Edmonds Pilates 2000 LLC-Street Use.pdf-J OV EVAjrl,
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PERMIT #: 1'-1 'J'VeL,610
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STREET USE PERMIT
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BUSINESS OWNER NAME:
ADDRESS, OF PUBLIC USE: -7 L.5,
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APPLICANT MAILING ADDRESS: 5iTZ
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Placement of any temporary or movable objects in any portion of public space or City right-of-way shall
meetall Code Requirements as set forth in the following, chapters of the Edmonds Con-u-nunity
Development Code.
18,70 STREET USE AND ENCROACHMENT PERMITS
17.65 LIMITED OUTDOOR DISPLAY OF MERCHANDISE
17.70.040 TEMPORARY USES; Bistro and outdoor dining
PERMIT ISSUANCE
A Street Use Permit may be issued, at the discretion of the Development Services Director, City Engineer
or their respective designee, for temporary objects located within any public space, right-of-way, roadway,
parking strip and/or sidewalk, including the air space, above thein, if they are placed in compliance with the
above referenced Code Sections and the following criteria are met:
It has been concluded that the proposal will not adversely impact public space open to vehicular or
pedestrian travel; ,
Architectural Design Board approval has been granted or the process has been administratively
approved;
The proposal will not unreasonably interfere with the rights of the public;
Items shall be placed adjacent to the building and may encroach onto a maximum of two feet of the
public sidewalk; or in accordance with Bistro and outdoor dining code;, or per an approved building
permit;
Safe pedestri"an'trav'el area, or clear zone, of 44 inches minimum widthshill be maintained on City
sidewalks; (see definition of clear zone below)
Exterior light fixtures, banners, signs and flags must be a minimum of 7 feet above City right--of-way;
Clear landings of 44 inches or no less than the width of the door (whichever is greater), measured
toward the street, shall be maintained on the exterior side of all required exit doors;
Illumination from City light fixtures shall not be blocked,
No objects shall be hung from City light standards; and
S TugTorms\Strect Usc Pmnit.doc Revised 1215/05
Three feet of clearance around fire hydrants, standpipes,, manholes, water meters, blowoffs, cleanouts
and valves shall be maintained.
Clar Zone" Definition: Clear ?one refers to an area. 7 feet in lac at and 44 inches in width providing a
level, safe walking surface along the public sidewalk (e.g. measuring 44 inches from edge of street tree
grates or newspaper stands toward place of business and from the gouund up to a height of 7 feet).
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APPLICANT TO READ AND SIGN
NOTE: The issuance of this permit is understood by the applicant to be of a temporary nature, shall vest rYa
permanent right and shall be issued anti may in any case be revoked at the sale discretion of the City per
ECIC 18.70.040. By signing this application, the applicant accepts responsibility for all existing and/oar
facture street uses° Applicant is responsible toprovide as copy of'the insurance ceri icaate to the City at the
beginning of'each calendaryear, arta later than the 21" dandy of January.
INDEMN-ITY: The applicant understands and by his/her signature to this application, agrees to holed the
City of Edmonds harmless from any injuries, damages or claims of any kind or descriptionwhatsoever,
foreseen or unforeseen, that naay be made against the applicant or the City aafEcdmonds, or any of its
departments or employees, including but not limited to the defense of'aany legal proceedings including
defense costs, court casts, anti attorney fees by reason of granting this permit. .Iia addition, the applicant
understands that he/she shall provide and continually maintain during the term of the,permit a certij` tate
of insurance naming the city as an additional insured, with respect to liability, and providing that it shall
be primary as to any other policy, of insurance.
CODE APPLICATION. By signing the application below the applicant warrants that s/he has read or had
the opportunity to read Chapter 18. 70, 17.65, and 17.70.040 of the Edmonds Community Development
Conde and s/he understands that all terms "of the adapted ordinance are incorporated herein as if set forth in
full and this applicataaw'a ad permits the re are subject to the terms of thaw Chapters.
SIGNATURE U � �" � , ��. ATS � �
P'roperty,,. arca ry usiness Owner
FOR CITY USE ONLY
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Approved by.: � � insurance Verified h � � , "
Building Permit : �� 'fr'"� ,. street Use P'eco
receipt No:
Issued by: Date: Copy to applicant; ❑ pick -tap ❑ Mail
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CERTIFICATE OF LIABILITY INSURANCE /DD/YyYY)
C
(mmIDAT /2011
PRODUCER THIS CERTIFICATION IS ISSUED' —AS A AKT—TER Ur—
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27"-ite In".T.7 Agency' I... IMFORMATION ONLY AND CONFERS NO RIGHTS UL -109
7101, Pulrta Re.]. Sllite 200
Md -i.. Viejo, CA 92691- THE CERTIFICATE HOLDER. THIS CERTIFICATE
PD21E�1HOT AMMEND, EXTEND OR ALTER THE COVERAGE
PilaLe. Fd-�d- LLC
307 B all St 9 "it., 103 INSURER 13:
Edmonds, WdA, 98020--3216 TNSURER C:
114SLIBER D.
INSURER E.,
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABovn FOR 15r, POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR, OTHER DOCUMENT WIT14
RESPECT TO WHICH THIS CERIFICATION MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES
DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS Or SUCH POLICIES, AGGRLGWTE LIMITS
SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
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POLICY POLICY
INSR INSR POLICY
EFFECTIVE DATE EXPIRATION DATE
LTR D TYPE �OF INSURANCE HIMER
imm nn yvvyi (M/DD/YYYY) LIMITS
A. X GENERAL LIABILITY PHI -K639151
10/1412010 10/14/2011 EACH OCCURENCE $1,000,,000
COMMERCIAL GENERAL LIABILIry�TY 000
DTitXG-ETO RENI2
PR,141S F $100,000
CLAIMS MADE
MEDNay — $9,000
X PROFESSIONAL ITARILITY
PERSONAL & ADV iwQR)c $1,000,000
GENERAL AGGREGATE $3,000,9;00
(41DN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTq - COMP/OP' AGO $3,000,000
PROJEC
T
A X AUTOMOBILE LIABILITY LIHPK639191,
10/1412010 10/14/2611 COMHtNEP SINN LIMIT
ANY AUTO 000
{EA a,,Vid-L)
ALL OWNED AUTOS
BODILY INJURY
SPHEDU1,ED AUTOS
(Par p .... r)
HIRED AUTOS
P.D11Y INIURY
NON-OWNFU AUTOS
(P.r ... id.ut)
PROPERTY DAMAGE..
@Per accident)
GARAGE LIABILITY
AUTO 0-MI,Y - EA ACCIDENT
ANY AUTO
RA
OTHER THAN
AUTO ONLY: ACT
-EXCEIISS
AGG
/ UMBRELLA LIABILITY
EACH OCCURENCE
IOCCUR F7 CLAIMS 14ADE
AGGREGATE
EGURiCPIBliE
RETENTION
COMPENSWTION AND
TU--- 611'
,M1,0,11M I LIABILITY
TORY FR
Y/m
ANY
LIMITS
PROPKILITOR/ PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
OFFICER/MEMBER EXCLUDED?
(K..datory in NE)
E.L. DISEASE EA
AMPLOYEE
IfL de—iba der
-PROVISIONS
Spd-l-A h.l..
E.L. DisEAsE
LIMIT
OTIMR
DESCRIPTION OF OprMTIONi-i'-LUC-iT-i&S/—VERICLES I EXCLUSIONS ADDED BY EMBORMMENT SPECIAL PROVISIONS
It I. und-sL—] and .9read that the follow ing entity is added as an
additional insured but only with d
insured except that liability resulting from the additional insured's
code nuqliqenco.
CERTIFICATE HOLDER
4,� . . . . . . . . . . . . I . . . . . . . . . .
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TEL
City of Edmond. E.qi .. ri.q Division
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAY
.121 5th A- N
DAYS WRITTEN XOTIC1 TO THE CERTIFICATE HOLDER NAMED TO THE lZrT,
Edmond., WA 9S'020-314520-3145
FAILURE TO DO SO SMALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY RIND
ACORD 25 (2009/01)
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reserved.
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are registered marks of ACORD
ACORD 25 (2009/01)