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960266.pdfI7 X (� 2 CITY OF EDMONDS "sE PERMIT 96 2 66 ZONE s_ Z NUMBER CONSTRUCTION PERMIT APPLICATION pH - Slalf AI', Wr'I'z."1" `. �•1•I .`I 911SINL" 4DDAESS RUGG I ERO, PH I L I P LEGAL DESCRIPTION CHELn SUCDnI>c'• .O m ••,: ` L - - - b126 ll)TH CT.N.E. PUBLIC RIGHT OF WAY PER OFFICIAL STREE, jjjAAAA P Ew6T,NG ______. REOUInED DEDICATION - T15CP A,,,urr,l ❑ FEW Pr—., Hrnl„„•n 51,r,, Use PruI Rraa ❑ lz,Irl r mall„rn ^'ll • 11P REDMOND LVN 98052 IEEE PHONE NUMBER 4(;2-7393 PReaosED .. S,dr.-Araunro '51 4ISEATTLE VINCE OJALA A. I .A z - M TER sizr. ;NE slzE NO OF Vlx,l01L`: PAv muU,nlD 703 33RD AV. N.E. RE —S d• a.w WN. 98115 T527 8289ER vN CJ J li% f�Q� %rf NAME Anonr ss ENGINEERING MEMO UATED nEViE W F.n UV a -ITS I TELEPHON/E NUMBER TJJ _ ,E! .n l-E%PIEAIIONOATE IREMEMO DATED HLVILIY I:O IfY STATE LICENSE NUMBER .'f —� f• O _ SIGN AREA ALLOWED PROPOSED SEPA REVIEW COMPLETE E%EMPL AO oLUT Legal OescnpDon of Property - include all easements 2 M - E%P sHo uNE. m- s. . BLOCK 59 DIEADUWDALE BEACH VARIANCE RCU �� LA W By DATE a SETBACKS— E HEIGHT LOT VE as-23-90 _ w 51R FRONT 0E EAR , Properly T PArcel 'KA" ""' 5131 Nn-059-004-0003 �,. .• RESIDENTIAL ILLIN1.111. RE///MfffARKS J n;,l l,l l.. a � COMMERCIAL �' MECHANICAL ❑ III ^•4 r,,1 t Ej APT. BLOC L f SIGN tM' / of f o ✓ All Lp — TT ID /IGIj�Qr `� CHECNEO BY TYPE OF CONSTRUCTION CODE 'MM COOtfPANI 3 G CYDS ❑ FENCE K—� ® 6 �I1LM1It II,ti,I O NEEERr TOVE ❑ HOTUBSWIM BPA i1 C RETAINING WALL/ t'.vU'OAI ROCKERY RENEWAL (TYPEOFUSE BUSINESSOR ACTIVITY) EXPLAIN. RPOUIRED ECIAL S; ECT YES A / fil/({ YES O PANT REMARKS PROGRESS INSPECTIONS PER UBC 305 A/[.1/!JY ✓ l �.�/"F�'� 11T% Il :1 1 ER ITICAL %/� F K�p�/� '✓f��Jl+s O o HI �tBSMT nWF.LLING AREAS — tiff E UNI15 ONE NUMBER PLOT PLAN) DESCRIBE WORK TO BE DONE (ATTACH FINAL INSPECTION REQUIRED r VALUATION FEE PLAN CHECK FEE Z '✓ BUILDING 11� % f 7-0 Ir.AI 't1IIR LE GLAZING PLUMBING Plan Check No. y -� 7 MECHANICAL This Permit covers work to be done on private property ONLY. GRADINGIFILL 2-6 Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. STATE SURCHARGE Permit Applicallon: 180 Days Permit Limit: 1 Year - Provided Work fa Started Within 180 Days STORM DRAINAGE FEE 'Applicant. on behalf of his or her spouse, heirs, assigns and v, Successors in interest, agrees to indemnify, defend and hold harmless the City of Edmonds, Washington, its Dilicials, LT /�ier�sr/off � �a s employees. and agents from any and all claims for damages of ,,, •i whatever nature, arising directly or indirectly from the issuanceIPA u to PLAN CHECK DEPOSIT b ?+ of this permit. Issuance of this permit shall not be deemed m modify, waive or reduce any requireent of any city ordinance any ordinance _ nor limit in any way the City's ability to enforce TOTAL AMOUNT DUE provision." I hereby acknowledge that I have read this application; that the ATTENTION APPLICATION APPROVAL Information given is correct: and That I am the owner, or the duly authorized agent of the owner. I agree to comply with city and THIS PERMIT This application is not a permit until '} in he work authoriz r tiom and in do I state laws regulating e 9 be employ in violation of the Labor A TH RI s u o zE ONLY THE _ si ned b the Building Official or his/her 9 Y 9 4 n will ed thereby, no person will m n a. Code of the State of Washington rely ' g to Workmen's Co pe s woaK NOTEo Deputy: and fees are paid, and receipt is -1 tion Ins(PanCo and RCW 18.27 INSPECTION PAHTME'+' aoknowletlged in space provided. vAtuHF C:. ER CR AGENT, -"' DATE 51 ,NED DE CITY OF $qqq OFFICIAL 51GNA'URE DATE r L (f i7 EDMONDS ' /// ) .a •a)j ATTENTION CALL FOR INSPECTION ELEA n° DATE s ^ �/ IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ��� �OLGo ORIGINAL - F� 1 YELLOW - inspector A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC CHAPTER 7 loner PINK - O.:.re, GOLD - Assessor � gfgpp 9 e•y e I i... R. .aw wr; CITY OFF EDMONDS CONSTRUCTION PERMIT APPLICATION OVINEA NAML NAME OF BUSINESS w MAIIING AUG-(SS 2 Yy - O CU) jIP , iELEPMONE NUMBER ..,•, IVI.:., ..fl :I :;l; ;3L :IJ :, •r J.: .� NAME t 4 1J i J i11.11 "1 r I s 71l ,O„ A ORFSS I , ZIP TELEPHONE NUMBER q CITY NAME CAI 14 r+C. r"/1 !) <=7"vIlf7`:i ,L1 U EXPIHAIION DATE $1 ATE LIGENS[ NllA1HE�Ry t J r1 Lagal Description of Property - include all easements 0 sl J Ii .1.7 tf_'AL)0 DALr tat.'ACH 0 w -� Properly < ((� 1 . TeX AGC IlnI :r „S1•-U5 "yiu ei,.;J1 0 P((A��rjr 1 No. I PL.1 ,,, � RESIDENTIAL � PLUMBING YY❑l nnnINUN COMMBRCIAL ;9' MECHANICAL HEMItnEI APT L.G.6LJ SIGN GRAgrII�.dGG.�.'� W � FENCE CYDS. (--K—� �DEMOLISH Fi NSERr WOODSTOVE ❑ MOfMPOOL TTUDSPA tilt GnnAOEHi L' RETAINING WALL/ RENEWAL } ' Cn11POROCKERY 0 F (1VPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: U NU _ - _ NUMBER t" n • I 'CRITICALl/�� o OF DWELLING Sl \ AREAS m0 On1ES' �':7 ,)1'i� UNITS J{(L- NUMBER / DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) X Trlr.Lor se PERMIT ONE NUMBER �� GR 5 ME API 1Drstss it :; I--ll '1! •I GAL DESCI}IPTION CH-1 s7a vismN NO III+ Irt) PUBLIC RIGHT OF WAY PER OFFICIAL .S-i_R_EE-•T -rMAP EXSUNtTREOUIIIED DEDICATION PnoposEGN TESCP nPPue RW P-11. nu111,UI11V Slt Uec Purin,l RC11 If I"p,Ia nRLRI11IV1 SlUnwalA PpnnmW .�, 0L❑I 0 ME1 EH SIZE LINE. SIZE NO (IF FFIIXTURES 3 I'IiV (ILO NO❑ + REMARKS •r,+ ALLOWED PROPOSED COMPLETE EXEMI A! EXP i IARIANCE OR CU PLA W BY .l . r iETBACKS-,FEE - + HEIGHT FRONT fe; SIDE /(._BEAR El . I..TIT.- AYES jfAjTj C•re -fir 4 REMARKS PROGRESS INSPECTIONS PER UBC 305 FINAL INSPECTION REQUIRED VALUATION PLAN CHECK FEE 1 z~I �/J •I/ /i/f�EY --- BUILDING T SOUR" GLAZIN' p 0 PLUMBING 44.1 y7- 41619 Check No.+,� MECHANICAL Plan This Permit covers work to be done on private property ONLY. GRADINGIFILL Any construction on the public domain (curbs, sidewalks, etc will require separate permission. STATE suRCHARGE ,.+. C.+ driveways, marquees, -I Penult Application: 180 Days STORM DRAINAGE FEE Permit Limit: 1 Year - Provided Work Is Stalled Within 180 Days Er ur.4 EN&HNSPEBFISN+E5' I J11..•. ••Applicant, on behalf of his or her sipouse, heirs, assigns and its oflicials, successors in interest, agrees to IntlAify, delend and hold�.��i�,�Nr _ w harmless the City Of Edmonds, Washington, ford 9 of employees, and agents from any. and all claims a nature, arising directly or -indirectly from the issuance PLAN CHECK DEPOSIT q T whatever of this permit. Issuance of Is permit shalt not be deemed to waive or reduce any requirement of any city ordinance 0 modlly, nor limit in any way the City's ability to enforce an ordinance TOTAL AMOUNT DUE •;ItL ;,��..7.ir. provision." I hereby acknowledge That i have read this application; that the ATTENTION APPLICATION APPROVAL information given is correct; and that I am the owner, or the duly the owner. I agree to comply with city and THIS PERMIT This application is not a permit until authorized agent of state laws regular Ing construction; and In doing the work authoriz- be employed in violation of the Labor AUTHORIZES ONLY TH signed by the Building Official or his/her Deputy; and fees are paid, and receipt is ed thereby, no person will Code of the Slate of Washington rela(Irig to Workmen's Compensa- WORK NOTED acknowledged in space Provided. to.. Insuranl:e and R 18.27. / SIGNED. INsvecTloN DEPARTMENT DATE GE SIGNATURE IOIYNEP OR AGENT(„. ' JDATE CITY OF EDMONDs OFFICIAL !$SIGN TOPE r ry / f l' �'7 c•Fu � CALL FOR ELEA D D, ATTENTION INSPECTION IT IS TO USE OR OCCUPY A Nb HAS BEEN MADE IANDOAPPROVALURE OF' 771-0220 ORIGINAL - F.I. YELLOW —Inspector UNTIL ALFINAL INSPECTION A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC PINK - Ov,cer GOLD - Assessor CHAPTER 7. 0 O' I a r�ti �ik 0 RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ................... ' FOUNDATION: Footing .................... '. Wall ....................... � r o-CH 9zPZ3 Pier/Porch................ Retaining Well............ J Sla61 nsulation ............ PLUMBING: _ s Underground.....J Rough -In ................. , t� Commercial Final ........;� 't HEATING: Gas Test ................. •„ Cc.4S Tom"' T' Gas Piping ................ 1_.Gb Equipment ................ %% ' • % rr 8 Commercial Final......... .a EXTERIOR SHEATHING NAILING .................... sv j FRAMING ................... —��-..` �l • lam' 9� '? ni INSULATION: , s. Floorinsulation .......... ; ' S /2L lz •f1c Wall Insulation ...- `y Ceiling Insulation......... SHEETROCK NAILING, i �---� __. Z• ' �� SPECIAL INSPECTION ...... i� RADON MONITOR ATSITE . FINAL APPROVAL FOROROCCOCCUPANCY....... 0 0 I* , RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ................... ' FOUNDATION: Footing .................... '. Wall ....................... � r o-CH 9zPZ3 Pier/Porch................ Retaining Well............ J Sla61 nsulation ............ PLUMBING: _ s Underground.....J Rough -In ................. , t� Commercial Final ........;� 't HEATING: Gas Test ................. •„ Cc.4S Tom"' T' Gas Piping ................ 1_.Gb Equipment ................ %% ' • % rr 8 Commercial Final......... .a EXTERIOR SHEATHING NAILING .................... sv j FRAMING ................... —��-..` �l • lam' 9� '? ni INSULATION: , s. Floorinsulation .......... ; ' S /2L lz •f1c Wall Insulation ...- `y Ceiling Insulation......... SHEETROCK NAILING, i �---� __. Z• ' �� SPECIAL INSPECTION ...... i� RADON MONITOR ATSITE . FINAL APPROVAL FOROROCCOCCUPANCY....... 0 0 I* , 0 Im GeoEngineers OCT 1 5 1997 PERMIT COUNTER September 10, 1997 Consulting Engineers and Geosclentists Offices in Washington, Oregon, and Alaska Snare Construction Company 107 - 148th Avenue Northeast Arlington, Washington 98223 Attention: Ron Snare Summary Construction Monitoring Ruggiero Residence 16010 - 75th Place West Edmonds, Washington File No. 3475-002-10 This letter summarizes the results of our monitoring of the geotechnically related aspects of construction of the Ruggiero residence located at 16010 - 75th Place West in Edmonds, Washington. The construction monitoring was authorized by Phil Ruggiero on May 1, 1996. Our initial services consisted of an evaluation of the soil moisture conditions at the site and submittal of our field report to the City of Edmonds documenting our opinion that soil moisture conditions were such that site grading activities could begin. A copy of that field report, dated May 6, 1996, was transmitted to you. A copy is attached to this report for your files. After site clearing was completed, grading of the site began with the installation of the H-pile/timber lagging retaining wall. Numerous difficulties were encountered during the installation of the retaining wall, including equipment access and unusually heavy rains. At our recommendation, a change in design was completed and a rock buttress consisting of quarry spalls was placed behind the wall to prevent movement of the uphill slope. Field Report Nos. 2 through 6 document our observations during the construction of the retaining wall and the rock buttress. Copies of these daily reports are also attached for your records. V Geolingineers, Inc 8410154th Avenue N.E. Redmond, WA 98052 Telephone (425) 861-6000 Fax (425) 861-6050 wm-geoengineers.com � rrr ■r µ 32XIC Snare Construction Company September 10, 1997 Page 2 The final construction activities which we monitored at the site included the placement and construction of the rockeries upslope of the retaining wall and the subgrade excavation and preparation for spread footings for support of the house. Our monitoring of those activities is documented in Field Report Nos. 7 through 11, copies of which are also attached. In summary, it is our opinion that geotechnically related activities during construction of the subject residence were completed in general accordance with our recommendations and the plans and specifications. A O ► Please contact us should you have any questions concerning this summary letter or the results of our monitoring activities. KGBmd Document ID: 3475002.SUM Attachments Two copies submitted Copyright m 1997 by GeoEngineers, Inc., All rights reserved G a o E n g i nears Yours very truly, GeoEngineers, Inc. /�C--"--J - Kenneth G. Buss, P.E. Associate File No. 3475-M-10-1130 d Geo Engineers RECEWED 0 C T 0 11 10.95 PERMIT COUNTER September 28, 1995 Consulting Engineers and Geoscient Isis Offices in Washington, -y..� , f Oregon, and Alaska Mr. Phillip John Ruggiero Y ®� 6126 - 140th Court Northeast Redmond, Washington 98052 Geotechnical Consultation Services Proposed Residential Construction Meadowdale Beach Area Edmonds, Washington File No. 3475-001-R02 INTRODUCTION This letter provides additional geotechnical information that the City of Edmonds requires relative to your proposed Meadowdale Beach residence. Our current services on this project were requested by Mr. Vince Ojala, your architect, during a telephone conversation with Mr. Gary Beckham of GeoEngineers on September 13, 1995. We understand that you have authorized our preparation of this letter. Our current services continue our involvement in your project, which include our March 29,1994 "Report, Geotechnical Consultation Services, Proposed Residential Construction, Meadowdale Beach Area, Edmonds, Washington," and our "Statement of Risk Letter ..." dated September 6, 1994, and "Letter of Response :.." dated May 17, 1995. We understand that the City of Edmonds requires further clarification relative to the statistical probability of earth movement at the site. According to Mr. Ojala, the city wants GeoEngineers to provide an exact number for the probability of earth movement the -Site within a 25-year period. SCOPE The purpose of our services is to respond to the city of Edmonds' request for additional information. Our scope of services included a review of our files and previous reports for this project and reevaluation of the probability of future earth movements at the site. 32XIC 0 rom Im 0 7-1 Mr. Phillip John Ruggiero September 28, 1995 Page 2 DISCUSSION Our May 17 Letter of Response included a discussion of the statistical probability of earth movements within a 25-year period at the site (page 2, item 1. Slope Stability). We concluded, at that time, that "the probability of earth movement within a 25-year period should be less than 30 percent, providing that the city utility drain systems are maintained. It is also likely that the proposed construction will further improve the existing slope stability conditions. This may result in a further decrease in the actual risk of slope movement." If the city maintains the utility drain systems, the risk of slope movement within a 25-year period is less than 30 percent, as stated above. Thus, the upper boundary of the probability of slope movement should be 30 percent (likely less). The proposed development of your property will include removal of much of the colluvium on the site, reconfiguration of the upper slope, construction of a pile -supported retaining wall, and installation of new surface and subsurface drainage facilities. These improvements will decrease the amount of soil and water available to contribute to slope movement mechanisms. The retaining wall will restrict further movement of soil. We have estimated improvement of slope stability (in percent relative to the probability of slope movement within a 25-year period) for each of the proposed elements of site development, as summarized below: Estimated Slope Improvement* Remove colluvium 2 percent Reconfigure upper slope 1 percent New retaining wall 2 percent Drainage improvements 2 percent Sum of Improvements 7 percent *Estimated percent of improvement of slope stability based on the probability of slope movement in percent within a 25-year period. As indicated above, a seven percent improvement in the existing slope stability condition may result from the development of your property, as currently planned. As such, the seven percent improvement should reduce the overall probability of slope movement over a 25-year period to about 23 percent. Goo E n Q i nears _,� �. c ra , File No. 3475.001•R02 _ ... 10 32XIC M Mr. Phillip John Ruggiero September 28, 1995 Page 3 ASSUMPTIONS We have made a number of assumptions to estimate the amount of slope stability improvement on your property. The conditions upon which these assumptions are made must not change over the next 25 years or the estimate of improvement of slope stability stated above may be invalid. These assumptions include: • The city maintains the utility drain systems in the vicinity of the site. • The water levels in the existing ground water monitoring wells in the vicinity of the site remain at their current elevations or drop to lower elevations, indicating that the City's utility drain systems are functioning. • The site is developed as currently planned and as indicated in the drawings approved by the city, including (1) construction of the cantilever retaining wall, (2) reconfiguration of the upper slope area and installation of rockeries, (3) installation of rockery and yard drains in the upper slope, (4) installation of house foundation wall drains, and (5) removal of practically all of the colluvium and surficial soils at house foundation subgrade elevation. • The soil and water conditions encountered during construction are essentially the same as encountered during our field explorations on February 2, 1994 and in previous studies on the site for others, as described in our March 29, 1994 report. CONCLUSIONS In our opinion, providing that the above assumptions remain valid and that the existing soil and water conditions on your property after construction are the same or better than existing conditions, the probability of earth (slope) movement on your property within a 25-year period is about 23 percent. LIMITATIONS We have prepared this report for use by Mr. Phillip John Ruggiero in evaluating the potential for future slope movements on his property located in the Meadowdale area of Edmonds, Washington. This report is not intended for use by others, except for a design/construction team retained by Mr. Ruggiero, and the city of Edmonds. The information contained herein is specific to the Ruggiero property and is not applicable to other sites or the Meadowdale area as a whole. The same limitations as presented in our March 29, 1994 report and September 6, 1994 letter also apply to the conclusions presented in this letter. The scope of our services does not include services related to construction safety precautions and our recommendations are not intended to direct the contractor's methods, techniques, sequences or procedures, except as specifically described in our report for consideration in design. a e o E n g i n e e r s File No. 3475.001•Ro2 ° A 32 x E li»� i7 Mr. Phillip John Ruggiero September 28, 1995 Page 4 Our letter, conclusions and interpretations should not be construed as a warranty of the subsurface conditions. Subsurface conditions will likely vary across the site and may also change over time. These variable conditions and changes may affect the probability of occurrence of any future earth movements and could influence construction activities. Therefore, a contingency for unanticipated conditions should be included in the construction budget and schedule. Sufficient monitoring, testing and consultation by our firm should be provided during construction to confirm that the conditions encountered are consistent with those indicated by the explorations described in our March 1994 report, to provide recommendations for design changes should the conditions revealed during the work differ from those anticipated, and to evaluate whether earthwork and foundation installation activities comply with contract plans and specifications. Within the limitations of scope, schedule and budget, we have accomplished our services in accordance with generally accepted geotechnical practices in this area at the time this letter was prepared. No warranty or other conditions, express or implied, should be understood. O ► If there are any questions regarding this letter, please contact us. ii Yours very truly, . G• o� wnsy Ge{oEngineers, Inc. �,�, a J' o � � a^"l � . (��✓�.�.-�--- / w Gary D. Beckham Project Engineering Geologist EXKenneth G. Buss, P.E. Associate GDB:KGB:cmt Document ID: 3475001.E Two copies submitted cc: ✓Mr. Vince Ojala, Architect 7703 - 33rd St. N.E. Seattle, WA 98115 e Mr. Greg Gilda Victor H. Kimsey Engineers 1818 Westlake Ave. N., Suite 308 Seattle, WA 98109 G e o E n y i n e e r s File No. 3475.001-R02 o e10 e 32X I I f� a SII [a] E %A i r CLERK I I �� sRECEIVED 6ITY OF EDMONOS 505 BELL STREET Mhv 9 1996 EDMONDS, WA 98020 EDMONDS CITY CLERK COVENANT OF NOTIFICATION AND INDEMNIFICATION/HOLD HARMLESS Under the review procedures established pursuant to the State Building Code, incorporating amendments promulgated by the City of Edmonds, and as a prerequisite to the issuance of a building permit for the construction of a residential structure and attendant facilities, the undersigned OWNERS of property do hereby covenant, stipulate and promise as follows: 1. Description of oub:aat 2-^ Er`-. This covenant of notification and indemnification/hold harmless relates to a tract of land at the street address of O( O/O 757'7 P/A4� k�Sr (insert Lf� street address), Edmonds, Snohomish County, Washington and legally described as: LQ t h-c �c-ems � pZ s—z3-9d -Catz J � u I PfX 116C7 /°N44e L ,�# 5/3i 059- vice3 q 1 Ol J C 2. Notification and Covenant of Notification. The above referenced site (hereinafter "subject site") lies within an area which has been identified by the City of Edmonds as having a potential for earth subsidence or landslide' hazard. The risks associated with development of the site have been evaluated by technical consultants and engineers engaged by the applicant as a part of the process to obtain a building permit for the subject site. The results of the consultant's reports and evaluations of WSS52079A/0006.040.034 WSS/klt 02/08/90 VOI. 3159PAGE2S 53 0 BUILDING FEB 9 - ;°90 W] • 0 32 X I C7 RE 141 F-7 the risks associated with development are contained in building permit file number �� (insert number) on file with the City of Edmonds Building Department. Conditions, limitations, or prohibitions an development may have been imposed in accordance with the recommendations of the consultants in the course of permit issuance. The conditions, limitations, or prohibitions may require ongoing maintenance on the part of any owner or lessee or may require modifications to the structures and earth stabilization matters in order to address future or anticipated changes in soil or other site conditions. The statements and conditions proposed by the OWNERS' geotechnical engineer, geologist, architect and/or structural engineer are hereby incorporated by reference from the contents of the file as fully as if herein set.forth. Any future purchaser, lessee, lender or any other person acquiring or seeking to acquire an interest. in the property is put on notice of the 'existence of the content of the file and the City urges review of its contents. The file may be reviewed during normal business hours or copies obtained at. the Planning Department, City of Edmonds, 505 Bell Street, Edmonds, Washington 98020. 3. Indemnification and Hold Harmless. The undersigned OWNERS hereby waive any and all liability associated with development, stating that they have fully informed themselves of all risks associated with development of the property and do` therefore waive and relinquish any and all causes of action against the City of Edmonds, its officers, agents and employees WSS52079A/0006.040.034 -2- WSS/kit 02/08/90 Cm 96050803159PAGE 2554 _ ° _.. ME 32 X E M J 0 arising from and out of such development. In addition, the OWNERS on behalf of themselves, their successors in interest, heirs and .assignees, do hereby promise to indemnify and hold harmless the City of Edmonds, its officers, agents and employees from any loss, claim, liability .or damage of any kind or nature to persons or property either on or off the site resulting from or out of earth subsidence or landslide hazard, arising from or out of the issuance of any permit(s) authorizing development of the site, or occurring or arising out of any false, misleading, or inaccurate information provided by the OWNERS, their employees, or professional consultants in the course of issuance of the building permit. 4. insurance Requirement.. In addition to any bonding which may be required during the course of development, the Community Services Director has/h(s Xt (strike one) specifically required the maintenance of an insurance policy for public liability coverage in the amount and for the time set forth below in order to provide for the financial responsibilities established through the indemnification and hold harmless agreement above: f} oN� �,/pia✓ �6//.�ti ��s�� �e o%�y s!�!/ ,� ��,�v�� Aye aW,'eA.- ,nV.L 41614 /Yd r� c�,rcc�a' t,✓ y� ,�s . �affwl Copy ,//At Arst vf.✓zr s�/� �e CuirPti� �osk d Wed Cr�I [insert insurance requirements and tim& period, if any --if no insurance required, so state.] WSS52079A/0006.040.034 -3- WSS/klt 02/08/90 .9605080386 von. 31-59PAGE2555 32XC 2A 5. Covenant to Touch and Concern the Land. This covenant of notification and indemnification/hold harmless touches and concerns the subject tract and shall run with the land, binding, obligating and/or inuring to the benefit of future owners, heirs, successors and interests or any other person or entity acquiring an interest in property, as their interest may appear. This provision shall not be interpreted to require a mortgagor or lender to indemnify the City except to the extent of their loss nor to obligate such persons to maintain the insurance .above required. DONE this (2-tk day of OWNERS) By: By. STATE OF WASHINGTON ) ) ss: COUNTY OF _�/06 ) I certify that I know or have satisfactory evidence er that f h1 1;pJ_ �,n ',rn_„ signed this instrument and acknowledged' WSS52079A/0006.040.034 -4- WSS/klt 02/08/90 9(605060 3 f? VOL. 3 1 59PAGE2556 �' p.: it to be (his/her) free and voluntary act for the nuip mentioned in this instrument. DATED this 0 day of &'Q4 .n. u"e , 199V. _ //�� 16 f IM•^ • b-f,+,...��%h ��cJ Q���-tom.-✓ • r ,; ; <<� • NOTARY PUBLIC My commission expires: 4-I-y7 STATE OF WASHINGTON ) ) ss: COUNTY OF ) I certify that I know or have satisfactory evidence that signed this instrument and acknowledged it to be (his/her) free and voluntary act for the purposes mentioned in this instrument. DATED.this day of , 199_. NOTARY PUBLIC My commission expires: STATE OF WASHINGTON ) ) ss: COUNTY OF ) I certify that I know or have satisfactory evidence that signed this instrument, on oath stated that (he/she) was authorized to execute the instrument and acknowledged it as the (title) of (name of party on behalf of whom instrument was executed)- to be the free and voluntary act of such party for the uses and purposes mentioned in this instrument. ,.., DATED this day of , 199_. NOTARY PUBLIC My commission expires: WSS520.79A/0006.040.034 -5- WSS/klt 02/08/90 9605080986 voi. 3159PAGE 255'7 t,� r� w NZ C ACORD_ CERTIFICATE OF INSUFtANCtID C2' °ATE`MIA0 :. .LIABILITY .. .... ;,.., ... ..OGGP81 ' .'. 12/10/97 :. 9 _ .:..... PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Unity Group - Lynnwood HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 36608 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Lynnwood WA 98036 COMPANIES AFFORDING COVERAGE Christina Anthony COMPANY Pnona No. 425-774-5622 FOXNo. 425-776-5996 A C N A INSURED COMPANY B COMPANY Philip J. Ruggiero C 19609 27th Ave. NW Shorelline WA 98177 COMPANY D COVERAGES.::: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE(MMRIGIYY) E EXPIRATION PDATE(MMMDNY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE S COMMERCIAL GENERAL LIABILITY PRODUCTS•COMPIOPAGG $ CLAIMS MADE ❑OCCUR PERSONAL S ACV INJURY S EACH OCCURRENCE $500,000 OWNER'SSCONTRACTOR'SPROT A X Comp Pers Liab US 145304B86 06/26/97 06/26/98 1 FIRE DAMAGE (Any one&e) S MED EXP (Anyone p-) S AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT S ALL OWNED AUT05 SCHEDULED AUTOS BODILY INJURY (Perpe n) 5 HIRED AUTOS NON -OWNED AUTOS (Pat aeutl) INJURY $ PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY -FAA CGDENT S OTHER THAN AUTO ONLY: ANY AUTO EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE 5$1,000,000 A X UMBRELLA FORM US 145304886 06/26/97 06/26/98 AGGREGATE S 5 OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WCSTATU- OTH TORV LIMI ER EL EACH ACCIDENT S THE PROPRIETORI PARTNER Sl 1ECUTIVE !NCL T EL DISEASE - POLICY LIMB S EL DISEASE - EA EMPLOYEE S OFFICERS ARE: EXCL OTHER A Homeowners US145304886 06/26/97 06/26/9B DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESISPECIAL ITEMS Single family home located at 16010 75th Pl W, Edmonds, WA 98020. City of Edmonds also listed as additional insured CERTIFICATE HOLDER ;.: :;: :. - �..-CANCELLATION - X7iXXXIX SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL MAIL City of Edmonds Building Department 250 5th Ave N, Edmonds WA 98020 3 -OGs WRTTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT AUTHOR2E° REPRESENTATNE ACORD:26S:(196). .' - :. .- - wGACOROCORPO RATION`.1888 i'> 1. a ® e.eF� 1 eaeeae.eaw� TO: Permit Coordinator, Building Division FROM: FIRE DEPARTMENT --iJ'r,ENGINEERING DIVISION PLANNING DIVISION OWNERT� { Y"U ADDRESS PERMIT# ` 6 D2 00/ ADB# INSPECTED ON 67C'1' 3� ` A field inspection was conducted to determine compliance with approved plans. Final approval denotes there are no objections to the granting of: _Occupancy for the building Performance Bonds may be released Maintenance Bonds may be released Landscaping is approved Other inspected PASSED FIRST INSPECTION - CONDITIONS NOTED 1. 2. FAILED INSPECTION - OUTSTANDING REQUIREMENTS - RECALL FOR INSPECTION I. 2. 3. 4. J` OCCUPANCY APPROVAL FAILED FIRST INSPECTION RE -INSPECTED - APPROVED RE -INSPECTED - FAILED RE -INSPECTED APPROVED OCCAPRVL/TXTRECEP/October 13, 1993 DATE (U! 3 7 BY DATE BY DATE BY DATE BY DATE FEES RECEIPT# t 32 x E 11 M®oa�m W.-Im 1'. "nuno Is] PROJECT REVIEW CHECKLIST PROJECT NAME:— PLAN CHECK #: PROJECT ADDRESS:_/601) RECEIPT DATE: ]REVIEWfl) B,Y:, COMMENTS (1"i!!aI/qa1e.. PLAN: IWATE FIRE BLDG. SEWER STREET - ENG. Setbacks/Variance/Setback Adjustment Conditional Use Permit a - . Requireme ts 3� Ot he Z Dning Requirements Underground Wiring Required e Lot S& .6 iiEPA Environmental Checklist/H Tree Cutting Plan Plat/Sub division Requirements Le al escription Verification 5-29- 'Fa 1 O�. Quit Claim/Street Dedications L47— 12 Easements - Public/Private Engineering Storm Drain Review Fee -13: 19 ��20' Enqineering 2.2 Inspection Fee Drainage Plan (On -Site) Setback - To of Bank, Stream, Water Courses Setback - Storm Drain Line Open Ditch - Existing Culvert Required Culvert Size Shoulder Drainage/Shale Open Runoff Catch BisinRequired A-L- . . . . . . . . . . . . . . . . . Driveway Slope & Vehicle Access Oc- —</�-/, Sidewalk Required Y6-, 24: Curb & Gutter Required .25 Curb Cut For Driveway Required Street �aving Required 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : IL 30 'ght_ If -Way Construction Permit Required LIE-) Street Name Sign Required Other Si nin Re quired . . Bond r Public Improv --A Re For F EM Table Side Sewer Availability LJC15 Calculate Sewer Connection Fee If No LID #010 -Create —Street File lExIsting Water Main Size A Water Meter Size Rw -39: Service Line Size Water Meter Charge Required H ,dra I Required ! Ent F iYa Size Existing Fire Line Charge Required - Sprinkler -'42: Street Cut Miscellaneous S M. 43 Reviewed By: FIRE PLANNING ENGINEERING PUETLIC WORKS 0 a 0 M