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23426 84TH AVE W.PDF111111111111 7959 23426 84TH AVE W ADDRESS: TAX ACCOUNTIPARCEL NUMBER: - BUILDING PERMIT (NEW STRUCTURE): COVENANTS (RECORDED) FOR- AA &?5� ffnme- CRMCAL AREAS: DETERMINATION: []Conditional Waiver E] Study Required KWaiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED PERMITS (OTHER): PLANNING DATA CHECKLIST DA SCALED PLOT PLAN DA SEWER LID FEE $: LID #: SHORT PLAT FILE: LOT: BLOCK: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S).#:_ GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT FOR: WATER METER TAP CARD DATED: L-.\TEMP\f)S'rs\Fonns\Street File Checklist.doc 0 PLANNING DATA SINGLE FAMILY RESIDENTIAL Name: N Date: Site Address: —RA Ave_\w Plan Check 4: Q00-7 _0_4Gp Project Description: Ad/W+ ne-a> Reduced Site Plan Provided: NO) Zoning: Map Page: Corner Lot:(D/ NO) Flag Lot: (YES Critical Areas Determination #: 2coq - 0XI-a El Study Required Waiver SE15A Determination: R Exempt El Needed (for -over 500 cubic yards of grading) 0 Fee 0 Checklist 0 APO List with notarized form Required Setbacks : , . : Street: LE) Side: (W) 7. S Side- I , (S� _::�- p4e@#: as ActualSetbacks *-rn Street: Sid /,a- I Side: �S� -7..5/ R@ai KI'N "4- r?f Detached Structures: ekw_d wv/ C�r?c�r-k (64� Rockeries: Fences/Trellises: Bay Windows/Projecting Modulation. Stairs/Deck: 6.uildin Height Datum Point: NIA Datum Elevation: Maximum Height Ailowed: Actual Height: No dn�rR_ Other. Parking Required: Parking Provided: + Lot Area: No Maximum Lot Coverage: 35% Proposed: Lot Coverage Calculations:Q "S" \9" V,A, so'yV c/be_-, ADU Created: (YES c-cw�e- Subdivision: Legal Nonconforming Land Use Determination Issued: (YES Comments Plan Review By: Planning Data Form 04-11-06.doc Page I of I Bowman, Duane From: Total IyRadAN L@aol!'co m Sent: Wednesday, SepteAver 24, 2008 7:12 PM To: Bowman, Duane Subject: Request Refund Mr. Bowman Attach is a request for refund. THANKS A MILLION. AL RAD 17410 nth AVE. W. Edmonds WA. 98026 (206)605-7427 Looking for simple solutions to your real -life financial'Achallenges? Check out Walletpop for. the latest news and information, tip _s and calculators. 9/26/2008 Planning Department 09-24-2008 City of Edmonds Mr. Bowman I am requesting to withdraw my permit # bld20080104 dated 02-11-2008 for amount of $565.00. Due to new city ordinance #3696, 1 am not going to do my project any more, TANKS TO YOU. If you have any question please let me know. Al Rad 1741076 1h Ave. w. Edmonds WA. 98026 (206)605-7427 E 0,jj In-c . I s9e, Expiration Date: 3/2/2008 Parce I No: 00504700200100 CITY OF EDMO 121 5TH AVENUE NORTH - EDMONDS,WA 98020 PHONE: (425) 771-0220 - FAX: (425) 771-0221 HAPPY DAYSADULT FAMILY 11 HAPPY DAYS ADULT FAMILY If OWNER EXEMPTION TAKEN 23426 84TH AVE W 23426 84TH AVE W EDMONDS, WA 98026-86 10 EDMONDS, WA EDMONDS, WA 98026-8610 425-778-4723 425-778-4723 425-778-4723 LICENSE EXP: JOB DESCRIPTION ADULT FAMILY HOME COMPLIANCE PERMIT, NEW RAMP, WfNDOW ALTERATION BEDROOM #4 VALUATION: $1,622 PERMIT TYPE: Residential PERMIT GROUP: 4 - Alteration/Remodel Interior GRADING. N CYDS: 0 TYPE OF CONSTRUCTION: VB RETAINING WALL'ROCKERY: N OCCUPANT GROUP: R3 OCCUPANT LOAD: FENCE: N ( -0 X 0 Fr.) CODE: 2006 OTHER: N — ----- OTHER DESC: ZONE: RS-8 NUMBER OF STORIES: 0 VESTED DATE: NUMBER OF DWELLING UNITS: 0 BASEMENT: 0 1 ST* FLOOR: 0 2ND FLOOR: 0 BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0 3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0 3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0 FRONT S ETBACK SIDESETBACK RE-kRSE'I'BACK FLEQ�UIRED: See Below, PROPOSED: REQUIRED: PROPOSED: IREQUIRED: PROPOSED: HEIGHT ALLOWED:O PROPOSED:O --dREQUIRED: PROPOSED: SET BACK NOT ES: Property is a corner lot, therefore required setbacks are 25' street setbacks from E and N property lines and 7.5' side setbacks from W and S property lines. Proposed setbacks to the new ramp are as follows: E=35', W=7.5'+, S--7.5'+, N=25'+- I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY, NOTERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF T14E STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18 i27. THISAPPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS(HER DEPUTY AND ALL FEES ARE PAID. L- 11 A--%) VW07 \1 W, Print Narne Date Released By ATTENTION MS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBCI09,'IBC I 10i IRCI 10. ARcnrvE APPLICANT ASSESSOR Ttfl9k #P20 CA File No:.0-7-1/3 Critical Areas Checklist Site Information (soils/ topography/ hydrology/ vegetation) 1. Site Address/ Location: 2,14 24, !&(t 7- H A 2. Property Tax Account Number: 3. Approximate Site Size (acres or square feet): L/z 4 r ,P- 4. Is this site currently developed? _ZYes; — no. If yes; how is. site developed? 5. Describe the general site topography. Check all that apply. 7. F-11 V Flat less than 5-feet elevation change over entire site.. Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a horizontal distance of 66-feet). Hilly: slopes present on site of more than 15% and less than 30% (a vertical rise of 10-feet over. a horizontal distance of 33 to 66-feet). Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a horizontal distance of less than 33-feet). Other (please describe): Site contains areas of year-round standing water: Site contains areas of seasonal standing water: What season(s) of the year? ;Approx. Depth: — ; Approx. Depth: . Site is in the floodway floodplain of a water course. 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round? ,A) 0 Flows are seasonal? (What time of year? 10. Site is primarily: forested �&J c7 jmeadow shrubs mixed urban landscaped (lawn, shrubs etc) 11. Obvious wetland is present on site: 02 For City Staff Use Only 1. Plan Check Number, if pficable?—XA- 2. Site is Zoned? � 5 - 7 3. SCS mapped soil type(s)? 5-- Of Wcod C.HM (a-d .9V (2 4. Critical Areas inventory or C.A. map indicates Critical Area on site? 5. Site within designated earth subsidence landslide hazard area? AID DETERMINATION REQUIRED Reviewed d WAIVER #P20 City. of Edmonds Development Services Department Planning Division Phone: 425.771.0220 Fax: 425.771.0221 ne Critical Areas Checklist contained on diis form is to be filled out by any person preparing a Development Permit Application for the City of Edmonds prior to his/her submittal of the application to the City. The purpose of the Checklist is to enable City staff to determine whether any potential Critical Areas are, or may be, present on the subject property. The information needed to complete the Checklist should be easily available from observations of the site or data available at City Hall (Critical areas inventories, maps, 'or soil surveys). Date Received: 9— 0 — C20 6 -� CityReceipt#: 0/4f�1?07-> Critical Areas File #: &&A2.00101 Critical Areas Checklist Fee: ' $135.00 Date Mailed to Applicant: R- Ua,�-1 - ' A property owner, or his/her authorized representative, must fill out the checklist, sign and date it, and submit it to the City. The City will review the checklist, make a precursory site visit, and make a determination of the subsequent steps necessary to complete a development permit application. Please submit a vicinity map, along with the signed copy of this form to assist City staff in firiding and locating the specific piece of property described on this form. In addition, the applicant shall include other pertinent information (e.g. site plan, topography map, etc.) or studies in conjunction with this Checklist to assistant staff in completing their preliminary assessment of the site. The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including r . easonable attorney's fees, arising from any action or infi-action based in whole or part upon false, misleading, inaccurate or incomplete information furnished by the applicant, his/her/its agents or employees. By my signature, I cer* that the information and exhibits herewith submitted are true and correct to the best of my knowledge and that I am authorized to file this application on the behalf of the owner as*listed below. SIGNATURE oF APPLicANT/AGENT IVIAN Property Owner's Authorization By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use application, and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the purposes of inspection and posting ttendant to this application. U -SIGNATURE OF OWNER . . / A -7 aYA DATE PLEASE PRINT CLEARLY Owner/Applicant: A L '_�? A 2 Name 23q�& g- q T /Y 4 t-/ Street Address .,D/Vteowv� -L,-/-- I — �8 0 city State Zip Telephone: 6 ') �_ - 7 4 �- I Applicant Representative: Name Street Address City State zip Telephone: Email address (optional): 7-o 7-4�& Q& p,4,vt LV,4ct_.(, Email Address (optional): cmcopy REQUEST FOR INSPECTION- Adult Family Home APPLICATION NUMBER: Applicant must complete sections 1, 2, 3, and 4. Application must be complete to be processed. SECTION 1 - PROPERTY INFORMATION SITE ADDRESS:- 2-1 q Lip E(!J:Jy AtIF' W, �7 0AId p vA - 9eel.1f, ASSESSOR'S TAX/PARCEL #: 1raa_6 aq7—&e2-,oai -eel PROPERTY OWNER NAME: A-L i Lur,,LA R AD DAYTIME PHONE: (-416) 7.79-i47Z3 LICENSEE NAME (IF DIFFERENT): A L- Jikllo DAY-171ME PHONE: ( 44 Z 5 ) 7-7 �(- 'A 72 1 A complete floor plan must include all sleeping rooms, identified by number (#1, #2, #3 etc.) and ail components for exiting, i.e. stairs, ramps, platform lifts and elevators. (Attach additional sheets if necessary) 47--rAC-0 e-opv F:00 VPJ'4ii-5� A151 -t,9 # 3 - .V 51 i lit '�' 4, 0 Z , , W51 #JKq 1C 10 i 1/6 �" 0a -4k t;l to / Lo/i . )"I P-X ' " b�* 4 0 to H.4 10vA 3xi7 'i� 5' FA- L f Aoo- �Rt W�f I , J 0X lap Ph,- P le i" I)P,-p HA,-O R,41L SECTION 4 - DISCLAIMER/ SIGNATURE 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 own& 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 attomeys'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 where such claim arises out of the reliance of the jurisdiction, including its officers and employees, upon the accuracy of the information supplied to the jurisclic n a part of this application. NAME/TffLE: -kel DATE: '7 - ?, 0 -7 RE 'VED 4 Own- C* ��/-'PROPERTY OWNER --VAPPUCANT eUCENSEE JUL '1. 0 2007 i3UILDING DEPARTMENT CATy Or EDMONDS SECTION 5 - INSPECTION CHECKLIST YES NO Home licensed (or applying for license) on or after July 1, 2001 E D SLEEPING ROOMS F- 71 Sleeping Room #1 ikr S NS1 -I NS2 Bedroom door is openable from the outside when locked F. Closet doors are readily openable from the inside L -�j 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 X S NS1 NS2 Bedroom door is openable from the outside when locked F -I Closet doors are readily openable from the inside Smoke alarm is installed in the bedroom L Sleeping room window has a minimum net openable area of 5.7 sf. (minimum dimensions- 24" high; 20" wide) L Sleeping room window has a maximum sill height of 44" E :1 Sleeping Room #3 - S N S I NS2 �d Bedroom door is openable from the outside when lock( F 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) i Sleeping room window has a maximum sill height of 44" . L Sleeping Room #4 ki S NSI j 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 L —1 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 - S NSI NS2 X,— Bedroom door is openable from the outside when locked Closet doors are readily openable from the inside Smoke alarm is installed in the bedroom L j Sleeping room window has a minimum net openable area of 5.7 Sf. (minimum dimensions- 24" high; 20" wide) L A Sleeping room window has a maximum sill height of 44" E. Sleeping Room #6 e7 S NS1 -1 NS2 Bedroom door is openable from the outside when lockk 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) L Sleeping room window has a maximum sill height of 44" L GENERAL ,.,Bathroom doors are openable from the outside when locked I ,Smoke alarms are installed on all levels of the dwelling F. -.1 ,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 A,O &PASSED INSPECTOR: DATE: D PERMIT REQUIRED 8-ZL LICENSE LicenseNumber: 750813 RECEIVED FEB'- 8 2008 ADULT,". a Licensing Authority U BUILDING NOTE: The department renewal of a license does not pr'eciiLide..:thq dPpArt . Mmt ti�rn t;king.any action under WAC 388-76-705, based on inspection, This license is not transferable, and Is valid only for use by the co drat thefshi 'd 'Individual(s) to whom It Is issued and at the location above described. Issued by Authority of. Chapter RCW 70.128 ea-la-,p 0 ._ ­.., -RN . DRESS: R.'ETU, AD ftdriionds, City Clerk .1", 1.5, t .,�Avenue North Edmbnads, WA 98020 CONFORMED COPY 20080JO3068j 4 PGS 03103 21014, 11�1 �41 - 11 TON SNOHOMISH COONT , AS81NG NOTICE OF LIMITATION AND COVENANT ADULT FAMILY HOME (2) Additional on pg, G-rantet(s): City of Edmonds ugit.Description (abbreviated): Sec Twn Rng Qtr OR Lot I Block_2�_Plat A"e 's Tax Parcel ID#(s): (1) 5Qy7—QQP'-Q0-QQ-0 (2) s.s.o.r­ Assessor's.Ta.x,Parcel JD# not yet assigned AUTHORIZED FOR RECORDING City of Edmonds B y Date- lic4ul) -page 4— Of WHEREAS, the undersigned owners of property located at,23V,.24, Ale. 'ld*,/.* , in Edmonds, Washington legally described 6:0,16W 6r-'on'' the -attached Exhibit A, have applied for a building permit for .6oitioli'ance and/or to remodel a structure located on the site; and WHE­.. the applicant has notified the City of applicant's intention to utilize the improv*ements and/or to convert an existing single family structure to an adult -ne;:and of occu' ants of a V-VIA-REAS, under 1he Uniform -Building Code the number p t certain requirements relating to the fire suppression and exiting trigger: requirements; and WHEREAS the City has notified the applicant that the permit will be issued fewer residents and their 40i�,ioned onlimitation of residents to or caret'. ers; and WHEREAS, the City has issued a permit based upon such representations; NOW, THEREFORE, the unaers'igned property owners (hereinafter I.I.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 --an"d-agree as follows: a . 1. Covenant: Limitation on Residence. The owner hereby stipulates and agrees that occupancy. of the structure as an adult family home shall be limited to or fewer adults and their caretakers as allowed by applicable provisions of state law. The O*wner 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 (o 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 UnIf ' orm 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. Subiect Tract. The above stipulation and promises shall apply to and run withthe-land with respect to a residential structure located at JAJ_ _—, Edmonds, Washington and legally described as: 9UH1 Ale, 7 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 Ilimitation at the current leveUf 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. 11 AUTHORIZED FOR RECORDING C1 Y of Edmonds By: I-ffl — Date: page of DATED this —day of SIGNATURES Accepted By: Property OW'n-er Z�� L� Property Owner Jeannine L.-GraTL/ Building Official Building Permit No., 01 - 1)12 APH License* No.-16ffL License Holder License Holder COVENANT AND NOTIFICATION ACKNOWLEDGED: NOTAIky FOR OWNER SIGNATURES state of Washington )ss County of Dry evidence that I certify that I know or have, satisfact, L xecute the oath stated tha&she was at thorized to e glaied this instrument, on (title) of st d it as the 0 instrument and acknowledge (name of party on behalf on whom instrument was executed) to be freeand voluntary act of such party for theuses and purposes mentions in this the F, day 4!s� instru'mento Subscribed and sworn to before me this ----------- tate of WashingiDn.-. Notary Pub ic Ila S . PUBOG ul - ires My commission exp Y WA I certify that I know or have satisfactory evidence that ,signed this instrument, on oath stated that he/she was authorized to execute the (title) of instrument and acknowledged it as the s executed) to be (name of party on behalf on whom instrument wa ofsuch poses mentions in this the free and voluntary act party for the uses and pur ins I trument. Subscribed and sworn to before me this day of — — — —t 2 -------- Notary Public in and for the State of Washington. My commission expires - AUTHORIZED FOR RECORDING 0 ' "Y ol dmi D t By. —aPag4e of Lt\TFMP\BUILDING\FORMS\AFHCOVENANT7/07 0 ea­lc� 0 Ul�N ADDRESS: �ity.ofldrnonds, City Clerk �;. . . h­ 124�, 5�t 'Avenue North Edmonds, WA 98020 CONFORMED COPY 00803030681 4 PGS 310312008 4 '15r 145.00 SNOHOMISR CO-1 , ASHINGTON A,64rehce #: Granlorw: (1) :A� (2) Additional on pg. Qrantee�(s): City of Edmonds �-,Og Description (abbreviated): See Twn Rng_.� __Qtr OR Lot I Block_.Z_Plat Assessor's Tax Parcel ID#(s): (1) (2) Assessor's Tax,Parcel ID# not yet assigned AUTHORIZED FOR RECORDING City of Edm onds By, --VI Date-. -Page _�_ of WHEREAS, the undersigned owners of property located at e23V,�(g 5'-'/ 11 �' in Edmonds, Washington legally described '.6e'46w or on the attached Exhibit A, have applied for a building permit for compliance andlor to remodel a structure located on the site; and J' WHEREAS the applicant has notified the City of applicant's intention to utilize the t , m.pr overn - ents' and/or to convert an existing single family structure to an adult jativi ,home;�And W11EREAS under.the Uniform Building Code the number of occu" ants of a P -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 fi 0 . n of residents to or f ewer residents and their difi n..ed o Jimitation caretakers; and WHEREAS, the City.has issued a permit ba$edLupon such representations; NOW, THEREFORE, the undersigned property owners (hereinafter 1I.Owner") in consideration of the issuance�Lff a building permit and in order to v6 firm the promises upon Which such i : s . suan . ce is based -while providing notice to .any ffiture owners or mortgagors of the property does.hereby stipulate,. covenant as follows: I . 1. Covenant: Limitation on Residence. The owner hereby stipulates and agrees that occupa n*cy. of the structure as an adult family home shall be limited to or fewer adults and their caretakers as allowed by applicable provisions of state law. The owner acknowledges that in the event that the applicant seeks revision of the applicant's state license to operate an adult family home with an occupancy of greater than (o 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. 2. Subiect Tract. The above stipulation and promises shall apply to and run with the,land with respect to a residential structure located at 23qZ-- JAJ Edmonds, Washington and legally described as: 9V 4V-L 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 leve of improvement to single families and adult family homeresid6nts 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 C y of Edmon s By:- 4 Date: Page -;t— of DATED this day of 2A02 SIGNATURES Accepted By: Property Ow'ner Property Owner Jeannine L..GraT'-/ Building Official Building Permit No. 0� - La AFH License'No..15AL�—) License Holder License Holder COVENANT AND NOTIFICATION ACKNOWLEDGED: NOTARY FOR OWNER SIGNATURES State ofWashington )ss County of I certify that I know or have satisfactory evidence that the st'.. ed . thi I s, instrument, on oath stated thv��he was authorized to execute d acknowledged it as the (title) of instrument an n whom instrument was executed) to be V-- (name of party on behalf o for theuses and purr oses mentions in this the free and voluntary act of such party thi - day OAS WW.H— d sworn to before me S __qP instrument. Subscribed an T A in. Notary Public in and for the State of Washin My commission expires P(JF3L%G -k Zy -0 �WA I certify that I know or have satisfactory evidence that n oath stated that he/she was authorized to execute the ,sig ' ned this instrument, o he . (title) of instrument and acknowledged it as t alf on whom instrument was executed) to be (name of party on beh the free and voluntary act of such party for the uses and purposes mentions in this day of instrument. Subscribed and sworn to before me this ------------ -12 ------- Notary Public in and for the State of Washington. My commission expires_ FAUTHORIZED FOR RECORDING UT -ty of Edm By-:3 DaoteRt P. L-.\TEMP\BUILDING\FORMS\AF.HCOVENANT7/07 i�; , . . _. '. RETURN ADDRESS: C. _,6f Edmonds, City Clerk emue North .:Av Edmonds, WA 98020 CONFORMED COP 200803030681 4 PGS 0310312008 4 - 11�1 �41,11 TON SNOHOMISH COUNT , ASHING %"NOTICE OFLIMITATIONAND COVENANT ADULT FAMILY HOME (2) Additional on pg. 4�g il'.1beseription (abbreviated): Sec Twn Rng Qtr- OR Lot Block _j__Plat Asses s6r's Tax Parcel ID#(s): (1) 50 (2) Assessor's Ta.x,Parcel ID# not yet assigned AUTHORIZED FORRECORDING City of Edmonds "I 111C/ By-,--VJ Date- -page _�_ of -4- WHEREAS, the undersigned owners of property located at e:23VP6 5'-/ 7e A Ll;o - Lyi. in Edmonds, Washington legally described Ulow or on''the attached Exhibit A, have applied for a building permit for tompliance and�/or to remodel a structure located on the site; and WHMEAS., the applicant has notified the City of applicant's intention to utilize the j provements and/or to convert an existing single family structure to an adult -fq. fh.qme;�and d�'W'.,REREAS­ the Uniform: Building Code. the number- of occupants of a . t *,.Ilrigger requirements relating to the fire suppression and exiting ir cer fevirements; and ied the applicant that the permit will be issued the City has notif '�dfti6nedi on,limitation of residents to or fewer residents and their caie6ke*r's; and WHEREAS, the City. has issue.d a permit based 10 upon such representations; NOW, THEREFORE, . the undersigned property owners (hereinafter '-.�Iiowner") in consideration of the issuance�,-o'f a building permit and in order to ic6dIr'M the. I promises u . pon which such i:ssuance is based,while providing notice to any fiiture owners or mortgagors of the property does hereby stipulate, covenant afid:agree as follows: . 1. Covenant: Limitation on Residence. The owner hereby stipulates and agrees that occupancy, of the structure as an ;—dult family* home shall be limited to . .6 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 (o residents or attempts to rent, lease or otherwise provide residence for additional residents above the I J permitted in the current occupancy classification, the structure shall be vacated and all residential use ceased until such time as the property is brought in . to compliance with the provisions of the State Building Code, under the edition of the Uniform Building Code then in effect. The owner further stipulates that this covenant touches and concerns the land ' so long as the present structure and use continues and shall run with the land to all future purchasers and assigns. 2. Sub'ect Tract. The above stipulation and promises shall apply to and run withthe-land with respect to a resid ' ential structure located at -�h JAJ Washington and legally described as: /&L - - —, Edmonds, 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 leveUf 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. 0 AUTHORIZED FOR RECORDING By: 4C y of Edmonds -- Date: Page DATED this day of 2 SIGNATURES Accepted By': Property Ow'ner i I eannine L. GraT"' Property Owner Building Official Building Permit No. 61-62a AFH License No. 16OL.S License Holder License Holder COVENANT AND NOTIFICATION ACKNOWLEDGED: NOTAI�YFOR OWNER SIGNATURES State of Washington )ss County of I certify that I know or have satisfactory evidence that sign . ed . thi s instrument, on oath stated th�&she was authorized to execute the . (title) of .,instrument and acknowledged it as the if on whom instrument was executed) to be W., (name of party on beha for theus, es and purposes mentions in this firee.and voluntary act of such party day the Subscribed and sworn to before me this u .... . . instr '2 &7 % '�\OTAt State of Washingth... Notary Pub ic Ila %80G Z' mission expires My com le M� N I know or have satisfactory evidence that W A *$ .1 certify that d that he/she was authorized to xecute the ,signed this instrument, on oath state he (title) of instrument and acknowledged it as t atf on whom instrument was executed) to be (name of party on beh th I e . free and voluntary act of such party for the uses and purposes mentions in this o before me this day of instrument. Subscribed and sworn t --------------- -12 ............... Notary Public in and for the State of Washington. My commission expires AUTHORIZED FOR RECORDING ,.P)ty of EdMODAS By: Date: 0 2Pa g �e L:\TEMP\BUILDING\FORMS\AFHCOVENANT7/07