19308 83RD PL W.PDF111111111111
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19308 83RD PL W
STREET FILE
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RETURN ADDRESS:
City of Edmonds, City Clerk
121 Fifth Avenue 14o. 17081YO00Y
Edmonds, WA 98020 08/14/97 09:24
P-0003 Recorded
Snohomish County
NOTICE OF LIMITATION AND COVENANT
ADULT FAMILY HOME
Reference N: 9 7 -.21
Grantor(s): (2) Z05A AdkW_5 Additional on pg.
Grantee(s): City of Edmonds
Legal Description (abbreviated): Sec — Twn Rng tr
OR Lot o�Q Block PlatS;e,,,,A Vills4ec AVA
Assessor's Tax Parcel ID#(s): (1) ��5�6W�%9ZOW
-Assessor's Tax Parcel 1D# not yet assigned
AUTHORIZED FOR RECORDING
City of Edmonds
By: a6 Date: jolsh;r
Page / of
WIJEREAS, the undersigned owners of property located at 1'730f__D12W.
_ 1-11.-7ce Wes r --t 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 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;
NOW9 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 or the structure as an adult family home shall be limited
to -5- _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 ' -5'- - residents or attempts to rent, lease or
otherwise provide residence for additional residents above the
___ permitted in the current occupancy classification, the structure shaH
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
193,00 f3,-d )01- A/ Edmonds, Washington and legally described as:
I
Aor 0 Af a-- flewx,# vlllmc 1-571plila-ie 14
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 6 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
By:6J—z6 Date:
I Page Z of -3
9708140004
DATED this day of 19
_Z,,7
ACCEPTED BY:
OWNER:
JV
eannine L. Graf V
Building Official
h�// * 3V 2 6 00
NOTIFICATION
NOTARY FOR OWNER SIGNATURES
State of Washington )
)ss
County of � �j
.t,L
Uwner
COVENANT AND
ACKNOWLEDGED:
Mortgagor
I certify that I know or have satisfactory evidence that
signed this instrument, on o . ath stated that -A n
JWshe was authorized to execute the
instrument and acknowledged itas the QL,A_1r)C-Q- _(title) of 0Ary�(-Aj::--K_j
1i � . e party on behalf on who mi instrument was executed) to be
the act of such party for the uses and Purposes mentions in this
ins e aAd sworn to before me this day of 13 t-1
A 01 AS-7
C19 1'-�
. "-40—
VA . OPUBur,
0— STEPHANIE SILVA.
11-y Public in and for the State of Washington.
c4mission expires () -- I C)'- C1 P,
I certify that I know or have satisfactory evidence that -2p---5q (-)rw.in!�--)
signed this instrument, on oath stated that lietsimwas authorized to execup the
instrument and acknowledged' it as the�oncQ
(title) of c n (Y,) c-A E- r,-
Ion e f party on behalf on whom instrument was executed) to be
the act of such party for the uses and purposes mentions in this
d d sworn to before me this
in VA an V dayofCALIC-11 t4)-T
9
*W
PUBUC
�)k STEPHANIES
Public in and for the State of Washington.
L. mmission expires M-99
AUTHORIZED FOR RECORDING
City of Edmonds
y 02 61� Date:
:— J
Page of
1708140004
hington State
DEPART ENT OF
SOCIAL HEALTH
S Si
ERVICES
Adult Fam—i ome Llcen6e
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
ZOSA & DONALD ADKINS 392600
License Number
to
19308 83RD PLACE WEST
,'-to conduct and maintain at
98026 SNOHOMISH
EDMONDS
zip code county of
_cft of.
as follows:
-.,State of Washington, an Adult Family Home for the care and supervision of adults
t* `3
24-hour'family care for no more than FIvE (5) adults
number
ISTH APRIL 1998 o and including,''
."This license shall be in force from the day of
use.
-day of
TE
18 APRIL 19 9 9 subject to revocation for due. ca
ff)
6WTerms-.,
SDe
4
_MV
—sing Auth_��
Mary DeLange
pul
JoAnd
ssued and at the loe%fion above
NOTE: This licinse is not transferable, and Is valid only for use by the individual(s) to whom it is I
of 1967, and RCW 70.128.
A ed. Issued by Authority of Chapter 172, Laws
esck1b
V
CITY OF-:EDMONDS
USE
ZONE PERMIT
RS— e NUMBER 97060*
'CONSTRUCTION
PERMIT APPLICATION,
.
joB- .
. SUITE/APT It
ADDRESS /4743 of roe JA
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OwNER NANIEiNAME 00 BUSINESS ,o?ff 14, rr Ty—
CA. me-
LEGAL DESCRIPTION, CHECK
SUBDIVISION No. LID
NO,
M LING ADDRESS
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING REQUIRED DEDICATION
PRO POSED
TESCP Approved 0"
RW Permit Required 0
Street Use Permit Req'd 11
Inspection Required 0
Sidewalk Required 13
CITY ZIP
TELEPHONE NUMBER
-7 _16 96
Lu
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NAME
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
YES 0 NO 0
I`_
ADDRESS
REMARKS,
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CITY ZIP, ITELEPHONE
NUMBER
M
NAME
Y
ADDRESS
ENGINEERING MEMO DATED REVIMED ltllttl�BY
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CITY ZIP
TELEPHONE NUMBER
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0
0
FIRE MEMO DATED REVIEWED BY
Lu
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STATE LICENSE NUMBER EXPIRATION DATE
SIGN AREA
ALLOWED PROPOSED
'SEPA REVIEW
COMPLETE
ADB NO.
Legal Description.of Property - include all easements
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JEXEMPT
EXP
SHORELINE 4
20 11,,tr t).,c _51et-14 0114y1e —
VARIANCE OR CU
PLANNING REVIEW BY
��4
DATE
-
411VI f /&-V- 19
SETBACKS — FEET
FRONT SIDE REAR
HEIGHT
LOT COVERAGE
z
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Propert y
Tax Account 0-- 00
REMARKS
5
CL
17
Parcel No.
5itus Idw lw,�j IA" V.Sg C�W(AbO�l AM,
NEW RESIDENTIAL PLUMBINGfMECH
'fie!g%&
COMPLIANCEO]R.�,Wt_
ElAbDITION 1:1 COMMERCIAL CHANGE OF USE
AIT� BLDG:
REMd6EL - ':1
El SIGN'
I;A:I% harJ4 A.( III K.M; IA A
#
4�H t�5; A74 A
CHECKED BY
ITYPE OF CONSTRUCTION
6 0/"101
1 CODE
OCCUPANT
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0
M
GRADING FENCE
REPAIR CYDS. I x _FT)
DEMOLISH WOODSTOVE SWIM POOL
INSERT HOT TLIB/SPA
FGARAGE RETAINING WALL/
-I C El ROCKERY
SPECIAL INSPECTOR JAREA
REQUIRED 13YES
OCCOPANT
LOAD
REMARKS
PROGRESS INSPECTIONSPER.UBC 108
CD
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: .
5AX Alm# /�,ffltv t OVAC
NUMBER
OF
STORIES
NUMBER OF
DWELLING 91Vre
I UNITS
CRITICAL
AREAS
INUMBER
DESCRIBE WORK TO BE DONE (ATTACH PLOT P A
FINAL I NSPECTI ON REQU MED
]PLUMBING
VALUATION
F
PLAN CHECK' FEE
BUILDING
HEAT S C
OR,
GLAZING
NC-
FIan Check No. 6?77-
P 7 z
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGWILL
Any construction on the public domain (curbs, sidewpiks,
STATESURCHARGE
driveway�s, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit '. Lim , It: . I Yeai�- Filroildid Work Is Started Within 166 bays
S�CIRM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENO. INSPECTION FEE
ww
successors in interest, agrees to indemnity, defend and hold
harmless the City of Edmonds, Washington, its officials,
2
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0
,
0
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 I.imit in any way the City's ability to enforce any ordinance
provision."
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that th * a
information given is correct; and that I am the owner, or th.e 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-"e State of Waishington relating to Workmen's Compensa- WORK: NOTED Deputy; and fees are paid, and. receipt:.is
tion ln§urlrkce anffRCW 18.27. INSPECT16N acknowledged in space provided.
SIGNATURE A E�7 DATE SIGNED DEPARTMENT
W(IONE,
(>/�A` ... OFFICIAL1 SIGNATURE DATE
CITY OF
/3 EDMONDS. I-Ikll* 61207
L yj 1 97
CALL FOR 1$flEAS�b BV DATE
A T t EA f 1, C5 N INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS SEEN MADE AND APPROVAL OR 771 M 0220 ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
SECTION i09 PINK — Owner GOLD — Assessor
4M.47
NOTICE:
N'o --wa rra nty. of -a-cc-u Y
The information'shown on the attached
map(s) WaS compiled for use by the Gty of
Edmonds, its Employees and Consultants.
The City of �Edm.qnds does not. wa rra nt the
accuracy of anything set for.th on these
map(§-). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
t-Fe -m a p (S) I including, but not limited to,
wn. Such
the lociation of any sewer stub sho
sewer stubs may or may- not exist and may
or m'ay not exist at the location shown.
r-ity of Edmo'nd'c, nor its
Neither the
I -the
emp'[O'Yee-s o-r officle-rs -shal-1 be 1--ia-b-11--e for
information given on this Map(s), nor for
ation provided based
any one represent
upon said map(s).
7-tt APPLICATION LYNN PLANY
- FILE for 3&7
The City of Edmonds ST" SIDE SEWER PERMIT EASEMENT No . ..........................................
0 (D NEW CONSTRUCTION REPAIRS 10 /l?
.... ..... ...................................... CONTRACTOR ................... LOA]
OWNER .......... ........ t-w� ......... 6-7 - -5 . ...................... ................................ PERMIT No.
ADDRESS ..... )3.3-0-8 ....... 0-7..V4 ... W�0-4 7 .... LEGAL DESCRIPTION: LOT No . ......... Z;;� .......... ............. � BLOCK No . ...........................
.... .... .... .... ... ............... * ...... * ....... ..........
4��4 �� .... ....................
NAME OF ADDITION ..... ...... X.4 .. ....
171
9
Approved:
DATE
--- 7.61.2 ........
.......... .....
.............................
krdythe end Donald L. Hedges
1q$08J93rd Place West
Edm onds, Washington
Lot 20, IS.ierra Village" Division A, according
to plat thereof recorded in volume 17 of Platst
50, records of Snohomish County, Washington
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CITY OF EDMONDS
Call PRospect 6-1107 when work*
CIVIC CENTER WATER -SEWER DEPARTMENT Is'r dy for inspection. (No inspec-
ca
NO.
tions Saturday, Sunday or.holidays.)
SIDE SEWER PERMIT
ADDRESS ........................ 19308 83rd Place West
....................... I ........................................................................................................................................................
OWNER -Donald L. _Hed�,es_
......... .......................... . ..................................................... CONTRACTOR ..... Owner
........................................................................
Permission is granted ...... 94KP4_�& .................... 19.61, f . . ...................... days, to REPAIR or CONNECT a side sewer
with City Sewers In accordanc'e.witil application on. file and governing ordinances.*
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. I —The owners of the property may
obtain a permit t construct sev�ei Inside property line. A licensed Side Sewer Contractor must
as
be employed to construct side sewer in street area Do not cover any.portion of sewer before. it h been inspected.
NOTE No. 2—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
.NOTE No. 3—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 '/a will be.permitted.
NOTE No. 4—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. 5—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 ap-
purtenances except to Insert the pipe Into the wye.
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