BLD20130467 ADU Statement Signed by Owner.pdfa
C
DEVELOPMENT SERVICES DEPARTMENT
121 5°i Avenue N, Edmonds, WA 98020
Phone 425.771.0220 Q Fax 425.771.0221
Property Address (Street, City, State, Zip): I Parcel #:
23910 — 80t" Way W.
Edmonds, WA 98026
00451900202007
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 am not requesting to establish an Accessory Dwelling Unit on my property as part of the
subject building permit application (File No. BLD20130467), and 1 will obtain all applicable
ADU permits if I 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 deelare under penalty of perjury laws that the above information is true, eorrect and
complete, and that I am the owner of the above described property.
Print Name: �_ , A% V�,N,L�
..,�.. Date:
Signatuh: ��'
Revised on 7/23/2013 BLD20130467 AD U Statement Page I of I