SignedADUStatement.pdfSTATEMENT ON ACCESSORY
DWELLING UNITS
DEVELOPMENT SERVICES DEPARTMENT
121 5h Avenue N, Edmonds, WA 98020
Phone 425.771.0220 A Fax 425.771.0221
Property Address (Street, City, State, Zip): V Parcel 4-
110 Pine Street, Edmonds, WA 95020 100582000400103
I have read the requirements for Accessory Dwelling Units contained in Chapter 20.21 of the
Edmonds Community Development Code (ECDC) and understand that an Accessory Dwelling
Unit (ADU) as defined in ECDC Section 21.05.015 is prohibited until the required ADU
permit(s) are approved and any required inspections are finalized.
I also understand that an ADU permit cannot be approved unless all the criteria in Chapter 20.21
are met, and all the necessary items are submitted, including an affidavit of occupancy and a
covenant to be filed with the Snohomish County regarding the regulations imposed on ADUs.
I amliot requesting to establish ars Accessory Dwelling Unit on my property as part of the
subject building perniit application (Itile No ELD20161097), and I will obtain all applicable
ADU permits if 1 choose to establish an ADU in the future prior to establishing such ADU. I
understand that the city's review of the subject building permit application does not imply any
future approval of an ADU.
I declare under penalty of perjury laws that the above information is true, correct and
complete, and that I am the owner of the above described property.
Print Name: � m
Date:
Signature: .. ..
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