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20723 MAPLEWOOD DR.PDFiiiiiiiiiiiiii 12255 20723 MAPLEWOOD DR —01 � , EM CITY OF EDMONDS " SIDE SEWER PERMIT WATER-SZWXR I)EPARTKONT PERMIT Call 775-2525 for side sewer inspections BEFORE covering any Portion of the constructl . Inspection will be provided within 24 hours after requat. NO gat., Sun., or holiday inspecti .0n.) ADDRESS LOCATION OF CoNsmucTxoN .. . ' !.� ... �ri.v.e ........................... ................... . .. . .......... . ........................................... PWPIMTY LEGAL DESCRIPTION .................. S. 96.L`5' Of 155-5- cf LrA, 20 . ................................................................. ...................................... ................................................. .................... I .... .................................................... ................... ................ .. . .. . .......................... . .................................................. F.�;.A. (TERRACE RkALTY) ..... .................. .................................... O-OrNza AND/OR BUILDER ........................................ . ....... I .......................... . ....................................................... cow,RAcTo]&,sNAmE&ADDREss..�.�.B. 9 Excavaters, 218.Pop ! � n Y'r% .......... ............... p .. . ................................................... Permission Is gr=W ........... July 9, 194� ....... for r4pair and/or conneMon of a side sewer to the city saWWy sewer sy4m In awordance wfth 61�j�F -��j�ances. AT,AWON IS CALLED TO THE FOLLOWING: NdjjV. I —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 newer In street area. Do not cover any portion of sewer before it has bean Inspected. NOTE No. 2—All work Performed in city right-of-way requires an Invanion of RLght-qf-Way Permit obtainable from the City Enginoer's office. NOTE No. 3—Obtaln 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 cover&ge at property line and 12 Inches Inildie property line; minimum grade of 2%. No bends in grade xharper than % will be permitted. NOTE No. 5--Trenches In street must be water settled and surface of street restored to original condition. ContractorB shall be responsible f , or 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 In Provided for in the permlt� or to do any work On the -aJn sewer or its appurtenancee except to in - not the pipe Into the wYe- DISAPPROVED, 0 Date .. . .......... . ..... . By .......... mi . ...... .... APPROVED 'k Date.— . . ...... 75, ....... By. Remarks: ................. .... j .. ..... .. . . . ........... ...................... ............ . ... ................. -T -------------- - Date.......... . .. . .. . ............... . By ................ BOTHIL P rmit Copies XUST Be Signed liy Owner of Mrm Performing Construction PRIOR To Request For Inspection "T ....... I ............ hereby certify that the Side Sewer inetanation constructed under this permit (OwZr �ofontractlng Firm I e;i- -_-A&.ta,Hed in Z�r'&�ce with all governing ordinances of the Citu nf irAm^-A- ...... :!y Of .......................................................... . .. is ........ Sewer other Adult famil a ..... Ston tate rDE-PARTMENT OF CIAL&HEALTH 7 SERVICES So 7 s(� Hom Licen8c 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 LAUREL A. HAMMER License Number 418400 to conduct and maintain at 20723 MAPLEWOOD DRIVE city of EDMONDS zip code 9 8 0 2 0 _) 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. FOUR (4) adults numbrr This license shall be in force from the 22ND dayof AUGUST 19 97 , to and including the 2 2ND day.of AUGUST 19 9 8 , subject to revocation for due cause. Special Terms: JoAnne L.Len - Mary DeLange�- 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. ---- -... L---- ---I i :> a hington Stale rDEPAKFMENT OF 7 S�' CIAL&HEALTH SERVICES Adult Famil Liccn,� 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 LAUREL A. HAMMER to conduct and maintain at 20723 MAPLEWOOD DRIVE License Number 418400 city of EDMONDS zip code 98020_, county of S�OHOMISH State of Washington, an.Adult Family Home for the care and supervision of adults as follows: 24-hour family care for no more than FOUR (4) adults number This license shall be in force from the 22ND dayof AUGUST 19 97 , to and including the 22ND day of AUGUST -) 19 9 8 , subject to revocation for due cause. Special Terms: d; 19 0<1 I !889 1�00 �, J LicensingAuLhorily rl Mary DeLang 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. USH3 10-173 (Rev. 1/01) TO 4 AUG 1997 DATE TO: FROM: PERMIT COORDINATOR, BUILDING DIVISION FIRE DEPARTMENT DATE g Z �2�lf 7 ENGINEERING DIVISION DATE PLANNING DIVISION DATE OWNER— 17�PIM 6,0— -.7'2 —ADDRESS PERMIT # ADB# INSPECTED ONL_ A fielP inspection was conducted to determine compliance with approved plans. Final approval denof&s there are no objections to the granting of: —Occupancy forthe building —Performance Bonds may be released —Maintenance Bonds may be released Landscaping is approved __��Other inspected PASSED FIRST INSPECTION - CONDITIONS NOTED —FAILED INSPECTION - OUTSTANDING REQUIREMENTS - RECALL FOR INSPECTION 2. 3. 4. OCCUPANCY OR FINAL APPROVAL DATE 7 B —RE-INSPECTED - APPROVED RE INSPECTED - FAILED 0 RE -INSPECTED APPROVED /OCCAPRVL12/96 DATE__B DATE�___BY DATE y . ....... ..... 7 ashingron tate rDIEPAKMENT OF s(nERVICES SOCIAL&HEALTH Adult family Home Licen6c 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 LAUREL A. HAMMER License Number 418400 to conduct and maintain at 20723 MAPLEWOOD DRIVE city of EDMONbS zip code 98020 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. FOUR (4) adults This license shall be in force from the 22ND day*of AUGUST —) 19 97 , to and including the 22ND day of AUGUST —) 19 9 8 , subject to revocation for due cause. Special Terms: .3 ;Z M. T% T ' Licensing Authority <J -.Y - --%J 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. M"a 1wild knev. UU11 4� City of Edmonds STREETTILE RIGHT-OF-WAY CONSTRUCTION'. PERMIT Permit Number: 52) Issue Date: A. Address or Vicinity of Construction: 1111stall New Servir-A 9 9 B. Type of Work (be specific): 20723 Maplewood Drive C. Contractor: `,Washington Nat'l. Gas Co. Contact: Iftak Gimah Mailing Address: 815 Mercer St. Phone: 224-2278 Seattle, Wash. 98111 State License #: I Liability Insurance: Bond: $ D. Building Permit # (if applicable): Side Sewer Permit # (if applicable): E. Commercial.— El'Subdivision 0 City Project. 6L Utility (PUD, GTE, WNG, CABLE, WATER) Multi -Family E] Single Family Other INSPECTOR: INSPECTOR: rg F. Pavement or Concrete Cut Uyes * E]No G. Size of Cut(.1)2!�x _4 H. Chai e $ r APPLICANYTO READ holdth, a INDEMNITY. Applicant understands and by his signature to this application, agrees f Edmonds harmlessfirom injuries, damages, or claims of any Aind or description whatsoever, foreseen or unforeen, that may be made against the City of Edmonds, or any of itsdepartments or employ- ees, including or not limited to the defense of any legal proce�dings including defense costs, and attorney fees by reason.of granting this permit., THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS& QR�PERIOD OFOAIE YEAR FOLLOWfffG�14F&il-INSPECHON AND ACCEPTANCE OF THE WORK ES77MATED RESTORA77ON FEES WILL iEHE6 UN77L THE FINAL STREET PATCH IS COMPLETED BY CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICAN7Y, Construction drawing of proposed work required with permit application. A 24 hour notice is required for inspection;. Please call the Engineering Department- 771-3202. Work is to be inspected during progress and at completion. Restoration is to be in accordance with Cit' Codes. y Street shall be kept clean at all times. Traffic 6nt'rol and Public Safety shall be in accordance with City rpgulations as required by thA�Iit, Ingineer. All street cut ditches shall be patched with asphalt or City approved"material prior to the end`of-tlFe ;atiiog day; NO EXCEPTIONS. I have read the above statements and understand the mit requirements and the pink copy of the permit will be available on site at all timesfor inspection purpos - es. Signature: Date: November 20, 1992 (Contractor or Agent) CALL DIAL -A -DIG PRIOR TO BEGINNING WORK NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Engrg. Div. 1991 FIELD INSPECTION NOTES (Fund I I I - Route copy fo Street Dept - .) Comments: I Diagram: CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO Partial Work Inspection by P. W.: Work Disapproved, By: Date: FINAL APPROVAL BY: Date: Eng. Div. July s c, 7 7- -=, Addendum to Submitted by: Y%AA9L-eW0o0 DO- ri '1- 11 gas main City of Edmonds Right of Way Permit Application ft1c,�AA-,9-D HIL-L-AQD Engineering Aide Washington Natural Gas 622-6767 x2761 pager 9W-1(05G I ( sx'q) (P -e- water hydrant 0 water valve 815 Mercer St. (P.O. Box 1869), Seattle, WA 98111 (206) 622-6767 REGARDING: 20723 lewood Drive 4Q.2 -6 (address) R E C 0 R D 0 F C 0 N T A C T S DATE NAME, PHONE NO. , & ccmvffwrs ADDRESS of CALLER 5/l/74 Occupant Certified Letter not sent. Meter pulled for non use 3/73. 7/9/74 Terrace Realty R.R.B. Excavators obtained permit #495S. 7/11/74 Lyle Munday Connection cgMleted. Water restored. Lij LJL. Lij cc co "I ACTION TAKEN INITLALS TE TE TE Z, Tho City of Edmonds APPUCATION for SIDE SEWER PERM EASEMENT NO. -- ... ----- ------------------------------ NEW CONSTRUCTION REPAIRS LID NO. -.-k--(0A.--.-ASMT. NO. —4WNEP - ----- CONTRACTOR .... ... PERMIT NO. -4,DSS -------------- ---- -------------------------------- ............................ -------------------- L�OB ADDRESS ----- C:RLEGAL DESCRIPTION: LOT NO. — --------------------- ------------- BLOCK NO - ------------------------------------ . ......... -- -------------------------------------------- ----------- NAME OF ADDITION --- ------- "t��Pt ---- V ---. ...... (2:)C� ..................................... 3: 7' -MIS 7 - 1 1 -All f:t \J- (d Approved: DATE - Z14ZZO-55r'� -------------- By 4(� ........... ........ � The City of Edmonds OWNER ....... ADDRESS .... A�A2%3 ------ APPLICATION for S11DE SEW= PERRM NEW CONSTRUCTION AK REPAIRS 0 EASEMENT No . .......................................... ......... PERMIT No. ---------- ............. . ............ LEGAL DEscRnmON: LOT No . .............. ............................... BIA)CK No . ............... ............................ NAME: OF ADDITION .04 4 '0 ......... P�w .... . ............... ej, � RECEIVED k JU�, 9 1974 liz ZI DXTE------------------------------------------------ By ................ ..................................................... SVEET FILE USE ZONE PERMIT CITY OF EDMONDS NUMBER 9 70702- CONSTRUCTION PERMIT APPLICATION JOB Sul FiA OWNER NAME/NAME OF BUS Es�: ADDRE S Janu IL-4 /_1 LEGAL DESCRIPTION CHECK SUBDIVISION NO. LID NO. uj MAILING ADDRESS Z 0 PUBLIC RIGHT.OF WAY PER OFFICIAL'STREET MAP. TESCP Approved 0 CITY I TELEPHONE NUMBER RW Permit Required 0 EXISTING — — ----- REQUIRED DEDICATION Street Use Permit Req'd 0 zip PROPOSED Inspection Required 0 NAME Sidewalk Required 0 METER SIZE7 LINE SIZE NO. OF FIXTURES PRV REQUIRED u0i ADDRESS -YES 0 NO 0 M RKS ZIP <[CITY TELEPHONE NUMBER mee NAME tvllyol j.4vd I v)e--, toylyeeleolltl- elx-ll ,jADDRESS 1<C0A4S' ENGINEERING MEMO DATED REVIEWED BY CITY ZIP TELEPHONE NUMBER Z IRE 0 #A' U REVIEWED BY 0 STATE LICE I NSE NUMBER EXPIRATION DATE Zr 0 I 60VIEr VARIANCE OR CU ADB# SHORELINE # Legal Description 0, P 7oqrt� include all easements SERA REVIEW SIGN AREA HEIGHT Z 0 r-A)- r, , E-- COMPLETE I EXEMPT ALLOWED PROPOSED ALLOWED I PROPOSED S .-S P D co LOT COVERAGE REQUIRED SETBACKS PROPOSED SETBACKS (Fr.) ALLOWED I PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR w_j Property Tax Account LOT AREA PLANNING REVIEW BY DATE �Parcel No. Q�> REMARKSf,. FINEW Ind RESIDENTIAL BINGIM&H 5&W]*4kA"� A,,Ld i0jy'i ,�4 ��j va-,A 1:1 ADDITION M COMMERCIAL -s A ip.lc cA EIREMODEL 1:1 APT. BLDG. Sl IN GRADING FENCE E(QFfVY TYPE OF CONSTRUCTION ICOW OCCLIPAN.T REPAIR 0 CY'DS. x _FT) G? XV EIDEMOLISH WOODSTOVE SWIM POOL SPECIAL INSPECTOR INSERT. HOT TUB/SPA REQUIRED LOAD I AREA OCCUP —0-GARAGE RETAINING WALL/ OYES C ROCKERY Aq ERN E REMARKS Z -0 (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: PROGRESS INSPECTIONS PER UBC 108 rL NUMBER NUMBERIOF CRITICAL lqf.# W 0 OF 04le- DWELLING 0/1/6 AREAS M STORIES UNITS NUMBER 0 DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) k c ri v-e 6A-Ae-/.4-,7 FINAL INSPECTION REQUIRED j0el,44 I 4&la VALUATION FEE PLAN CHECK FEE /�ily Hot"- BUILDING HEAT SOURCE: GLAZING % PLUMBING Plan Check No. zo MECHANICAL This Permit covers work to be done on private property ONLY. GRADING/FILL Any construction on the public domain (curbs, sidewelks, driveways, marquees, etc.). will require separate permission. STATE SURCHARGE Permit A a pplicatio6: 180 Days STORM DRAINAGE FEE Permit Limit: I Year - Provided Work Is Started Within 180 Days "�pplicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE successors in Interest, agrees to indemnify, defend and hold ow) harmless the City of Edmonds, Washington, its officials, m employees, and agents from any and all claims for damages of a: 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, waive or reduce any requirement of any city ordinance 0 Emu nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE -Z;�l provision." 6?0 1 hereby acknowledge that I have read this application; that*the information given is correct; and that I am the owner, or the duty 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 lnsju�M-64Q RCW 18.2 INSPECTION acknowledged in space provided. SIG , �T��t (OWNEFIg/ AGENT DATE S1 NED � / �'�) �,, If DEPARTMENT CITY OF OF I I .'S S1 ATURE S S, V4TE Y_ 7 EDMONDS �Aw) SAY197 ATOtENTION CALL FOR ARELEASED AYI DATE I INSPECTION IT I� UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-02 go 051GINAL — File YELLOW — Inspector A 'CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 V.— 0/77-117 - R Ar ,7 PINK — Owner GOLD — Assessor I tss I C�D RETURN ADDRESS: City of Edmonds, City Clerk 121 - 5th..Avenue No. Edmonds, WA 98020 70 1!1D-M---- 09/11/97 10:38 P-0003 Recorded Snohomish County NOTICE OF LIMITATION AND COVENANT ADULTFAMILYHOME Reference N: Grantor(s): Additional on pg. Grantee(s): City of Edmonds Legal Description (abbreviated): Sec Twn':O WtvrOkn Qtr OR L't I hb. 0--,).., Block lat Z&9MCJAC,(�� Assessor's Tax Parcel ID#(s): (1) S (3(-0- Ozf��- O-Z-cr-O-Sm (2) Assessor's Tax Parcel 1D# not yet assigned AUTHORIZED FOR RECORDING City of Edmonds BY: 26 Date: 012 0 ;4 Page I of .3 WHEREAS, the undersigned owners of property located at '6,0-7 '2�— C�) V1' v-e 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 .1 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 REAS, the City has notified the a 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: . 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 A- 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 st te 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 tile 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. Suboect Tract., The above stipulation and promises shall apply to and run with the land wit re4pect to a residen tial structure located at kA60 U_u3 D6-7 al 4 bNJUdmonds, Washington and legally described.as: M 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 C5 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 or this code and, in so doing, to recover its reasonable attorney's fees and costs. AUTHORIZED FOR RECORDING City of Edmonds By:- a6 D a t e: 00/2 ?19 -7- Page Id— of .3 1 VA1 3 7 DATED this — 2 ?-Ald -_ day of /9U614Sr 19 C? .7 ACCEPTED BY: OWNER: kannine L. Grdf/-- Building Official I-leelm # 1/5 -%00 NOTIFICATION NOTARY FOR OWNER SIGNATURES State of Washington ) County o6 )ss � (� �,-c 1PROPERTY N plicant Applicant Owner Owner COVENANTAND ACKNOWLEDGED: Mortgagor I certify that I know or have satisfactory evidence that jj, 5 L signed this instrument, on oath stated that he/she was authorized to execute the instrument and acknowledged itas the--- (title) of -40 fjj 0 be (name of party on behalf on whom instrument was executed) t be the free and voluntary act of such party for the uses and purposes mentio s in this instrument Subscribed and sworn to before me this day of 0 1 -4 n -4 Notary Public in and for tqe tate of Washin My commission expires if-,9-00 Is certify that I know or have satisfactory evidence that signed this instrument, on oath stated that he/she was authorized 4 instrument and acknowledged' it as the (title) OV1101.11140 — (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 instrument. Subscribed and sworn to before me this � day of Notary Public in and for the State of Washington. My commission expires AUTHORMED FOR REC;RDING City of Edmonds , BY: JZ6 Date: S/W-17 j_ of Page _ -? I 9709110137 v CITY OF EDMONDS USE ZONE PERMIT 19 7-0-707— NUMBER CONSTRUCTION PERMIT APPLICATION joB ADDRESS .a SUITE/APT lc_�)" ve� OWNER NAME/NAME OF B S S3 UPE # LEGAL DE'SCRIPTION CHECK SUBDIV191ON No. LID NO. ZS1 MAILING ADDRESS I D — I ti�8 PUBLIC RIGHT'OF WAY PER OFFICIAL'STREET MAP. EXISTING REQUIRED TESCP Approved 0 RW Permit Required 0 0 CITY ZIP 7ffL—EPHONE OJr4� _24 NUMBER �A; It P_ C� ?)0 qn) A%s q — DEDICAT ION Street Use Permit Req'd 0 . PROPOSED Inspection Required 0 Sidewalk Required 0 NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED ADDRESS YES 0 NO 0 L) w RErKS 1 01 01-e o CITY zip LEPHONE NUMBER NAME COA4.S ADDRESS cc ENGINEERING MEMO DATED REVIEWED BY CITY ZIP TELEPHONE NUMBER Z UP FIRE MEMO DATED - REVIEWED BY STATE LICENSE NUMBER EXPIRATION DATE VARIANCE OR cu ADB SHORELINE 0 egal Description o P Voqrtt include all easements SEPA REVIEW SIGN AREA HEIGHT Z 0 COMPLETE EXEMPT ALLOWED PROPOSED LL A OWED 91. EX 1PROPOSED UP LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT.) FRO19T SIDE REAR PROPOSED SETBACKS (Fr.) FRONT URSIDE REAR I Property Tax Account CUC) _j LOT AREA -PLANNING REVIEW BY DATE �.Parcel No. 16-10— r/ 7 NEW RESIDENTIAL PLIJMBINGIME0�;, REMARKS7% .5&4CL� 00�;-� A-r,) IgM -.N- f,14,J&0, A WA i, ;w- 11) COMPLIANCE OR ADDITION COMMERCIAL El CHANGE OF USE REMODEL APT. BLDG. E -SIGN GRADING FENCE REPAIR CY'DS. I x —FT) . CHECKED BY TYPE OF CONSTRUCTION co I 1�emv( 14elt 6- 1 W OCCLIPAN7 . WOODSTOVE SWIM POOL DEMOLISH INSERT HOT TUB/SPA SPECIAL INSPECTOR REQUIRED AREA OCCU* 0GARAGE RETAINING WALL/ CARPORT ".ROCKERY 13 YES LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108 Z 0 0 Z (T�PE PF U BLt§INESS CRACTIVITY) EXPLAIN: 05 ir y AC-_, NUMBER NUMBER10F CRITICAL W 0 OF 04le DWELLING 0/j/6 AREAS to STORiES UNITS NUMBER r/ L.Ae DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) FINAL INSPECTION, REOUIRED VALUATION FEE PLAN CHECK FE E HEAT SOURCE: GLAZING' BUILDING PLUMBING Plan Check No. MECHANICAL This Permit covers work to be done on private property ONLY. GRADINGIFILL Any Construction on the public domain (curbs, sidewpiks, driveways, marquees, etc.). will require separate permission. STATE SURCHARGE Permit -APP16tlonk 180 Days Permit Limit: 1 Year - Provided Work Is Started Within 180 Days STORM DR AINAGE FEE "Applicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE successors in interest, agrees to indemnify, defend and hold 'Wn harmless the City of Edmonds, Washington, its officials, I 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, waive or reduce any requirement of any city ordinance 0 X nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE provision." I hereby acknowledge Ahat I have read this application; that -the information given is correct� and that I am the owner, or tho-duly ATTENTION APPLICATION APPROVAL authorized agent of the.ow�er. I agree to co mply with city -.and ' state laws regulating construction; and in doing the work authoriz- THIS PERMIT 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 Compansa- WORK NOTED Deputy; and fees are paid; and receipt is 0 tion ln�� RCW 18.27. i 1 1 NSPECTION acknowledged in space provided. 1 SIG U I E 'm AGENT [DATE S�IPNED DEPARTMENT �lf 7 CITY OF EDMONDS OF g1l, 'S Sl ATURE VATE '1, , ) X197 ATtENTION CALL FOR OIRELEASED dYl DATE INSPECTION It,14S, UNLAWFUL TO USE 6R OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR - 771-02?0 ORIGINAL — File YELLOW — Inspector L A CERTIFICATE' OF OCCUPANCY HAS BEEN GRANTED. U13C SECTION 109 :Pjr AJ77_1q_7- PINK — Ow-e, GOLD — Assessor tm - elf � RETURN ADDRESS: City of Edmonds, City Clerk 121 - 5th..Avenue No. Edmonds, WA 98020 -1 7-011FO 3 �7 .. - 09/11/97 10:38 P-0003 Recorded Snohomish County MICROFILM NOTICE OF LIMITATION AND COVENANT ADULT FAMILY HOME Reference #: 97 -70 .70 -Z� - Grantor(s): (1)L.-AxveA k,.VA-,->mvnV� Additional on pg. Grantee(s): City of Edmonds Legal Description (abbreviated): See Twn':R WMAn S'G—'&A-Qtr OR Lot__,QL, MCI Assessor's Tax Parcel ID#(s): (1) S 4S (2) Assessor's Tax Parcel lD# not yet assigned AUTHORT D FOR RECORDING City of Edmonds By: JZ6 Date: ehfAz Page I of 3 WHEREAS, the undersigned owners of property located at '8�-0-7 a:'�) — 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; 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: MICROFILM . 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 A— 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 st t license to operate an adult family home with an occupancy of greater than residents or attempts to rent, lease or othe ,Tise 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 rqpect to a residential structure located at (0 00db&tEdmonds, 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 - C� 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:- J16. D a t e: 81Z Page Z of 3 7 UA 09" 110 13 7 MICROFILM DATED this 2 ?- lvd day of 4u6as)— 191?7 ACCEPTED BY: OWNER: Ji(annine L. Grd,/ Building Official ,1-.C,q # -�/b 100 NOTIFICATION NOTARY FOR OWNER SIGNATURES State of Washington ) County o6 )ss �� ,-e Applicant Owner Owner COVENANTAND ACKNOWLEDGED: Mortgagor I certify that I know or have satisfactory evidence that —L 4 t-j'?64— "Ifflaza signed this instrument, on oath stated that he/she was authorized to execute the instrument and acknowledged it as the — a, IAI,15R (title) of —40 tji_7' �6-- (name of party on behalf on whom instru Iment was executed) to be the free and voluntary act or such party for the nses and purposes mentio this instrument. Subscribed and sworn to before me this day of ae-v '19 1-4 1,4 iA—. 2, Notary Public in and fortife tateofWashing�b&f .311eq, My commission expires— If. q — I certify that I know or have satisfactory evidence that signed this instrument, on oath stated that he/she was authorize'd instrument and acknowledged it as the (title) 0"? ....... — (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 instrument. Subscribed and sworn to before me this day of '19—. Notary Public in and for the State of Washington. My commission expires AUTHORIZED FOR REC5RDING City of Edmonds By: U16 Date: Page of S g` V0911^137 U