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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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THIS PERMIT AUl..RDEl OMLYTHE WORK NOIED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY ANY CONSTRUCTION ON THE PUBLIC
D ETC.) WILL REQUIRE
OMAIN (CURDS, SIDEWALKS, DRIVEWAY , MARQUEES,
GRADINGIRILL
SEPARATE PERMISSION.
PERMITAPPILICATiO : ISODAYS
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
SU ES PIS
ENG. INSPECTION FEE,-,
A PPUCANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND
THE ITY F
LANDSCAPING
IN NTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS
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AGENTS FROM ANYA
EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND
A LLCLAIMS FORDAMAGESOFWHATEVERNATURE. ARISING DIRECTLYOR INDIRE T
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
DEEMED 7 MODIFY.WAIVE OR REDUCE ANY R QUIREMENTOFANYCITYORDINANCE
0 E
TOTAL AMOUNT DUE
NOR LIMIT IN ANYWAYTHE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
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IHERE Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFO MATION
I AM THE OWNER* ORTH DULY AUTHORIZED AGENT OF
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GIVEN IS CORRECT, AND THAT
THE OWNER. I AGREE TO COMPLY WITH C17Y AND STATE LAWS REGULATING CONSTRUC-
CALL
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
REI ATING TO
FOR INSPECTU
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON
WORKMEN S COMPENSATION INSURANCE AND ACW 1827,
10 T REID DA E SIGNED
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771-0220
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EXT 1333
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IT NLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A NAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS 13EEN GRANTED. UBC SECTION 109
FAX
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IGINAL � FILE YELLOW - INSPECTOR
PINK - OWNER GOLD - ASSESSOR
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RECEIVED
NOV 0 9 2001
PERMIT COUNTER
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HWAGEOSCIENCES INC
19730-64TH AVE, W., SUITE 200
LYNNWOOD, WA 98036-5957
TEL 42 5 -774-QI06
�.42 5_7 74-2714
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November 8, 2001 6(-�- IT
HWA Project No. 2001 167
Emerald Services Inc
7343 E. Marginal Way South
Seattle, Washington 98108
Attention: Mr. Terry Johnson
Subject: Final Letter on Construction Materials Testing
Unocal Edmonds Backfill Project
Edmonds, Washington
Dear Mr. Johnson:
HWA GFOSCIENCES JNC performed periodic testing to assess the compaction of fill
materials placed within Excavations A, B, C, and D. Field compaction tests were carried
out periodically on a 'call out' basis. Full time monitoring of fill placement was not
provided. Specific details of the testing carried out are provided on the attached Field
Reports (Report No-s I to 11)
To the best of our knowledge, all locations tested were in accordance with the project
requirements. To our knowledge there are no outstanding deficiencies.
We appreciate the o0portunity to be of service on this project. Should you have any
additional requirements, please contact our office.
Sincerely,
HWA GEOSCMNCES INC
Richard McKinley
Manager, Laboratory and Construction Services Group
RM:rm
GEOLOGY
GEOENVIRONMENTAL SERVICES
HYDROGEOLOGY
GEOTECHNICAL ENGINEERI-
TESTING & INSPECTION
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ST,s/MosterLeftm/RelemaperfommceD2/OI
EDMONDS r.ARY HAAKENSON
CITY OF P61AYOR
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 FAX (425) 771-0221
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
March 18,2002
Western Surety Company
PO Box 8010
Mill Creek, WA 98010
Attn: Rainey LaMiaux
Re: Bond 492916408/11720 UnOco Road
Dear Sir or Madam:
The City of Edmonds hereby authorizes the release of $50,000 from the above referenced
bond. All interested City departments have approved this release.
Lara Knaak
permit Coordinator
Cc: Applicant
File
Chron File
!nccrporcted August 11: 1890
Date Bond Posted
Bond Due To Expire
Bond Nllmber-2�9-216408
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
Edmonds Building Permit NO- 7()C:)l — Octo 'Z q
Project Address 11720 unoco Rd., Eawnds, VIA 98020
Developer/O
anerald services, Inc.
WHEREAS, — hereinafter referred to as "the Principal", has
'ity of Edmonds, hereinafter referred to as "the City", to construct the project known
applied to the C on a site located
Unocal 1,ower Yard Tnterim Act -ion Proj
at_11720 Un. within the City of Edmonds, and
WHEREAS, the City approved the reqaested action and,
WHEREAS, the approval granted by the City and the provisions of the Edmonds Development
Code require certain improvements to be made in connection with construction of the project, and
whereas the improvements are shown on the approved site plan and other required plans and are further
defined by the conditions identified in the City file,
NOW, THEREFORE, the undersigned Principal and bonding company a
corporation authorized to transact. surety business in the State of Washington, hereinafter referred to as
"the Surety", agree and bind themselves, their heirs, executors, administrators and assigns, unto the
City in the sum of Fifty h011sand & M/100—s— 50,000.00 lawful money of
the United States, according to the following terms and conditions:
1) if the Principal does not complete all improvements required by the above -referenced
conditions, plans, and file within 4 months months (not to exceed 24 months), then the
Surety shall, upon the demand of the City, remit to the City within ten (10) days of receipt of said
demand the amount of this bond or such lesser amount as may be specified in the demand.
2) In the event the Principal fails to complete all of the above referenced improvements within
the time period specified by the City, its employees and agents shall have the right at their sole election
to enter onto said property described above for the purpose of completing the improvements. This
provision shall not be construed as creating an obligation on the part of the City or its representatives to
complete such improvements.
3) in the event any lawsuit is instituted by the City of Edmonds, the Principal or the Surety to
enforce the terms of this bond or to determine the rights of any party hereunder, the prevailing party in
such litigation shall be entitled to recover from the losing party its costs, including reasonable
attorneys' fees, incurred as a result of such lawsuit.
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City of Edmonds Performance Bond Bonding Company
Page Two
4) This bond shall remain in ftill force and effect until the obligations secured hereby have
been fully performed and a bond guaranteeing maintenance of all improvements for a period of two (2)
years from acceptance has been submitted to the City in an amount to be determined by the City, of the
cost of the improvements and in a form suitable to the City, and until released in writing by the City at
the request of the Surety or the Principal upon expiration of the period specified in the above
paragraph.
15th August 2001
DATED this _— day of
Western Surety Ccopany
Bonding Company
j�ff—ice—rr Fltje—R�Iney LaMlaux, Attorney In Fact Title
M%j-3 E,
Mailing Address Mailing Address
PO Box 8010, mill Creek, WA 98010 7- 0 (0 - a -3'? - .30 3 6
Bond Number,) 92916408 Telephone Number
Date
Bond AcceWted by Development Services Technician
BONDING COMP
STATE OF WASBINGTON
) ss.
COUNTY OF
On this 15th day of August 2001 before me, the
under -signed, a Notary Public in and for the State of Washington, duly commissioned and sworn,
personally appeared painey LgHiMZ_ tome known to be the Att-orney-im-Eact— Of
Western Surety (--, the corporation that executed the foregoing instrument, and acknowledged the
said instrument to be the free and voluntary act and deed of said corporation, for the uses and purposes
therein mentioned, and on oath stated that - - She was authorized to execute
said instrument and that the seal affixed is the corporate seal of said corporation.
WTTI,�-WMhwd and official seal hereto affixed the day and year first above written.
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City of Edmonds Performance Bond Bonding Company
Page Three
Ac,em-;r
STATE OF WASBINGTON)
) ss.
COUNTY OF
On Us day of --- CC- before me, the under -signed, a
Notary Public in and for the State of Washington, duly commissioned and sworn, personally appeared
)e,]e- CoM540CAC tomeknowntobethe— C�-* V"\ 4- of
Emt�py4LD 5eq,0eTAie general partnership that executed the foregoing instrument, and
acknowledged the said instrument to be the free and voluntary act and deed of said partnership, for the
uses and purposes therein mentioned, and on oath stated that ------Nas
authorized to execute said instrument.
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W1 SS my hand and official seal hereto affixed the day and year first above written.
X ELQ4,,%N
OTARY PUBLIC in and for
I the
4ta�tc ofWashington, residing at .4L%% .
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Y> Western Surety Company
POWER OF ATTORNEY APPOINTING IND. IVIDUAL ATTORNEY -IN -FACT
Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, Is a duly organized and
existing corporation having its principal office in the city of sic" Falls, and State of South Dakota, and that it does by virtue of the s!gnabire
and seal herein affixed hereby make. constitute a nt
�d applas
Rainey La Miaux, Ricliard L. Nicho on, Individuall
----------
of I authority hereby conferred to sign, seal and execute for and on Its behalf bonds,
its true and lawful Altomey(s)-in-Fact with full power anc limited Amounts
undertakings and other obligatory Instruments of similar nature _- In Un
same extent as It such Instruments were signed by a duly authorized officer of the ooWratIon and all
and to bind It thereby as fully and to the
the acts of said Attorney, pursuant to the authority hereby given, are hereby ratified and confirmed.
Tnis Power of Attorney is made and executed pursuant to and by authorty of the By -Law pdnt- on the roverse hereof. duly adopted, as
Indicated. by the Shareholders of the corporation. as a presents to be signed by its President ind its corporate . seal
In Witness Whereof. V%rESTERN SURETY COMPANY has caused th
tobeheret02ffiXedond,j,,,_ _181h day of Ma 2000
W E S T E� �SR E T Y �NAA N Y'
Stephen T. Pate, President
State of South Dakota I "
County of Minnehaho May 2000 before me personally came Stephen T. Pate, to me known,
On this 18th . day of f Sioux Falls. State of South Dakota; that he is the President
who, being by me duly sworn, did depose and say: that he resides in the City 0 knows the seat of said corporation; that
of WESTERN SURETY COMPANY described in and which executed the :0bove Instrument; that he c
the seal affixed to the sald instrument Is such corporate seal: that It was u Ifixed pursuant to auth rity given by the Board of Directors of
thority. and acknowiedges same to be the act and deed of said
said corporation and that he signed his name thereto pursuant to like a 4.
corporation.
j. MOHR
My commission expires S_'�'b�NOTARY PU13LIC
October 22, 2005 SOUTH DAKOTA J. Mohr, y
My C..ri..j_ E:�j 10-22-2005
CERTIFICATE
Istant Secretary Of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney heminabove set forth
1. L Nelson, Ass ce. in testimany �hereof I have
Is still in force, and further certify that the By -Law of the corpomtlon prInted on the reverse hereof is still in for
hereunto subscribed my name and affixed the.seal of the said corporation this 15th day of
2001 WESTa. SURETY cOMPANY
_r
Form F4230-12-99
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AuthorIrJng By -Law
ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY:
This Power of Attorney is made and executed pursuant to and by authority of the following By -Law duly adopted by the
shareholders of the Company.
Section 7. Ail bonds, policies, undertakings, Powers of Attorney. or other obligations of the corporation shall be executed
In the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice
President, or by such other officers as the Board of Directors may authorize. The President any Vice President, Secretary,
any Assistant Secretary, or the Treasurer may appoint Attorneys In Fact or agents who shall have authority to Issue bonds,
policies. or undertakings in the name of the Company. The corporate Sea] Is not necessary for the validity of any bonds,
policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the
corporate seal may be printed by facsimile.
FINAL PROJECT,�PPRQVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE -
ENGINEERING DIVISION DATE
PLANNING DIVISION DATE-
PROJECT---J.
SITEADDRESS,
PERMIT #__UDJLLK4 ADB# I)
INSPECTF
DESCRIPTION OF WORK TO BE INSPE D
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A field inspection was conducted to determine final compliance with approved plans. Final approv
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of:
--�ZGRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
u Copy ofCONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
c3 Copy of CORRECTION NOTICE given to owner/contractor by inspector
2. MIC.FtoFILM
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date_ Sign_
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__fkHARGE
ENG. REVIEW FEES
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ENO. INSPECTION FEEg
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;APPLICANT. ON BEHALFOF His OR HER SPOUSE. HEIRS. ASSIGNS AND SUOCESORS
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I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN 15 CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATINKi CONSTRUC
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DATE SIGNED
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A VINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
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CATE OF OCCUPANCY HAS BEEN GRANTED. U13C SECTION 109
FAX PINK - OWNER GOLD - ASSESSOR