp
T2
41:1 U4-
PLAN CHECK FEE
rr 1-144
BUILDING
4iiSOURCE:
GLAZING
%
PLUMBING
Plan Check NO.
Y'T
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curts, sidewolks,
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
2W
2
0
"Applicani,-on behalf of his or her spouse, heirs, assigns and
successors in interest, agreeNto 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
of this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirement of any city ordinance
nor limit in any way the City's ability to enforce any ordinance
provision."
ENG. INSPECTION FEE
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
I hereby acknowledge that I have road this application; that the
information given is correct; and that I am the owner, or the duly ATTENTION
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
ed thereby, no person will be employed In violation of the Labor ONLY THE
Code of the State of Washington relating to Workmen's Compensa. WORK NOTED
tion Insuranc . I NSPECTION
SIGNATURE (OWNER OR AG?4'TV DEPARTMENT
CITY OF
EDMONDS
CALL FOR
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
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED., UBC
(!7C
U01P
APPLICATION APPROVAL .
This application is not a permit until
signed by the Building. Official or his/her
Deputy; and fees are paid, and receipt is
acknowledged in space provided.
-771
,'AV%?"3l 7
R E �LE '§�El DATE
L
ORIGINAL File YELLOW — Inspector
A--,
I
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS.
FOUNDATION:
Footing ................
Wall ........
r I a I. ol r c�,.� .............
Retaining Wall ............
PLUMBING:
Underground ..........
Rough -In ..............
CF....................
HEATING:
Gas Test ............... "_7
Gas Piping .............
Equipment .............
CF.....................
FRAMING ..............
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
FINAL APPROVAL
FOR OCCUPANCY .......
11
4—j!
CITY OF EDMONbs
USE
ZONE PERMIT 7.
9364-74�-.�'
NUMBER
CONSTRUCTION PERMIT APPLICATION
jos SUI7/APT 11
ADDRESS 7
(9(
OWNER NAME/NAME OF BUSINESS
LEGAL DESCRIPTION CHECK
SUBDIVISION NO.
LID NO
cc
w
Z
MAILING ADDRESS
0
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
TESCP Approved 0
CITY ZIP
TELEPHONE NUMBER
EXISTING — REQUIRED DEDICATION
RW Permit Required 0
Street Use Permit Req'd 0
PROPOSED
Inspection Required 0
Sidewalk Required 0 a
NAME 7711— V;?Id-
REMARKS
Lu
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Z
(u>j
ADDRESS
X
0
Z
W
cc
<ICITY
ZIP
TELEPHONE NUMBER
NAME
ENGINEERING MEMO DATED REVIEW BY
.,Z�
cc
ADDRESS
0
METER SIZE
BUILDING SUPPLY SIZE
NO. OF FIXTURES
<
CC
Z
CITY IP
TTTELEPHONE NUMBER
cc
W
Z
8
REMARKS
STA'FE LICENSE NUMBER EXPIRATI N DAT
le;e In
I SIGN WAER
.V��F 5__
7
NO.
ALLO*EI[L-_t_-PROQOsED�—j
_CoMRLE E
Legal Description of Property - include all easements
SETBACKS — FEET
HEIGHT
COVERAGE i
-j
Property
FRONT SIDE
REAR
ILOT
Z
Z
Tax Account
Parcel No.
F-1
NEW
It--T RESIDENTIAL
PLUMBING
EIADDITION
COMMER61AL
MECHANICAL
\C?r
APT. BLDG.
,r= REMODEL
SIGN
GRADING FENCE
CHEC D
A R DE
HEIGHT
REPAIR CYOS. I X_ FT)
DEMOLISH WOODSTOVE SWIM POOL
El INSERT D HOT TUB/SPA
OCCUPANT
SPECIAL INSPECTOR
REOUIRED
13 YES
G OUP
LOAD
GARAGE RETAINING WALL/
C ROCKERY RENEWAL
REMARKS
Z
0
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
0
PROGRESS INSPECTIONS PER UBC 305 Z
NUMBER
NUMBER OF
CRITICAL
0
OF
DWELLING
AREAS
INUMBER
STORIES
UNITS
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
FINAL INSPECTION REQUIRED
VALUATION
FEE
K FEE
HEAT SOURCE:
GLAZING
PLUMBING
—7,
eck No.
MECHANICAL
This Permit covers work to be done on private property 0
GRADING/FILL
Any construction on the public domain (curbs, sidewalks,
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
w
successors in interest, agrees to indemnity, defend and hold
02
harmless the City of Edmonds, Washington, its officials,
m
employees, and agents from any and all claims for damages of
Cc
<
whatever nature, arising directly or Indirectly from the Issuance
I
of �this permit. Issuance of this perr 91t shall not be deemed to
PLAN CHECK DEPOSIT
0
modify, waive or reduce any requirethent of any city ordinance
0
norl . imit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
3� 00
provision."
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 authorlz-
AUTHORIZES
T his application is not a permit until
ed thereby, no person will be employed in.YIqlation of the Labor
ONLY THE
.
signed by the Building Official or his/her
Code of the State of Washington relatin W&Rmen's Compensa.
WORK NOTED
Deputy: and fees are paid, and receipt is
ti I urance.
.Un ns
INSPECTION
acknowledged in space provided.
SI N OR AGE T DATE SIGNED
DEPARTMENT
e A
CITY OF
OFFICIAOS TUR D TE
EDMONDS
'ATTENTION
CALL FOR
'RELEASED OY: (T
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
771-0220
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
ORIGINAL — File YELLOW — inspector
1i
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED, UBC
.
CHAPTER 3.
PINK — Owner GOLD — Assessor
CITY CLERK
CiVIC CENTER
EDMONDS. WA 98020 71 &U) JAN 14 1994
�r �nw' r
NOTICE OF LIMITATION o Rm NEE, FiLE
WHEREAS, the undersigned owners of p located at in
roperty 4 A/
Edmonds, Washington, legally described on the attached Exhibit A, have applied for a building
permit 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 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 ,
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 ti ulates and agrees that
occupancy of the structure as an adult family home shall be limited to I or fewer adult Pew5a*S
and their caretakers as allowed by applicable provisions of state law. The owner
acknowledges that in the event that th . e applicant seeks revision of the applicant's state license
to operate an adult family home with an occupancy of greater than _* residents or attempts to
rentl 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 /257/f W7141le AKE-S—r , Edmonds,
Washington and legally described as:
OR. qA-, a y c 10,fr, a-4 0 � - Oa) - a6 -19-1 -0 Z
'0,'14'r X64 wettl zPz"gar zle- oev A-0-�r- ZC6 -�;w e4e Ase
.20e N-,6 W ZIV '70.xr 771 S81A41 .5&V-*Zt3
�-3 91-Z �71*
SW=ba 13. 1993
WSS56089.IX/0006.040.010
lgaif 'ovk7w4w
1?,6. /0cr 70 ^'& exe W /'P"� lwac' al a- 6.-OAIVVVI Ive mo ztvjqj�z—
VOL. 2857PAGE2.8.32
"'� - - -1
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 ad ' dition to any and other remedies civil orcriminal 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 b, day of 199/1�
ACCEPTED BY:
dz-J�6
Je2Knine Graf, Acting B&I&ng
Official
SWxmber 13, 1993
WSS56089.IX10006.040.010
940 ' 12007 70'
9401200-1 7a
PA
APPLICANTIPROPERTY OWNER:
COVENANT AND NOTIFICATION
ACKNOWLEDGED:
Mortgagor x .
CAM
.ZC'
CD
VOL. 2857PAGE28 -33
APPLICATION
Tho City of Edmonds 2 ro for EASEMENT NO - ------------- ----------------- ------------
STREETFl SIDE SEWER PERMff
L;;Iw CONSTRUCTION 0 REPAIRS E] LID NO - ------------------ - ASMT. NO - ------------------
OWNER ---- E 5. �. --7 ----------------- CONTRACTOR LAtt-l%-l(,vam -------- ------- PERMIT NO. �4o-0-4!5
JOB ADDRESS AE�:k7vk--� --- �- ------------- LEGAL DESCRIPTION: LOT NO - ---------------- ---------- ---------- BLOCK NO - --------------- -----------------
- - � I'Q,, 4% kz-
'The City of Edmonds
APPUCATION
for
SIDE SEWER PERMff
EASEMENT NO - --------------------------------------------
NEW CONSTRUCTION E] REPAIRS n LID NO . .................. . ASMT. NO. ---- ----------
OWNER 45��47 ... Zd.�??Ve� 77 ----------- --------- PERMIT NO.
JOB ADDRESS ........... LEGAL DESCRIPTION: LOT NO - ------------ I ------------------------- BLOCK NO - ------------------------------------
--------------------------- -------------------- — ------------------
Z- 1�ea-14 z
771.4rl)0,4271-t�oV 6-10`1-72we-7-1411�
,o9&ecyl,&�Ilele 75 7-,-'IZ- 77,�W�47-'
AEc-,o,e,e), / 4*/ ole Z. 3 61Av7Lj-r
A 7- 7-171k� eOAV&�E 0701:'�
/4ig - r ZYSAO
lle&e4C Al& 0 ' "'
44 eAl C 77/4F' 4.1,rJ-17 AMF -7 0-a.r d�0 7":�,- %
. .0
ore
Aq 7;z1zF-,ve4�� -5--1 a9�1-
7a
+V ` / .7
/41
57,0.lp
7?4:5' a/C-7-r 7�1 o ?`� 7A0fdF#?6!'0;&
7-o 7-We d;rP`07-'� ,!Fhtw0.ov.A-r
7Z,,o 727 1,V -1:r>01 eO 44-7P
NAME OF ADDITION .....................
Approved:
DATE
By--------------------------------------------------- yi7yg
NOTICE:
'.0
..Warra
. hown on the attached
The information S
map(s) was compiled for use by the City Of
Edmonds- its Employees and Consultants.
Th,e City of �Edrn.qnds does not. warrant the
�th on these
accuracy of anything set fo
entity -requesting a
map(�-). Any person or
copy should conduct an independent
m-ation shown on
inquiry regarding the infor
-map(s), including, but not limited to,
th . e lociation of any sew-er stub shown. Such
sewer stubs may or may, not exist. and may
at the location shown.
or may not exist
,�ity of EdmoindS, nor its
Neit-heir the %__1
empj*o*yee*s o'r office-rs -sha-lfl be 11a.b.-Ife forthe
information given' on this map(s), nor for
ntation provided based
P represe
any on
upon said map(s).
7
CITY OF EDMONDS SIDE SEWER PERMIT
WATER-S DEPARTAMNT
PERMIT
Call 775-2525 for side sewer inspections BEFORE covering any portion of the constru tion.)
(Inspection will be provided within 24 hours after requst. No Sat., Sun., or holiday inspectcions.
ADDRESS LOCATION OF CONSTRUCTION ..... /A -7 /s- .... F. . ...... .............. . I ......................................................
....................... ............ .1 `> -`�
1// F L,-j -7.2AL.7 .........
....................
.................................
PROPERTY LEGAL DESCR11PTION._:T2&(--T ------ 16 ---------- ............................
...................... . .......................... . ...................... . ........................................................................................ . ................................... ..................................................
OWNER AND/OR BURMER --- A AA.A..R_Ar..Q.L�n ..............................
OL ------------------------------------------------------- P4 0 i
CONTRACTOR'S NAIMM & ADDRESS .... ......................... -------- ------------------- �7 ---------------
Perlinission Is granted ... ----------------------- . ............ 19-2-9, for repair and/or connection of a side sewer to the city sanitary sewer
.system in accordance with City of Edmonds ordinances.
ATTENTION IS CALLED TO THE FOLLOWING: ed to construct
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 employ
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-wav requires an Invasion of RIght-of-Way Permit obtairrable 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. roper
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 imp
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.
DISAPPROVEDE] Date ... . ...... I .............. I ............ By ---------------- Date --------------- - ------------------- By ................ Date ................ ................... 'By ................
APPROVED [:?—Date ... . .... Z/ 7,
. ........... 77_� ----- �5 By --- - ---------------------------------- - -- - ---------------------------------------------------------------------------------------
114 _ .
1 .. A ...... i..
Remarl 401 .. .................... . ...........................................................................................................
Es.
..................................................................... . .................................... ............................. ..................... . ................................... ................... 0 ...................................
BOTH Permit Copies M-USTRIle Sign d By Owner of Firm Performing Construction PRIOR To Request For Inspection
"Ig
hereby certify that the side sewer installation constructed under this permit
er
X .... .. ,,;,,,nin� 1.nirual
0 e" , 0. Pe-rfGrm- iug cons-it'r.u.-C-t-i---
was installed in ac dance with all governing ordinances of the City of Edmonds.
Datedthis ............... . ........... day of ---------------------------------------------------------------- 1 19 ---------
V V Check BEFORE you dig for: Water C], Gas E], Telephone 0, Power E], Sewer E], Other 0 V -4
0 STREET FILE
USE
ZONE gS_6 PERMIT
CITY OF EDMONDS NUMBER 9-30464-
CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT 4
OWNER NAME /NAME OF BUSINESS ADDRESS -7 b 0 F,,�
;:2 LEGAL DESCRIPTION CHECK SUBDIVISION NO. LID NO.
A W-
Lu
MAILING ADDRESS
i�7 )�- q �;9 r F, PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
0 TESCP Approved 0
CITY LIP TELEPHONE NUMBER RW Permit Required 0
EXISTING —REQUIRED DEDICATION Street Use Permit Req'd 13
PROPOSED s action Required 0
NAME Sidewalk Required 0 0
rs
REMARKS a:
Lu
9 - LU
U ADDRESS Z
All y /Vwv-
!E -0
Z
L) w
f'-ELEPHONE NUMBER
# 572,
CITY ZI P T
v,j w -,F- V 0
NAME
6� I L I ENGINEERING MEMO DATED REVIEW BY
cr ADDRESS
0 METER SIZE BU�ILDING SUPPLY SIZE NO. OF FIXTURES
CITY ZIP TELEPHONE NUMBER cc
w
Z REMARKS
o IM 6- -7 �34 - 052�
IkSTATE LICE�Sd NUMBER EXPIRATION DATE
15 H I f--� * I SIGN AREA SEPA REVIEW AOB NO.
Legal Description of Property - include all easements ALLOWED PROPOSED COMPLETE EXEMPT
SHORELINE N
Z
EXP
cc VARIANCE OR CUT PL�N" REVIEW BY /DATE
0
W
W
SETBACKS - FEET HEIGHT LOT COVERAGE
Z
FRONT SIDE REAR__ Z
Property 5
Tax Account REMARKS CL
Parcel No.
NEW WRESIDENTIAL PLUMBING
ADDITION 0 COMMERCIAL MECHANICAL
Nr.EMODEL M APT.BLDG. El SIGN W 76/11.
GRADING FENCE CHECKED BY TYPE OF CONS71ON CODE HEIGHT
1:1 REPAIR E] — CYDS. x —FT)
WOODSTOVE SWIM POOL SPECIAL INSPECTOR AREA OCCUPANCY. OCCUPAN7—
DEMOLISH INSERT HOT TUB/SPA REQUIRED GROUP LOAD C
GARAGE RETAINING WALL/
13 YES +
MC ROCKERY RENEWAL -REMARKS
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: PROGRESS INSPECTIONS PERUBC305 Z
5
NUMBER NUMBER OF ICRITICAL
0 OF DWELLING AREAS
M TORIES 21 UNITS 0/fd INUMBER IM
0
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
[IF- 1 (41 )JE r- r,x I -L-Q k IC4 Par- r-1 FINALINSPECTION REOUIRED
AMD r^Mlt�%r f2,0j_)H (PA'fZ-P,'v L-0 Wq VALUATION FEE
r1?1)\/1r)E- &Dr�a n KI A,/
PLAN CHECK FEE
(4 r-_ BUILDING
HeA'i S66RCE: G AZING 4
00/0 % PLUMBING
PlanCheckNo. MECHANICAL
Y,7 I? Cq
This Permit covers work to be done on private property ONLY. GRADINGIFILL
Any construction on the public domain (curbs, sidewelks,
driveways, marquees, etc.) will require separate permission. STATE SURCHARGE
Permit Application: 180 Days STORM DRAINAGE FEE
Permit Llmlt:l Year - Provided Work Is Started Within 180 Days
"Applicani,,bn -behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE
,n successors in interest, agrees to indemnify, defend and hold
'Uni harmless the City. of Edmonds, Washington, its officials,
m employees, and agents from any and all Claims for damages of
* whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT
modify, wall a or reduce any requirement of any city ordinance
* nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE
&
pr ovision."
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 auth ' oriz- AUTHORIZES T . his 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. INSPECTION acknowledged in space provided.
ED
SIGNATURE (OWNER OR AG DATE SION:_: DEPARTMENT
CITY OF 7AA SIG ATURE D AT E
EDMONDS _V
L i R7-i DATE
CALL FOR �'RE I§Ep UV5
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
CHAPTER 3. PINK - Owner GOLD - Assessor
Sn'TREET FILF
STATEMENT ON ACCESSORY DWELLING UNITS
i ?'7 1 -1
Property Address:
Legal Description :
I have read the requirements for accessory dwelling units contained Jin Chapter 20.21 of the
Edmonds Community Development Code and understand that an accessory dwelling unit,
including a second kitchen, is prohibited for two years after occupancy by the current owner is
granted and until after a conditional use permit has been approved by the City of Edmonds
Hearing Examiner.
I also understand that approval of a conditional use permit is subject to a public hearing, and
neither this statement nor the issuance of a building permit shall act to limit the discretion of
the City review in the review of any application for a conditional use permit
Property Owner Name
Date
STATE OF WASHINGTON
COUNTY OF SNOHOMISH
I certify that I know or have satisfactory evidence that C)
signed this instrument and acknowledge it to be his/her free and voluntary act for the uses and
purposes mentioned in this instrument.
LAW -9 3
Dated
Signature of
roo-, SIS Notary Public
*.Vo 7-
0 0
g; Z
K.0 - - Ln
Title
pews,
V4
* '%� "I ment
't, My appoint
,P,,p OF V4 NsISO _96
88818111016 Expires: _
THIS DOCUMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY
AUDITOR
ACDUSTM.DOC