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23005 76TH AVE W (2).PDF11111111 lill 6387 23005 76TH AVE W ADDRESS: 2,3005 7 b TAX ACCOUNTIPARCEL NUNfBER.:. cf) U3 K004(painez, BUILDING PERMIT (NEW STRUCTURE): — COVENANTS (RECORDED) FOR: CRITICAL AREAS: DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR: DETERMINATION: 0 Conditional Waiver n Study Required E] Waiver PERMITS (OTHER.): 19Jq -0Y0( 101-15-0007(Gdd) 4 ME-0163 PIUMO 1w, m, I m. ff rg Ard 11 �## I 2 C -01-P - 1317 �wlb) PLANNING DATA CHECKLIST DATED: -3; czIR0102 SCALED PLOT PLAN DATED: SEWER LID FEE $: LID #: SHORT PLAT FILE: LOT: BLOCK: SIDE SEWER AS BUILT DATED. SIDE SEWER PERMIT(S).ff: du 6 GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT FOR: WATER METER TAP CARD DA LATEMP\DS'Ps\Fomis\Strcet File Checklist.doc Uj .j LL. r A 0 Uj CD I,- I is 238TH ST. SW 85' NT IMPERVIOUS AREA CALCULATION LOT AREA: 14750 S.F. Existing Building Roof Outline: 2675 S.F. LOT COVERAGE Existing Porch and Deck: 751 S.F. Existing Footprint: 229z Existing Driveway: 2350 S.F. Existing Walkway: 407 S.F. Existing Pool and Patio: 1290 S.F. Proposed Open Decks: 170 S.F. HEIGHT CALCS. A: 0. 0 B: +4.5' EXISTING TWIDE CONIC. WALK 407 S.F. --7 EXISTI C: 6. 0' EXISTING ROOF LINE D: + 2.5' 2675 S.F. AVE GRADE=3.25' ACTUAL� 18.5' F- -- — — — — — — — — — — MAXIMUM=28.25' B 4,51 4 .................... .. PORC 4 GATE (SELF CLOSI'0111E EXISTING 6 CAR r �&.IG.FE.0 PARKING AREA 'ST T.R. < (CONCRETE) �11N 2350 S.F. .4 4 PROPOSED d 4 1, INTERIOR EXISTING 4 �,`RENOVATION� POOL LU Z \ON EXISTING 41 GARAGE S F cn 4 X- ------ -_j D 2-5'T 4, 130' 0�. :-C - 'r EXIST TO RrIVIAIN 58.0' 22 0* 50.01 OE3 I —V- FEE F="' I ogml-., " SCALE: 1" = 20'-0" 2; 4'0 APPROVID BY PLANNING - t141444,- 0 -�, - 0 + - 0 7.- OWNER: WINNAH FAJARILLO 23005 76TH. AVE. W EDMONDS, WA 98026 TEL. #: 206-795-4032 CELL #: 206-795-4032 FAX #: 425-673-6181 PROPERTY ADDRESS: 23005 76TH. AVE. W EDMONDS, WA 98026 PARCEL NUMBER: 00488800400102 this permt approval proem shall be mi all-owmger permittin the of any 00"fly iB*RL or unpainitted building xkn� or mite C:oq =t" w1awas in vulaski the the PW-MA regardl6m of wh== MUM111119 or condition is dwwn on the site Ian r drawing, Such " ma con%w%' be the --+j f a enforcmr action. 00, L .F LATCHING) z ';;( 0 0� ZWo X \S) XX C7 ��w 0 _Aj ce. CL lo At4t*5 U5 04 0 RESUB FEB 2 6 2007 BUILDING DEPAR7MENT CITY OF EDMONDS OR 7C- t-a ZONE S 717:74,4: 0 .4T INT F -EA- UJAIJ HEIGH 7W- - - - -------- /7-971) 42 10 -77777�7 777-� r-ISTILJG WALL S.-r I a L 'D.- X Lo 'A. P,y A... 4 L� 9. o t :I�KT 1�. 74 AVE ro Ar rr) arf OF el �EE -0. �E RECENED 13T5 po 4-b , NZ, N PLANNING DATA STREET=FILE Name: W%�XVIVIOk Focimoillo Date: 0 1 - I 1p - Je00 ;L. SiteAddress: -ktt)0e; -f(017N A-V-tW Plan Check #: BLD-2006- Project Description: CAMV?*1 oar -age. +b 6,jcAv*0v"f;, tN� Af-W. Reduced Site Plan Provided: (a / NO) Zoning: — 4g Map Page: 0 15 -4- Corner Lot: (9 NO) Flag Lot: (YES (NO Critical Areas Determination #: A0 rleW fvwhpy-�Vlf- El Study Required Waiver SEPA Determination: M Exempt q5 0 Needed (Requires: (1) Fee, (2) Environmental Checklist, and (3) APO List with notarized form). Re Setbddks Street- Side: Side: ActaafS6tbacks' Street: NJ L/ Side: N Side: Rent: C, Detached Structures: Rockeries: Fences/Trellises: eA . f-cAA C e.- Bay Windows/Projecting Modulation: Stairs/Deck: Parking Required: Parking Provided: + Lot Area: 1471,FD Lot Coverage: N Lot Coverage Calculations: 1AA 4 fifla- 4 41, G 0 00 Building 4ht Datum Point: Datum Elevation: Maximum Height: 1,67 Actual Height: ADU Created: (YES/_-@) Subdivision: Legal Nonconforming Land Use Determination Issued: (YES 0 Othet'.::,. Plan Review By: gc;w ae� - , C1r( OF EDMONDS NC BUILDING PERMIT APPLICATION 820! 22 NAME OF BUSINESSI ... -)0S it — z 0 Ile vue &14' V NAME 0 ADDRESS v C.Tv —NUMBER z 0 u i -, -!7 _N SE NUMBER Jv Lice—C NUMBER Legal Description of ProDer:y (Show Below &r Attach FoUr Copil-1) z 0 it 0 J uq 0 RESIDENTIAL PLUMBING ADD -LT.. r-CAVATE x R FILL FENCE L r I REPAIR P-r-'-VE,-HSP-/ WIM P CO.PLIA. E INSP. oo,_ NUMBER OF STORIES Nu. EIER OF z UN IT S , NATURE OPWORK TO CE DO�Ntt (ATTACH PLOT PLAN) u e,�r, 141 b ve C.- C'4- 7hi, Permit —er, work to be done on private property ONLY. Any mernruc, on on the pub it, domain (c.,bs, sidewalks, driveways, —, quo., etc.) vvil� require separate Permission. -;Uboill ...ON Is—, S.B No. P.BLIC VIG.1 OV WAY PER OVrICIAL 5—CET MAP C.IsT.NG 1-oP.sED IlCrILIENCY OF RIGHT 01 '.'.'Ay c. Lu .1 MEMO DATED-- .E—Rits 111 11"1 IN ITS SIGN AREA ALLOW- "ROPOsc, .1v. LvlE rl,""LC - 11'"" T11 j 'I, ---- — VARIA . NCC OR CU ]PLANNING IICVIEw 13Y 'DA YAIIDS r"oh sloe FICAR ILOT COVr."A�T__ RKs CHECKED BY I rYPE 01 IONI�IJCII.l I C.-. sPICIAL l"SPEC`tO1 RE.U, " c. 0 YES ED N o OCC 'PANCY U� OCCUPANT LOAD REMARKS F VALUATION F E FEE PLUMB?Nr IL MECHANICAL FENCE Permit Application: 180 Days Permit Limit: I Year - Provided Work Is Started Within 120 Days SIGN RETAINING WALL o ,n bcha!! ef hi, ,, he, p.c, h,i,,. a,siell o .c ...... is ill inte'e't. "e'e" w i.dehmit*y. !,;,n,' a,,,' 1,.IJ SWIMMING PO11L I the City ut Edmti�. Wa,hingion. it� (il!ici:jl�. < aporit, Ir"", art� and all clain" 1*,, d.,inag" "r 1,11a:'111 lIzi Illri'. : arisin ' I: directIv w indirectly I'T0111 the thi, 1.ait. 1-i. 0 an- ol th;s , hit hall n, be deo-d t dif�. i,, e, Pe TOTAL AMOUNT DIJE I I � 'it) !i it in Y Ill,, 0 0 �ny ___ 'itY'l �bilit, to fe y p,—kion." ATTENTION I hereby 36tt—ledg, th3t I h,I J I- aroi,a 'he i". format;.. plen i% co,rcct� md lh�; I ihe ,t ill , d,�I, THIS 1ET ized agent of the ov-her. I agree I,) compi "ith city and state ].I", "::I,. ..T.OIIIZES lating conitructi,ji: and in 0,,)ing the ulk awli,,iied therchv. tio pet%on ONLY E v.�illbccmploycd in vicitationo; the I.;,h,.,tC,,& of it,, N.T.o relating te Workmen*% COMP-201111 In—ance. NEI, INII—C—H DEPARTMENT DTC CITY OF' ONDS THIS SITE IS LOCATED IN THE CITY OF EDMONDS. LOCAL SALES TAX 775_ 2525 SHOULD BE CODED 31.04. ATTENT '314 !T IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPFCTION HAS BEEN MADE AND APPROVAL OP. A CERTIFICAT�_ Cr OCCUPANCY HAS BEEN GRANTED. UBC304,30C. P--!a APPLICATION APPROVAL Thi" .11,pkition is not a peTTI111 HIltil Sil�lli!d 1) V the Hllfldiflt� Offi�i;ll (It hi, Dcpkj:.�: :11'd fees are paid. and is k1w"Ic,lized ill 'J'a,e ;)rO. vided- DIRECTOR'S SIGNATURE )A .A ,A , ORIGINAL - YELLOW PINK — O,v,,,,-r GOLD — ML 0, D OF .!t!S—,— PILOM� _Rtte _A"d FOSJMDATION mar wpft oaraue. cwptst J)"devound Wzter serAce wEATING �rYSTOA FRAMING WN�LBOARD, Al APPVD Fill USE NUMBER ZONE, BUILDING DEPARTMENI APPlic I PERMIT APPLICATI 014 inside Heavy 'on ADD 0 No. NAME (OR NAME OF UUS' 55) AREA S LOT AREA LEGAL LOT R 'bert Graves j:) Y ES 0 NO ADD NO MAILI ADDRESS CARIA -CE OR Is ON.. usr No. z v a L �EF H 0 N E �NU M BE" 0 CITY t HEIGHT z z AR 6"SIDF ORE < onl W 2 778-0286 - ;k OFRONT J PROPOSED A ALLOWABLE SIGN AREA SIC— AREA ADDRESS OTHER EmENTs REQUIR DATE PLANNING DEPT. APPROVAL CITY T ;7 ,. THIS PROPERTY NAME corP oration 111ITlIG STPEKT R1 '!�� FT. San Juan P001 P. PLAN ST- F11W FT. ADOPIK'S -------- 735 N. it- 198111 geattle, Wa. 9 B155 van 0 CITY LIC7S a Nu E-CMIEWITZ NUM""' .3sw_ w u A FS STREET AND/OR u '61,40 223-5023-02 Legal Descrip ion of Property (-S ow F3.1 aw or Attl) n "u, Copies) WORK RCO'D 0 YES RGROUN 0 UND 0 NO WIRING REO'D vuslIFIED D z T - CoNNEICTION 2 w Cl vz% raRl' w SEPTI SYST w C 3 EM Na. C3 NO V C ITY REMARKS J --- KO a, 4 M 0 ,,YLR S111 C SERVIC. at%. W 01 ON COO19 GAS L FIRE ZONE YPE 0 F CONST i ;,PC- -7c) J e NEW I-L Eo oc PAN - R AN 11 SPECTOR i UP 40AD OR F: RETAIN"'* REQUIRED No -Do [] WALL YES 4. L r IN THE CITY le '..C. 0 E,,CAVATE 9_1`11 PLAN CHECKbD By ALTER OR FILL H IT EDMONDS. LOCAL SALES TAX z SH OVV S"' M OOL REPAIR REMARK 0 Or STORIES -rr4umilatt or DER NUM OW19LLIIIG UNITS z' r pec- 0 N.TURI, OF WORK 0 BE Do.. 'SEC swimming P001 ns rivate I tall a P VALUATION FEE PLAN CHECK 'l,"OSED USE 'No. 0 mily pleasur Fa q ; ,, U.Lo . . . . . . SETBACKS. BUILDING PL T, NG TREETS) I — M PLUMBING HrAT & GAS LINE 0 FE"Cc ND M SIGN IN,.. W.L CTAINING WAL�_ 0 5,000 WIMMma Do, CIO 7 . TOT AL AMOUNT DUE _�_ . read thl. PPIt1-At-h; that the 1 I hereby acknOwIldt- th I t ... r the duly �th �d that I "' the "'t"'Ld ATION APPROVAL formetlon even 1. e.,rect.. let- Is— "Int' ATTENTION e,, sent of the w-111 a... to comply wItb elty no person thereby. d.1.9.11- A�P P 1.1 is not a permit until Z.0rCk,:,uthorII:d Ixting constmctlOD: she . . IA of th State of Washington THIS %..IT d In Yl.10110. o' Lh AUTHORIZES PC, is pp"cetion b III j; official or his DeP' W be In, eye shoe. to Cm,peh..tl 1.ur ONLY THE ad " and IT1021"-Ure plud, and receipt is Etc "'rr.111.11A.; one Year 'Pt DEMOLITIONS WhIch WOR K NOTCO 'E'c.,,L,,,,;G3 hall be NoTE: Permit Limit �,Ln space prOVIded. .nowledged days: hall be completed to. ollety I.SF ECTION led In IM -O-lh'-) ';TE SIG... ,PApTME.T a -�U E� GN TUR W E CITY OF EDMONDS DATE 7f A10TE: Applicant Subject to Plan Chcck bec 775-2525 File YELLOW - I'll' �Cto' permit covers W rk to be done on priva,0 property ONLY- This i'C�Urb', s!'deW.Ik,, driv.-aY-, 4 ORICIt AL - GOLD-"""' th public doTain lh Ary, construction oh 'tc p �.p All that portion of Tract 1, Block 4, Lake Ballinger Land Co's Plat, Subdivision No. 1, according to the.plat thereof recorded in Volume 9 of Plats, P ages 57 and 58, records of the Auditor of the County of Snohomish, State of Washington, described as follows: Beginning at the Northwest corner - of.said Tract 1; thence South 0*1.4'30" West along the West line 122 feet; thence South 89*45'30" -illel ne 3.36.02 (ect; thence North 5'08'45" East par, to the South li East 71.51 feet to a point on the North line, -said point being a curve, the tangent of which bears North 56*01'40" West; thence North- westerly along the Northerly line an arc of a curve, having a radiUS if 310 feet, a distance of 152.5 feet to chc Northwest corner and point of beginning. Subject to casement, restrictions and reservations as of record, if any. -7 J lz2 r ec REr2QD CE 1�!�-ECTIONS. A FOUNDATION. Pnrch-�S. Oirs P1 �r.- rN nd 7, r(ough-in HEAT ING �,YSTE:%l FRM;1:NG �%IALLUGARZD A _,2 'I, ot PERNUT us NUMBER ZONE B U I L D I N,G REPARTMENT Applicant Fill JOB t "PERMIT', APPLICATION 1-110 fleav'y "Anes ADDRESS �NAMS,(OK NA.ME OF BUSINESS) /9 A ACTUCOLVICGGE LOT CO —RAG LOT PROPOSED HEIGHT 0 MAILING PER1,11881BUt —HEIGHT z —'—TOTAL BLDG. AREA ACTUAL CUT —AREA CMULA C! —AEQUII'.rD Y A FRUPOSEW ARDS FRONT SIDE REAR NAME E Oil CONDITIONAL 13 LEGAL LOT 'A K N E W ADDRESS 0 YES 0 NO I FRIMIT NUMDER v FILANNING DEPT. APFROVAL DATE� x di T Y, I TELEPBONE NUmBEft TKrLrr R/W EXISTING STREET R/W .-Fr. DEFICIENCY THIS PROPERTY N& COM-P. PLAN ST. R/W Xr. 4 REMARKS ADDRE88 44 —ICR—ECKED BY ELEPIJONE NUMBER 7-37-if 2Z SKI MEL) By Z& tVICE SIZE CLEARANCE CIIIX LICENSE NVUBER Lr..Il P On 0 toper tach Four C-Plt-) REMARKS Ty" CONIAE(;TIUN VI.R11"I 'Ll Ily Z. PERC. TFMT W I 'Lu FIRE ZUNr TYPS OF t;UNHTItU(.'TION . ...... . 0 YES C] NO HPMCIAL INjPKCTOJt RKQUIhkD__ CCUPANCY (IROUP OA (3 YEI; ONO nEUJI)KNTIAL LINE I'LAN C %CKNL1 BY THIS SITE IS LOCATED IN THE CITY NEW E] NON-RESIDENTIAL SIGN EDMONDS. LOCAL SALES TAX I M SHO�V 31.04. ADD T1ff1_A]_11______ _�J_LE CODED ALT11 Q DEMOLISH LL F�EXCAVATE FENCE oil FILL I _x ..M.) PRE. Ovr SWINT REPAIR INSP.M POOL NUMBER or LLINO UNITS PIVF NATURE OF WORK TO BE DONE V�Iunll Fo, 'N". 'lAn ChPcI4 I NO z BUILDING -FTI—OPOUED USE PLUIN PLOT PLAN (InIl-1, BUIldlog ett)-k., ItrItt.) BEAT & GAS LINE F EX C Z SIGN RETAINING WALL N SWIMMING POOL DEMOLITION PRE-MOVF INSPECTION �=AVATION OR PILL TOTAL A3 fOUNT DUE I hereby ackLoWledge that I have read tMe application; that the In- 'ect; formation given 1, c and that I — the owner, or the duly author lzol agent of the o—r. I "— to lornply with City and State I... re". ATTENTIOIN APPLICATION APPROVAL lating const—tion: and in doing the Work au'hori:ed thereby, no person will,bo employed in vloutf- of the L. b.r Cod. of the State of Washington THIS PERMIT This application is not a perMit until rela Ing to WorkM-'. C—PI—Alon Insurance. AUTBOTVZES Signed by the Building Official or his Dep- NOTE: Permit Limit One Year (E. Vt DEMO TIONS villch ONLY IrIFD uty; and fees are paid, and mcelpt is ac. C WORK NOTE BU ILDINGS Iluell b. ourn- &hall be Completed In 1A.1tY day,; knowledged In Space provided. pleted In .1. ..nthB.) INSPECTION SIGNATUI—a—VOWNER t AG DATE SIGNED �KE f - DEPARTMENT I CITY OF I).TE EDNIONDS 75- NOTE: Applicant Subject to Plan Cbeck Fee 775-2525 3 CK. SLY. Thil Permit work 1. bo done on private PoencItY 0 Any m-t-01— on the public domain (b, driveo,".. FILE etc.) ,III require -p—le P-11112-10n. ------------ e DEP ILDING', ARTMENT Fin Ulm ERMIT NUI&BER 50077 �'10MIT.-APPLICAITION, '�Ppucan Inside Heavy Lines -75117- ADDRESS 174 "E OF DUS.NE NAME (OR. bAhMIE 0 DUS.INEUS) C P E R N 1178-8 TB —LF LOT COVERAGE LOT CO�aACE t -FEBMIRIBLE --RE151IT 7aW c c) f7 — -7. TH �T. PAONE NU]dBr,— A r BEAR MONT REAR W ('Q2 :3� HONAL L LOT VA IN YES 0 NO PERMIT NUMBER PLANNInDE PROVA MA IIA I'. T.L.P..NE NUMBER T LE Q, FX.STINO STREET R/W. . DEFICIENCY THIS PROPERTY 1 NAME Y, I—M PLAN ST. R/W. F'r REMARKS FT —REMARKS FIRE ZONE TYPIO Ur CONIJI No it, fKgv =Olt Jtxq lit hour .-..IINTIAI, F1 GAS LIN' YCH 0 PI I) D THIS SITE IS LOCATED IN THE CIT NFW OF EDMONDS. L AL SALES TAX NON-1111.81DIINTIAT. E] SIGN UA I At r brb 11,ft' Its. [] RETABUTINO WALL Alt E-1 DEMOLIHII ALT11 EXCAVATE on FILL YE"'CE ( . REPAIR PRE-MOVII D SWIM IN$W. I root, -171-UMBElt OF STURIES —1 'Nulan'T 0" .IELL lo UNITS NATURE OF WORK TO BE DONE Fee "ll, A , At QtQ�) - - �Ik C-.J '—ff � Pl— Ch,k N... BUILDING �'J E OPOSED USE id PLUMBINIC; -FLO-T-PLAN Itig .,tbuckl, butting At IEAT & GAS LI I NE PENCE SIGN RETAINING WALL SWINIMING Poor, DEINTOW riox PRE-MOVF INSPECTION RXCAVAT�Ort OR FILL TOTAL AMOUNT DUE I hereby acknowledg, that I have read this application; that the In- form:tlon given correct; _it that I ara the o"ner, or the duty author. elso I wit Ized agent of 11 witer. I agree to comply It City and state I.— reg"u- A Tr ENT 10 N APPLICATION APPROVAL g -it authorized thcrtb,, no Person latin con3truCtIms; and In dolng.thebwo. be In violation or U, La or Code of the State of Wmhlngton T1114 PrRMIT This sipplication is not a permit until will employed relntlVS to Workmen-s Compensation Intur— AUTHORIZES sign id by the Building Official or hin Dep- NOTE: Permit Limit One Year (M—pt DrMOLITIONP which V THE WORK NOTED uty; and fees are paid, and receipt is Be &hall be completed In ninety days: MOVrD-IN BUILDINGS Ar.11 be Wm- kno ledged lit space provided. " V 'a . ., lkf�,.d 1.10 11" tulsh;rl 1-48PECTION D EPARTMENT / , A A 81 A BE 3 �— — A Wkyz SIGNED 0" A., Tiy _T I! , ; L :—LA Vt) C.. ' �—1 c%- I\ V) C tj)r"'ro C'7' (0- �i W � � 7' CITY OF J J A�Ti 6,:, 6 FWNIONDS NOTE: Applicant Subject to Plays Cbeck Fire 775-2525 Thl,c pe,mlt ,o,k to be done an pelva". property ONLY - Any ... I ... it.. .. the public do —An (etute, ld—alke. drl—y.. P-11"lon' �oi USE P RMIT -7 BUILDING, D E P A R T M.'E N p calot tu A�pl! F NE UMBER -PERMIT APPLICATIO N inside Heavy Lines -Tow ADDRESS NAhIE to NAME OF BUSINESS) —FER.11 is —BIBLE 11 LOT COVERAGE AOT(;�VEAAGE CC Al NO ADDRESS REIGHT PROP08ED HEIGHT TOTAL BLIJO. A-REA z PHONE NUMBIA1 ACTUAL LOT AREA —REQUIRED YARDS O.JJ1ROPa.4ED YARDS REAR FRONf--- REAR TELEPHONE CENSE N IDER L.C...: RESIDENTIAL F] GAS LINE 101-IE,9IDFNTIAJL SIGN A.. RETAINING ElDEMOLISH WALL ALTER 7 EXCAVATE on FILL FENCE C .. Fl.) E] REPAIR F� "'-"OV' INSP. EJ SWINI POOL ;UN113ER OF STORIE' —1 .111,111ER Or DWrLANG UNITS 1ATURI, Or, WORK TO BE DONE. VARIANCE R CO, DITIONAL USK LF AL LOT NO PERMIT NUMBER J. APPROVAL DA E: STREET R/%V EXISTING STREET R/W. FT. DEFICIENCY THIS PROPERTY z W CONIP. PLAN ST. R/W ., Fr - REMARKS z N lICXEI) Fly �JC t BIZE SERVICE UIZE CLEARANCE REMARICS \J �rYPE CONN ,I N V.RIFIED y PLI PERMIT NUMBER ce W Flit), ZONE TYPE OF VU Eu Y, No 8PECLAL IN-6-11 R—Ullt"D I OCCUPA GROUP 0 YrS I - P—LANCI EC.. THIS SITE 15 LULA I tV IN FHE CITY OF EDMO14DS. LOCAL SALES TAX 5 Lp BE CODED 31.04. HOV REMARK lm"_; 1,9 mn Fee It"er!"t No. -IV,-A'. el Pl check No. BUILDING PROPOSED BE PLUMBING HEAT Z, GAS LINE PLOT PLAN (indicate Building setbacks, alluttiOg st—ts) FENCE SIGN RETAINING WALL N SWIMMLNG POOL DMfOLITION PRE-SIOVE INSPECTION EXCAVATION Oft FILL TOTAL AMOUNT DUE 0 hot I h.v. read this &PPIIC.tt.c that the I.- '/ gi, 'rec aml that I m the .—I. or th ! duty Vul thor. ^KI ADDD^',,FAI tied scent ' the o,ner. I aKree to comply with city �d at to la— regu- ATTENTION ArrL1160A I I lating construction: and In doing the workocuthertled thereby, no person 'EltslIT This application is not a permit until will be employed In 11.1MI-ii of the Luber C do of the State of W-hington THIS I AUTHORIZER W.Risit to Workm_'. ConoVen-atiOn loo-11-h— , e!gned by the Building Official or hill DcP ONLY Tllr NOTE: Permit Limit One Year (E.tept DEMOLITIONS ohith WORK NOTED uty; nnd fees are paid, and receipt is ac ,hall be completed In cuuty day.; bIOVRD.lN RUILI)IN04 hall be com- knowledged in space provided. in month,,) INSPECTION ED Dil TOR'S KIG.NATURE/,' 'RE to" AGENT) DEPARTmi�NT I CITY OF EDMONDS NOTE: Applican't Subject to Plan Cbeck ree 775-252S This Permit ro—m work to b.,. done on private PTOWrtY ONIA- A construct[ n both c do .1. (ru,bl. Idcw�k., drlvll,.Y.. INSPECTOR or an - -te n,-,uec.. I sw A: S", N P A 1, �Ilmt- portion of 'Trlcz 1, J� lip, t 0 thc plat therear recorded 1 .1 t SLlbd 1v is ion :�O of tho Auditor of ,;,, c s .i n (I :' ^, Volume 9 OE I -,It:; 57 recol -is fO 110 15 -scribcd the-GOIllit'- Of" .'I'ollorli. I to,, d c at the Northwcst corner o f �--iid Tr,,ict .1; thence F)011th r) 3 0 t .110n,". tile 1.;Crt line 12'--' f(vet., thence Sollth U) 5 ! rth 5*0"115" t!l line Feet; thenze NO ::,ist par.'Mcl to tile S 0 I ine ':Ztid poilit beine I s t 71.51 ECOL to 'I 110ilt 011 tile o I':! I W I tile tall,rcnt of j;jj;cjj ;:rj r Ith 5)G'01'40" CS t ; the I Cu"Ve I . or ;i curve havin� a NOr till. u.,; tu rl y alolml, tile .'orthtit-11% t '1; 5 fect to the Northwc!; t corner of 310 ree t ;k L' .1ce 0 po 11 t of �q()'5L40 RECO D Otf INE S passed Fotjndation PlUmbiliq (Partill) -�:el Lilies Fj'.r;jv.CO Final Date MEMO TO: Building Division Community Development Department FROM: Engineering Division Public Works Department SUBJECT: After review of the subject building permit application, we have the - following comments: Coordination -of the location of any structure wi th respect to utilities, streets, property lines and driveway*grades is the responsibility of the contractor. The contractor is required to keep the abutting streets cleaned LIC7 of dirt and debris caused by the construction. The "Right -of -Way Construction Permit" is required, from the Engineering Division of.Public Wo ' rks, for any work within the Public Right-of-Way,or public easement. Driveway slope not to exceed 14%. /_7 Connection.to sanitary sewer required. f7 Septic Tank Permit required, submit design. 'Fire hydrant required, submit design. /_7 Site drainage per code.# See approved plans /_7 Curb /_7 Sidewalk 1_7 Paving required. /_7 Bond required for public improvements. Submit cost estimate. -7 Underground wiring required. L -7 Approved Engineering Plans required when applicable. L 1=zo R5o 4- m c_ 6E P(L0_rar-T-V--_Q T=iQV%A AI P 6a U6 A:ZQIR tZIIWZ 0,,-- 7;yn Dznor-i -tla C_C)NM�C-rr--O vrn For Fred F., Herzberg, P.E. City Engineer Department of Public,Works Rev. 7/78 :E: P4 0 Open Ditch Existi�_-__4L,�t Reqd. Culvert Reqd. Size /V/Z Catch Basin Reqd. Indicdte on Site Plam. Tn . rvFf: e__ Mlm-�hole reqd. Iedic'a;te q- i t7C- - S .1 1 -iditions and Ground Water Field Checked'....Zz-�_ oil Coi Review by DL CA 1QStreet Paving Reqd. )jCurb and Cutter Reqd. Sidewalk.Reqd. Curb Cut for Dr i'veway Reqd. P� Right -of -Way Construction Permi Bona Reqd. for Public Improven� Street Nme Sign Reqd. -iing Rcqd. __10ther Sigi 0 Pre Permit Site Inspection made on 0 BY:. MER WATER Lb U) S=- -T ENGII\=- RING d. / /' , Special Requ-ircn=ts listed in.mem to Comunity Development Department, Building Division BY; Date o All items filled in on Buildin P t Application r-4 BY ---Date t PA Errawings Starrped and Nlota6;�s Made BY Date lorks Deparnm- -it .lApproved by Public Iv. Revised: 1v 10-1977 WORKS DEPAR11MEW CHECKLIST Date BdILDINGPERMIT REVIEW -�E! &X_5� Address Street Right -of -Way Existing REQD Access Easements Existing REQD Utility Easement Existing REQD Lot per Subdivision Plat Assessor Map Site Plan Checked for Accuracy Underground Wiring Reqd. Check Accuracy of Legal Description Envirortmentally Sensitive Area Environmental Checklist Reqd. Flood Hazard Zone Shoreline Management Area Z )4 Slope, Soil, Vegetation �-Stream,-Creek,,Drainage Basin. - Existing Zoning Per Code Amenities Design Board ApprovalReqd. ADB # Approval Board of Adjustment Approval Reqd. Review By- Date: Existing Water Main Size Water Main Reqd. Service LineReqd. Hydrant Size Existing Hydrant Reqd. Per Fire Code Size Beeeftar Z70 U a C/yli�`/k- eqte 6�Ar-J Cross Connection Inspection /.s 'Regotp'&� Fire Department Comments Water Meter Charge' Reqd. kOMP-7- Review by: ,eCle,, Date: c Permit No. Sanitary Sewer Availability Proi. - Drawing N6. File No. Side Sewer Availability Sanitary Sewer Connection Fee Reqd. 000, Review By: Date: T�W_ 'DtSCHA*_G-f:; OUT_L(-_7,� -J-F �"p'jAt 1��- /-� t iZ & A (0 4:-% LRAc-r (6 a":� 7-11 r:—:, f=L4o_b R_ i ri C' P T-A F_ APPLICATION CARD No . ....................................... The City of Edmon for SEDE SEVVER PERN[IT tTREET FILE OUTSIDE 0 INSIDE REPAIRS EASEMENT No . ...................................... 423��6 �lp )O� OWNER --------------------------- CONTRACTOR .............................. ......... T No . ...... .......... .... PERMIT No . . ......... .... .............. STREET HOUSENo. ........ ........ ........ AVENUE LOT No . ...................................................................... BLOCK No . ............................................... NAMEADD. -- ................................................................ --------------- ........ ......................................................... APPROVED Date Approved: BACKFILL WORK ORDER ISSUED... .............. ................. DEPOSIT, $ .................................. SEWER WORK ORDER ISSUED .............. : ......... ................. DATE By .......... A� ----- NOTICE: No warranty of accuracy. The information shown on the attached map(s) was compiled for use by the City of Edmonds, its Employees and Consultants. The City of Edmonds does not warrant the accuracy of anything set forth on these map(s). Any person or entity requesting a copy should conduct an independent inquiry regarding the information shown on the map(s), including, but not limited to, the location of any sewer stub shown. Such sewer stubs may or may not exist and may or may not exist at the location shown. N either the City of Edmonds nor its employees or officers shall be liable for the information given on this map(s), nor for any one representation provided based upon said map(s). �� I 0�'I 4m Aft Ni W M 238TH ST. SW 85' FAR a LI IRE y F 01 rHD �ANT IMPERVIOUS AREA CALCULATION LOT AREA: 14750 S.F. Existing Building Roof Outline: 2675 S.F. L Existing Porch and Deck: 751 S.F. LU I kUVr_MMk.:Pr_ Existing Footprint: 2294 S.F. (16%) Existing Driveway: 2350 S.F. Existing Walkway: 407 S.F. Existing Pool and Patio: 1290 S.F. EXISTING MIDE Proposed Open Decks: 170 S.F. CONC. WALK 407 S.F. HEIGHT CALCS. A: 0 0 B: + 4.5' C: + 6. 0' EXISTING ROOF LINE D: + 2.5' 2675 S.F. AVE GRADE=3.25' ACTUAL� 18.5' -- — - MAXIMUM=28+25' — — — — — — — — — — — — A: U t 13 4.5140:: o4 EXIST 11�6 RA�MP EXISTING RESIDENCE 2294 S F (INCLUDING GARAGE) 0 4 r 4 EXI§TItiG*DECK: 415 S F 57< LU 4 hn 4 ..... ... .......... -,4 EXISTING 6 CAR PARKINGAREA, < (CONCRETE1 LU 2350 S.F. \,z LU > I PROPOSED'. 4 1 INTERIOR RENOVATION LLI Z 4 PA 4 J, 'ONEXISTING GARAGE 468 S F X X 04 4 6+0' 0 130' 58.0' IFE F=�w I SCALE: 1" = 20'-0" 0 20 40 I OWNER: WNAH FAJARILLO ?3005 76TH. AVE. W EDMONDS, WA 98026 +E+--#& 206-795-4032 CELL #: 206-795-4032 425-673-6181 PROPERTY ADDRESS: 23005 76TH. AVE. W EDMONDS, WA 98026 PARCEL NUMBER: 00488800400102 I this permit approval p " be as Whwmar the e of any awal. nonw 'J raitted t structure n' or ske cc a outside the mpe of the p =al reordim -of whetbw such w=A. .. oructure or conditin is &Iwwn on the site plan or drawing. Such buildmg, structure or ma =,dilior y be the subject of a separate enfo nt action.0 CT LATCHING) z 6- HIGH FENCE j za: EXIST. TO RE&rIN Wo 0 EXISTING bw POOL _JJ qz\ —7— D: 2.5'f VHIGH FENCE EXIST. TO REMAINA 2 Ju 50.0' V a e g RESUB N cn APPROVED BY . PLANNING FEB 2 6 2007 01?-OT-0-1— BUILDING DEPARTMENT crTy OF EDMONDS /, 7 -is 9 f3 STATUS: ISSUED 3/9/2007 Expiration Date: 3/9/2008 S-MEET FILE 7" CITY OF EDMONDS 121 5 T1 I A VI ' -NUE NORTH - r-DMONDS,WA'98020 PHONE: (425) 771-0220 - FAX: (425) 771-0221 Parcel No: 00488800400102 PROP ERT)7 OWINTR APPLICANT CONTRACTOR WINNAH FAJARILLO DAN GA RVI DO OWNER EXEMPT 23005 76TH AVE W 12613 SF 240TH Pl- EDMONDS, WA 98026 KENT, WA 98031 206-795-4032 206-261-2418 LICENSE #: EXP- ffreTITIMMM-m llvjk�E CONVERT 2CARGARAGE INTO 3 BEDROOMS AND ADD TWO 86 SF DECKS OFF THENORTH AND SOUTH SIDES (SEE AFH COMPLIANCE PERMIT BLD2006-1 100- WAS APPROVED 3 BEDROOMS PLUS THESE 3 =6 TOTAL). VALUATION: $38,683 PERMIT TYPE: Residential PERMIT GROUP: 4 - AlterationfRemodel Interior GRADING: N CYDS: 0 T YP E OF CONST RUCT ION: VB RETAINING WALL ROCKERY: N OCCUPANT GROUP: R3 OCCUPANT LOAD: FENCE: N ( 0 X 0 FT.) CODE: 2003 OTHER: N -------- OTHER DESC: ZONE- RS-8 NUMBER OF STORIES: I VEST ED DATE NUMBER OF DWELLING UNITS: I EXISTING AREA iBASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0 PROPOSED AREA IBASEMENT: 0 1 ST FLOOR: 387 2ND FLOOR 13 RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0 13RD FLOOR: 0 GARAGE: 0 DECK: 172 OTHER: FRONTSETBACK SIDESETBACK RF-ARSE]rBACK LEQUIRED'- NIW: 25 PROPOSED: N/C IREQUIR D: SIE: 7.5 PROPOSED: N/C IREQUIRED: PROPOSED: 1EIGHT ALLOWED:O PROPOSED:O IREQUIRED: PROPOSED: I ETBACK NOTES: NO CHANESTO SETBACKS, HEIGHT, COVERAGE. TWO REQUIRED PARKING SPACES ARE LOCATED IN THE )RIVEWAY. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOINGTHE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELAT INGTO WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR H!AEF4AEPUTYMND ALL FEES ARE PAID. 10 Acjnatur-d-,e'/\ ",,[I Print Name Date RdlAseMv k 1\ Date% ATTENTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION IIAAEEN� OCCUPANCY HAS BEEN GRANTED.UBC109/ IBCI 10/ IRCI I . F-1 ARCIUVE . E—IAPPLICANT [�] ASSESSOR AND APPROVAL OR ACERTIFICATEOF MAI � W , I M1 0 0 STATUS: ISSUED BLD20061387 CONDITIONS Obtain Dectrical Permit from State Department of Lzbor & Industries. �25-290-1309 Any request for alternate design, modification, variance or other administrative deviation (hereinafter "variance") from adopted codes, ordinances or policies must be specifically requested in writing and be called out and identified. Processing fees for such request shall be established by Council and shall be paid upon submittal and are non-refundable. Approval of any plat or plan containing provisions which do not comply with city code and for which a variance has not been specifically identified, requested and considered by the appropriate city official in accordance with the appropriate provision ofcity code or state law does not approve any items not to code specification. SoundfNoise originating fromtemporary construction sites as a result ofconstruction activity are exempt fromthe noise 14nks of ECC Chapter 5.30 only during the hours of 7:00amto 6:00pmon weekdays and 10:00amand 6:00pmon Saturdays, ewluding Sundays and Federal Holidays. At all other times the noise originating from construction sites/activites must comply with the noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120. I INSPECTIONS THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT TIME LIMIT. SEE ECDC 19.00.005(A)(6) I BUILDING (425) 771-0220 EXT. 1333 1 ENGMEERING (425) 771-0220 EXT. 1326 1 FIRE (425) 771-0215 PUBLIC WORKS (425) 771-0235 PRFTREATMENT (425) 672-5755 RECYCLING (425) 275-4801 _j When calling for an inspection please leave the folloving information: Permit Number, Job Site Address, Type of Inspection being rennested. Contact Name and Phone Number, Date Prefereed, and %bether Von lrefer morning or afternoon. No Engineering Inspections Required B-Footings B-Foundation Wall B-First Floor Framing B-Framing 13-Wall Insulation/Caulk B-Floor Insulation/Caulk B-Ceilling Insulation/Caulk B-Sheetrock Nail B-Building Final ID-1 Z,00(12 13S 7 -101ULECEIVED kle--c t-.,' JUL 18 Zuuf LL EDMONDS CITY CLERK LA4 twul LICENSE.. ADULT,..FAMILY HOME. License Number: 750529 Pursuan.tto- the 1�,ws of die State ofwashitigton and the Nfir�murn Licensi6g Requiremei)L- of theDepartment of Socialw'Pand Health Servimi,, a license t'&hereby gmnted'te A KLND HEAWr INC D 10 edrducl and inaimaiji an Adu:t Family -Home at 23005 76TH AVE W Cit), of EDMOINI)S, 99026 SjObo-Pnish Couray staw of Wwshin" "JI!, D i N b foe the rate and mipc, visior of' adults as fol low-S., Eli 247hour care for no more thar, 6 Mults Tbis 11=se i&ll be m" f6rc.e f riiin 1he I 3th n f.T ul y, 2007 Sz0bj&( to a" " pen . sion or re., ecat ion for, due, 6DUSe. Dc:rnenfia Spec �1�v, Mental Health Soeielty Licms ing Authorit� U NOTE: The depamoxnt renewal of a license does tint prectude. the 4eparmiern fn)m tak,ing any . ac I non under WAC 389-716-705, based or. inspec.tion. This Beew 6 not tramferable, aud iA valid nnly fot u-se by ibe corpoiiiien, pArtnersh.ip or Individual(%) to %whom it 6 issued and tit the location rilievc described. Issued by Atilhority ofOapter RCW 70.128 0 A A REQUEST FOR INSPECTION- Adult Family Home APPLicATiON NUMBER: Applicant must complete sections 1, 2, 3, and 4. Application must be complete to be processed. SITE ADDRESS: 230ZA -7M AW-- W, WWNW, k ��2� ASSESSOR'S TAX/PARCEL #: 0 0� 8 aa M�ftlfJ 2- PROPERTY OWNER NAME: 5WWKV. LVONOAR JNVVE391 DNJAI�UQ DAYTIME PHONE: LICENSEE NAME (IF DIFFEREUT): I SECTION 3 — FLOOR PLAN DAYTIME PHONE: A complete floor plan must include all sleeping rooms, identified by number (#1, #2, #3 etc.) and all components for exiting, i.e. stairs, ramps, platform lifts and elevators. (Attach additional sheets if necessary) SECTION 4 — DISCLAIMER/ SIG NATURE BLOCK I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and that I am authorized by the owner of the above premises to request inspection for and operate an Adult Family Home at this location. I further certify that I have made application to the Department of Social and Health Services and the jurisdiction for the.appropriate license(s) to conduct such business at this location. I further agree to hold harmless the jurisdiction conducting such inspections at my request as to any claim (including costs, expenses, and attorneys'fees incurred in the investigation of such claim), which may be made by any person, including the undersigned, and filed against the jurisdiction, but only wvhep�irn arises eliance of the jurisdiction, including its officers and employees, upon the accuracy of the )lied to information supp tfke jurr�,�tion as of hii lication. NAME/TrTLE: DATE: (Ff- Z7 ---LW CENSEE PROPERTY WC14ER Home licensed (or applying for license) on or after July 1, 2001 SLEEPING ROOMS Sleeping Room #1 S NSI -1 NS2 Bedroom door is openable from the outside when locked Closet doors are readily openable from the inside Smoke alarm is installed in the bedroom Sleeping room window has a minimum net openable area of 5.7 sf. (minimum dimensions- 24" high; 20" wide) Sleeping room window has a maximum sill height of 44" Sleeping Room #2 S 7 NSI -I NS2 Bedroom door is openable from the outside when locked Closet doors are readily openable from the inside Smoke alarm is installed in the bedroom Sleeping room window has a minimum net openable area of 5.7 Sf. (minimum dimensions- 24" high; 20" wide) Sleeping room window has a maximum sill height of 44" Sleeping Room #3 ID S NSI D NS2 Bedroom door is openable from the outside when locked Closet doors are readily openable from the inside Smoke alarm is installed in the bedroom Sleeping room window has a minimum net openable area of 5.7 Sf. (minimum dimensions- 24" high; 20" wide) Sleeping room window has a maximum sill height of 44" Sleeping Room #4 :1 S NSI D NS2 Bedroom door is openable from the outside when locked Closet doors are readily openable from the inside Smoke alarm is installed in the bedroom Sleeping room window has a minimum net openable area of 5.7 sf. (minimum dimensions- 24" high; 20" wide) Sleeping room window has a maximum sill height of 44" Sleeping Room #5 -1 S 7-6 N S I NS2 Bedroom door is openable from the outside when locked Closet doors are readily openable from the inside Smoke alarm is installed in the bedroom Sleeping room window has a minimum net openable area of 5.7 sf. (minimum dimensions- 24" high; 20" wide) Sleeping room window has a maximum sill height of 44" Sleeping Room #6 -.1 S NS1 -1 NS2 Bedroom door is openable from the outside when locked Closet doors are readily openable from the inside Smoke alarm is installed in the bedroom Sleeping room window has a minimum net openable area of 5.7 sf. (minimum dimensions- 24"high; 20"wide) Sleeping room window has a maximum sill height of 44" GENERAL Bathroom doors are openable from the outside when locked Smoke alarms are installed on all levels of the dwelling All smoke alarms are audible in all parts of the dwelling upon activation of a single device Access road and water supply approved by Fire Department PASSED CORRECTIONS REQUIRED INSPECTOR: )m (,Y? DATE: YES NO .F/ -D PERMIT REQUIRED �?-'-d -7 0 0 I ir RETURN ADDRESS: City of Edmonds, City Clerk 121 5,h Avenue North Edmonds, WA 98020 CONFORMED COPY 20070822�067 3 pGS 08/22120 7 4:27r N.00 SNOHOMISH COUNT I �SHINGTON NOTICE OF LIMITATION AND COVENANT ADULT FAMILY HOME Reference #: �0� —110 6) Grantor(s): (1)w blah YL 1110 (2) Additional on pg._ Grantee(s): City of Edmonds Legal Description (abbreviated): Sec Tw n Rng Qtr OR Lot Block —Plat Assessor's Tax Parcel ID#(s): (1) g2!Jt8&-)04<z �02 - (2) Assessor's Tax Parcel ID# not yet assigned AUTHORIZED FOR RECORDING City of Edmonds By: -TEA — DateUak� Page --�— of WHEREAS, the undersigned owners of property located at 29CZ9- 761'p Avff s0 � 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 6 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: M 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 4 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 residents or attempts to rent, lease or o . therwise 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 prov isions 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 23Qs- 761h /�VE k)l Edmonds, Washington and legally described as: 3. Notification to Future Purchasers and AssijZnees. This notification and covenant has been recorded in the records of Snohomish County, Washington in order to provide notice to any and all future owners of the property of the limitation at the current level of improvement to single families and adult family home. residents fewer than ;�- in number. 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 ty of Edmond By:_, Date: !O� Page of ---1, DATED this day of jce"Orelm 4M 20 06 ACCEPTED BY: OWNER: JeAnnine L. Graf Building Official 7S 0 5-2 9 34-0.200bl3oil NOTIFICATION APPLICANT/PROPERTY Applicant Applicant V\)� h V)A1+ \7W t�7z P-(LLO Owner Owner COVENANT AND ACKNOWLEDGED: Mortgagor NOTARY FOR OWNER SIGNATURES State of Washington )ss County of '��n � �� 6, �� -� I certify that I know or have satisfactory evidence tha signed . this instrument, on oath stated that ke/she was authorized to execute the instrument and acknowledged it as the'T77,Ut DdCuVyIfLj�� (title) of APtUr.,w"1111,111,110 12��j ��hA�—(name of party on behalf on whom instrument was executed) t"�A—A ......... the free and voluntary act of such party for the uses and Wurposes mention I XSSW[jr4A-- �( ,, oil instrument. Sub�cribed and sworn to before me this day of V ,20 Notary P40ic in and for th�State of Washinglon. 0 ...... '11ill, P W A'� My commission expires aa 4111d14610 I certify that I know or have satisfactory i ence that signed this instrument, on oath �tat at he/she was ed to execute the t s the (title) of instrument andd acknowled as �the u n M ame arty on behalf on�who usenstrument was execute to be volu ct 's in to e �ions iiin this 0 e s the free and volu ry act of such party fo e uses and purposes me 1 instrument. scribed and sw��efore me this d of 0 .20 Notary Public in and for the State of Washington. My commission expires AUTHORIZED FOR RECORDING City of Edmonds By- 1,1b � Date: Page -j- of L:\TEMP\BUILDING\FORMS\AFH-COV.D0008/29/06 I :r 0 CfTY CLERK MY OF EDMONDS 121 5TH AVENUE NO. EDMONDS. WA 98020 CONFORMED COPY 200709130083 2 PGS 09/13/2007 9:30am 41,00 SNOHOMISH COUNTY, NSHINGTON COVENANT For Adult Family Home's Second Kitchen Whereas, the Gran to r(s) �\)J�,)t\�AH \.�VJET2,— rAy\pJt-Lb hereafter referred to as "Grantor(s)", have received a Building Permit # ;��-IIPO for property which is zoned single family residential, and is located at.Z;C05 76TH Ayr— W, WN/UND3, VJA 98026 tax account parcel number W49188CD4CO102- and legally described as follows: L,,\KE� 13AWK�� LAVID CC> 5U13VIV I SLr� C01 0-02- MO NW C47K TK 1 TH SCt) '�+l ZOW ALG Vi LN 12-2 fl- 11i S8� X'2K 30E rurs L'N 1�6- 02 FT- TH 0054- Ob '49E -71-151 f-T TNP 06� N LN 5p pf f�EI�JG ON q7,V V" tJ G OF V\) 4 BEA KS W 9, 4 0 T 40 V) -M N WLY A L-G N L-N lq,� GF-V �-AID OF I ]U() rF IS�2 - c,;- fT To w to COKIFB - Q a N-y4ae, -- 03/7t� -o,-- Whereas, the City of Edmonds has received a building permit application for an Adult Family Home with a second kitchen to be located in anexisting single family residence in a single family residential zone. Whereas, pursuant to WAC 388-76-190 an adult family home is considered a residential use of property for zoning purposes, and are permitted in areas zoned for single family dwellings. Whereas, the City desires to approve utilization of a second kitchen in the Adult Family Home as a reasonable accommodation to the facil . ity as care provider to the disabled for so long as the second kitchen is utilized, and only utilized, in conjunction with the Adult Family Home use. Therefore, in consideration of the City of Edmonds, Washington approving the second kitchen as a reasonable accommodation by issuance of a building permit, the Grantors agree as -follows: 0 0 1. This covenant and all terms hereof shall be binding on Grantor, heirs, assigns . and successors in interest, and shall be deemed to run with the land and bind all future owners to the real properties described above. 2. This covenant shall be recorded with the Snohomish County Auditor and Grantors shall pay for all recording fees. Grantors hereby covenant that the kitchen on the lower, basement floor of the subject residence can be used only in conjunction with the Adult Family Home and that the said kitchen shall be removed immediately upon termination of the Adult Family Home State License # — '7-570_T-Z,7 for the subject facility or cessation of use of the property as an Adult Family Home, unless, or until, zoning laws allow otherwise. 4. The provisions of paragraph 3 above shall be specifically enforceable in the Superior Court of Snohomish County. The. prevailing part shall be entitled to its attorneys' fees in such a proceeding. S. Grantors acknowledge and agree that approval of the second kitchen for the Adult Family Home use and the creation of this Covenant are a reasonable accommodation of Grantors' rights as a care provider to the disabled and of its clients' foreseeable needs. The Grantors, therefore, on behalf of themselves, their successors and assigns do hereby waive any and all claims of the Americans With Disabilities Act or the Washington Law Against Discrimination which they may have as of the date of the execution of this Covenant and promise to hold harmless and indemnify the City, its officers, agents and employees from any cost, claim or liability which may be incurred in defense of such a claim. By signing and execution of this Covenant, the parties hereto agree that Grantors are in compliance with existing zoning regulations. 011111111111'r 0,14 N A 10PI 0 T41, ;, Subscri V efi NMIN X -1-1 M—W IPIAMIC-4071MAA MI MA a Vs. w1m; ip o; A re me this day of J r, A Notary Pu6c in and for the State of Washington. Residing at :S m6wq\,� 0 0 L--11� RETURN ADDRESS: City of Edmonds, City Clerk 1215 h Avenue North Edmonds, WA 98020 CONFORMED COPY 200708221067 3 PGS 08/22/2007 4:27r 142 00 SNOHOMISH COUNT I ASHINGTON STREET FILE NOTICE OF LIMITATION AND COVENANT ADULT FAMILY HOME Reference #: Grantor(s): (1) 110 C4 YAY 1110 (2). Additionalon pg._ �j Gf-antee(s)i City of Edmonds Legal Description (abbreviated): Sec.__. 4-2"L Tw n. Rng Qtr 0 R Lot Block Plat Assessor's Tax Parcel ID#(s): (1) Qj:&8QQJQQ �02 (2) Assessor's Tax Parcel 1D# not yet assigned AUTHO RIZED FOR RECORDING City of Edmonds By: -T71 Date - Page -4— Of L WHEREAS, the undersigned owners of property located at 29C09- -76TR AM We 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: 1. Covenant: Limitation on Residence. The owner hereby stipulates Anid.'agre.es that occupancy of the structure as an adult family home shall be limited to or fewer adults and their caretakers as allowed by applicable Ptovlsions 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 4n'occupancy of greater than residents 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. I 1 2. Sub'ect Tract. The above stipulation and promises shall apply to and run with the land with respect to a. residential structure located at 23CM -761B AVE tk)/ , Edmonds, Washington and legally described as: 3. Notification to Future Purchasers and Assi2nees. This notification And covenant has been recorded in the records of Snohomish County, Washington in order to provide notice to any and all future owners of the property of the limitation at the current level of improvement to single families and adult family home. residents fewer than �;- in number. 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 ty of Edmond B Y: VS Date: Page _,2—. of DATED this v' 7' day of Poarelm 4m 2006 ACCEPTED BY: OWNER: Jeannine L. Graf Building Official 1,�All 1-14tW.0 IvV. 7,r0,5-2 9 13#1 A"Ir 1340.200,6 130;1 NOTIFICATION APPLICANT/PROPERTY -W�V10A� Applicant Applicant WmOAW Owner Owner COVENANT AND ACKNOWLEDGED: Mortgagor NOTARY FOR OWNER SIGNATURES 'State of Washington ..County of )ss I certify that I know or have satisfactory evidence that signed this instrument, on oath stated that lit/she was authorized to execute the instrument and acknowledged it as the Tr-',Ut (title) of I 'tit, name of party on behalf on whom instrument was executed) tA 0 1 49, d the. free and voluntary act of such party for the uses an purposes mention day of instrument. Subicribed and sworn to before me this —,20 c— Notary P40ic in and for th State of Washingion. Or A'S My commission expires Nn(-� cla I certify that I know or have satisfactory e �,Odence that sigped.this instrument, on oath �t3yA-tliat he/she wa d to execute the instrument and acknowledgo-if-as the (title) of to exec u te th e title) of ( (name arty on behalf on who nstrument was execute to be n 11 wh t t i is the free and volu ry act of such party e uses and purposes me ions in this fo instrument. bscribed and sworn efore me this d of 2 0 0 Notary Public in and for the State of Washington. My commission expires AUTHORIZED FOR RECORDING City of Edmonds By: I'M D a t e: /6 Page —a— Of L:\TEMP\BUILDING\FORMS\AFH-COV.D0008/29/06 tip RETURN ADDRESS: CONFORMED JOPY City of Edmonds, City Clerk O�MjeIP47:27r �U,00 PGS 12 1 5.1h Avenue North jl� N OMI 8 COUNT SHINGTON Edmonds, WA 98020 NOTICE OF LIMITATION AND COVENANT ADULT FAMILY HOME Reference OU6 0 Grantor(s): (1) i� 110 a V)LY o I D (2) Additional.on pg._ G�antee(s); City of Edmonds Legal Description (abbreviated): Sec SA Twn Rng Qtr OR Lot Block Plat Assessor's Tax Parcel ID#(s): (1) g�4LS&)O±CL102 Assessor's Tax Parcel IN not yet assigned AUTHORIZED FOR RECORDING City of Edmonds -o B y: Date: ls)l (D Page --�— of WH-tREAS, the undersigned owners of property located at 29W9- -76Ri A�c W, in Edmonds, Washington legally described belo'w 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 im provements 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 "Own6r") 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 an-d4gre.es that o . ccupa,ncy of the structure as an adult family home shall be limited to. or fewer adults and their caretakers as allowed by applicable pro , Visions 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 4 : n :. occupancy of greater than residents 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 prov - isions 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 23= 16TA &VE LA3/ Edmonds, Washington and legally described as. Wi1MW#1=M[V1W"�0_P 3. Notification to Future Purchasers and Assignees. This notification and covenant has been recorded in the records of Snohomish County, Washington in order to provide notice to any and all future owners of the property of the limitation at the current level of improvement to single families and adult family home. residents fewer than in number, 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 'f covenant shall entitle the City to enforce by in -grant 0 junction the provisions of this code and,* in so doing, to recover its reasonable attorney's fees and costs. AUTHORIZED FOR RECORDING olEdmond By:... Date: Page of day of -P,4reM 4M ED'Ihis ACCEPTED BY: OWNER: i0n=6 L. Graf Building Official 1,31b�l A"Ir 1314 .200,6 13e,� NOTIFICATION APPLICANT/PROPERTY W�ilvv'�� J?wlffiz- vp'ILL& Applicant Applicant v0MO/% �nvifflz - 2LMFA� L-L0_ Owner Owner COVENANT AND ACKNOWLEDGED: Mortgagor NOTARY FOR OWNER SIGNATURES State of Washington ) County of )ss I c6rtify that I know or have satisfactory evidence that s . igned this instrument, on oath stated that k/she was authorized to execute the -instrument and acknowledged it as the TMM (title) of name of party on behalf on whom instrument was executed) t th. e free and voluntary act of such party for the uses and purposes ment on i . ns : trument. Subicribed and sworn to before me this on rp, s' irs. day of '20 oke 0 V % %.> 0& *jj� IQ A 171,y '_V1111&J1aa1V1A I-AkJAA �O I certify that I know or have satisfactory gy.Wence that signed this tnstrument� on oath stq�tat he/she was atit ized to execute the a s Incstrument and I d =as the acknow e ge (title) of (name arty on behalf on who h strument was execute o be 0 t s m ons it olu the free and A�volu ry act of such party e Kuses and purposes me ions in this ; >P1 I f instrument. scribed and sw efore me this d of 0 .20 Notary Public in and for the State of Washington. My commission expires AUTHORIZED FOR RECORDING City of Ed m nd, By. D sot V I - Page -3- Of _'42 L:\TEMP\BlUILDING�FORMS\AFH_COV.D0008/29/06 � :;01- STREET FILE CONFORMED COPY CffY CLERK 200709130083 2 PGS CffY OF EDmbNDS 09/1312007 9:30am 41.00 121 5TH AVENUE NO. SNOHOMISH COUNTY, NSHINGTON EDMONDS. WA 98020 RECEIVED SEP 19 2007 PERMIT COUNTER COVENANT For Adult Family Home's Second Kitchen Whereas, the Gran to r(s) �\)11,,3t\�AH \��Vlffj�,-f=Aj�\pju Permit# hereafter referred to as "Grantor(s)", have received a Building for property which is zoned single family residential, and is located at.Z;00�; 76TH AVr— K),, EDWND!3, VJA 98026 tax account parcel number .104861BCu."10.2- and legally described as follows: L,�,Ke BALUNGET2, LAnD CD 5ul3VIV I SLr, GO+ 0-02- RE6 NVJ CM TF, 1 TH SCt_> -LOW AL�G Vi LN i22 fT U S8� X'K 3C)E FL--r S LN 1��G-02 V:-TI-H tJQ54-08 457E -71 - 5� FT T7\ P OfJ N LN 5 () rr S El IJG ON C-,;� V W", tJC- 0f Wh BEARS W 9, 4 0[ 40 V3 -M t� WLX A Le N L-N CF-V V-Af) C)V-f 3,VC)t:T-- r2- S-fl- To N (AD COR -W 5 - Q a 442� -- C/Jt� -0,4' 194n D'v ot,-, Whereas, the City of Edmonds has received a building permit application for an Adult Family Home with a second kitchen to be located in an existing single family residence in a single family residential zone. Whereas, pursuant to WAC 388-76-190 an adult family home is considered a residential use of property for zoning purposes, and are permitted in areas zoned for single family dwellings. Whereas, the City desires to approve utilization of a.second kitchen in the Adult Family Home as a reasonable accommodation to the facility as care provider to the disabled for so long as the second kitchen is utilized, and only utilized, in conjunction with the Adult Family Home use. Therefore, in consideration of the City of Edmonds, Washington approving the second kitchen as a reasonable accommodation by issuance of a building permit, the Grantors agree asfollows: 1. This covenant and all terms hereof shall be binding on Grantor, heirs, assigns . and successors in interest, and shall be deemed to run with the land and bind all future owners to the real properties described above. 2. This covenant shall be recorded with the Snohomish County Auditor and Grantors shall pay for all recording fees. Grantors hereby covenant that the kitchen on the lower, basement floor of the subject residence can be used only in conjunction with the Adult Family Home and that the said kitchen shall be removed immediately upon termination of the Adult Family Home State License # — 7-5-0-57 17 for the subject facility or cessation of use of the property as an Adult Family Home, unless, or until, zoning laws allow otherwise. 4. The provisions of paragraph 3 above shall be specifically enforceable in the Superior Court of Snohomish County. The. prevailing part shall be entitled to its attorneys' fees in such a proceeding. 5. Grantors acknowledge and agree that approval of the second kitchen for the Adult Family Home use and the creation of this Covenant are a reasonable accommodation of Grantors' rights as a care provider to the disabled and of its clients' foreseeable needs. The Grantors, therefore, on behalf of themselves, their successors and assigns do hereby waive any and all claims of the Americans With Disabilities Act or the Washington Law Against Discrimination which they may have as of the date of the execution of this Covenant and promise to hold harmless and indemnify the City, its officers, agents and employees from any cost, claim or liability which may be incurred in defense of such a claim. By signing and execution of this Covenant, the parties hereto agree that Grantors are in compliance with existing zoning regulations. H A.' fillil, I Signed *0 4f eforeme this day of ,f"J�,IkJS Ijssel Itt% A Notary Puh)ic in and for the State of Washington. Residing at. :s Pz6w4,-,,