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PERMIT EXPIRES
CITY OF EDMONDS
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THIS PERMIT AUTHO IZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
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MAIN (CURBS. SIDEWALKS, DRIVEWAYS. MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATI N: IBDOAYS
-S�SURCHARGE
PERMIT LIMIT: I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
;_-APP CANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
ENG. INSPECTION FEE
IN INVEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS I HE CITY OF
I.ANDSCAP NG
Z EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FA- ANY AND
LL F014DAMAGESOFWHATEVER �TURE.ARlSINGDIRECTLYOR���DIRECTLI
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INSPECTION FEE
FROM THE 1111ANCE OF THIS PERM" SSUANCE OF THIS PERMIT SHAI L NOT BE
EE.EGTOMODIFY. WAIVEOR REDUCEANY REQUIREMENT OF ANICITY 011DINANCE
PLAN CHECK DEPOSIT
NOn LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PR( ls!ON
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT HEINFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE GULY AUTHORIZED AGENT OF
THEOWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CON'� raUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY NO PERSON WILL BE EMP IYED
CALL
N VIOLATION OF THE LABOR CODE OF T. E STATE OF WASHINGTON RELAT'I.G TO
FOR INSPECTP
WORKMENS COMPENSATION INSURANCE AND RCW 19.27.
ATE SIGNED
(425)
�,A/
771-0220
ENTION
EXT1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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When recorded
2-00 110020367
City Clerk 10/02/2001 11:25 AM Snohomish
City of Edmonds P-0005 RECORDED
121 Fifth Avenue North County
Edmonds, WA 98020
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RECORDER'S NOTE:
PORTIONS OF THIS DOCUMENT
POOR FOR SCANNING.
ARE OUALITY
SPACE All 0,E TKfS LM FOR RECORDER'S USE
7// L//,y -5-'- Assessor's P arcel No.
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A Me- 9 *F,, -I- 1Z 0 Frr Project No.& Narne� 09
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ENCROACHMNT AGREE114ENT
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This ENCROACfflvffi-NT AGREEMENT ("An,eement") is entered into between the
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CrrYOF EDMONDS CICity) and
18.70 of the V-GmOnub �nmunity Development
C,Owner[s]"), in accordance with Chapter
Code.
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De ProlLer - Owner is the owner of that certain real property located at
1 ithin the city of Edmonds, Washington,
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4/22z- irly described in Exhibit
Assessor's Parcel NUMVer QQ 4-21" —14QLA-)2,!4-- and more particul; -r, -V—W-A99;1
ES
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-,N' attached hereto and incorporated herein by reference. Business Owne that certain real
is the business owner of
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property noted above.
2. The Easement. The City currently Owns an existing easem ent over, under, and
across Owner's property for street, alley, sidewalk, other (
Exhibit "B" att ached hereto and incorporated by reference.
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which is described in
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3. The Encroachment. The City hereb y covenants and agrees and grants its
&:�e-r or —��ess Owner to allow
permission to City right-of-way/easement. A plat map showing the ocation of the
to in a portion of the This Agreement is
remain
encroachment is attached as Exhibit "C" and incorporated by reference.
subject to the following terms and conditions:
2. The encroachment shall be installed and maintained in a safe and sanitary
its successors in interest.
condition at the sole cost, risk, and responsibility of the owner and
b. The Owner shall agree at all times to indemnify and hold the City free and
nses resulting from the
harmless from any and all claims, demands, losses, damages or expe
construction, maintenance, use, repair or removal of the structure installed hereunder, including
any loss, damage or expense arising out of,(l) loss or damages to property and (2) injury to or
death of persons.
C. The Owner must remove or relocate any part of the encroachment within
ten (10) days or such other time as specified in the notice after receipt of it from the City
Engineer, or the City Engineer may cause such work to be done and the reasonable cost thereof
shall constitute a lien upon the property.
d. Whatever rights and obligations were acquired by the City with respect to
the easement shall remain and continue in full force and effect and shall in no way be affected by
city's grant of permission to construct and maintain the encroachment structure.
4. This Agreement constitutes the entire agreement between the
parties with respect to the subject matter hereof and supersedes and replaces all other
agreements, oral or written, between the parties with respect to the subject matter.
S. Notices. Any notice which is required or may be given pursuant to this
Agreement shall be sent in writing by United States mail, first class, postage pre -paid, registered
or certified with return receipt requested, or by other comparable commercial means and
addressed as follows:
IftotheCi :
City Engineer
C�ityofEdmonds
121 Fifth Avenue North
Edmonds, WA 98020
If to the Owner:
-W ; t �i�- �-T-s
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which addresses may be changed from time to time by providing notice to the other Party in the
manner described above.
6. Waive . City's consent to or approval of any act or omission by Owner shall not
constitute a waiver of any other default by Owner and shall not be deemed a waiver or render
unnecessary City's consent for approval to any subsequent act by Owner. Any waiver by City of
any default must be in writing and shall not be a waiver of any other default conceming the same
or any other provision of the Agreement.
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7. Successors and Assigns. This Agreement shall be binding and inure to the
benefit of the parties hereto and their respective legal representatives, successors, and assigns.
Owner agrees to incorporate this agreement by reference in any subsequent deeds to the
property, but any failure to do so does not invalidate this provision.
8. Capacity. Each party represents that the person(s) executing this Agreement on
behalf of such party has the authority to execute this Agreement and by such signature(s) thereby
bind such party.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement on this Yf—
day of 1 20 —cq
OW'NER(S):
B By:
STATE OF WASHINGTON
COUNTY OF SNOHOMISH
This day, personally appeared before -e,\,/. I r
t :
to me known to be the person(s) who executed the within and foregoing document and that
(helshelthey), Ae- signed the same as (hislherltheir) free and voluntary act
and deed for the uses and purposes therein mentioned.
A
Notary Public
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Typed or Printed Name
My Commission expires�fl �ai-�' no $1
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CITY,70FONDS
By:
E79GI—NEERING DIVISION
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FINAL PROJECT APPROVAL FORM
TO: DST
DALE
MEMO TO: PERMIT COORDINATOI� BUILDING DIVISION
FIRE DEPARTMENT DATE -
FROM:
ENGINEERING DIVISION DATE -
PLANNING DIVISION DATE
PROJEC
SITE ADDRESS
PERMIT #_ao, __JL�2Z_ADB#222_:_5Z1_DATE INSPECTED-.
DESCRIPTION OF WORK TO BE INSPECTED tay !_:L,
A Held inspection was conducted to determine final compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PER RMANCE BONDS and the granting of:
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
0 Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
1.
2.
MICROFILM
3.
RE-INSPECTFD OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Sign_
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SelifilikCKS .....................
FOUNDATION:
Footing......................
wait..........................
Pier/Parch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING::
Underground .............
Rough -in ...................
commercial Final
HEATING: -
Gas Iflast
Gas Piping .................
Equipment .................
Cmmeccial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING....
INSULATION ...................
Floor insulation
Wall insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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CITY OF EDMONDS
NUMBER
APPLICATION
CONSTRUCTION PERMIT APPLICATION
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P ROGRESS I NSPECTIONS PER UBC I DBIFINAL INSPECTION REG' DI
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VALUATION'
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PLAN CHECK NO,
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THIS PERMIT AU . IZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRII ATE P OPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC
ETC.) WILL REQUIRE
GRADINGIFILL I
DCMAIW tCURBS, SIDEWALKS, DRIVEWAYS , MARQUEES,
SEPARATE PEZISSION.
SURCHARGE
PERMIT APPLICATIoN 160 DAYS
-0
PERMIT LIMIT.- I YEAR - PROIADEG WORK IS STARTED WITHIN 190 DAYS
END, REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ONEIEHAL OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESOAS
ENG. INSPECTION FEE
;APPLICANT.
N NTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
IN AND
I-ANDSCA
EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FRO. ANY
INDIRECTLY
ALLCLAiMSFOR AMAGESOFWHATEVER NATURE. ARISING DIR ECTLIOR
FROM THE ISSUADNCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
PT
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANYCiTY ORDINANCE
NOR UNIT IN ANY WAYTHE CITY'SABIL11Y TO ENFORCE ANY ORDINANCE PROVISION.-
TOTALAMOUNTDIJE
RECEIPT
I HEREBY ACKNOWLEDGE THAT: HAVE READ THIS APPLICATION: THAT THE INFO MATION
APPLICATION APPROVAL
GIVEN IS CORRECT. AND TH AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
AT CONSTAUC-
LAWS REGULATING
CALL
T gnld by IhS
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE
NO PERSON WILL BE EMPLOYED
P
TION; AND IN DOING THE WORK AUTHORIZED THEREBY,
THE STATE OF WASHINGTON RELATING TO
FOR ANSPECTION
ip, " .'k—OV.
IN VIDI-ATION OF THE LABOR CODE OF
WORKMEN'S COMPENSATION INSURANCE AND RCW IB.27.
oF(I�IALS SIGNATURE)
DATE SIGNED
(425)
6 12, �/
771-0220
LEASED BY
ATrffNT16N
EXT�33
cl
IT IS UNLAWFUL TO USE 08 OCCUPY A BUILDING 08 STRUCTURE UNTIL 771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE - YELLOW - INSPECTOR
OWNER - GOLD - ASSESSOR
CATE OF OCCUPANCY HAS BEEN GRANTED. LIBC SECTION 109
PINK -
FAX
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