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BLD1993-0287 LEGAL DOCSRECEIVED OWNER'S LIABILITY LANDSLIDE ACKNOWLEDGEMENTEB 03 1993 DECLARATION TO THE CITY OF EDMONDS, WA PERMIT COUNTER Whereas Richard H. Rhydes, Architect licensed in the State of Washington, has been retained by Mary K. Neering, M.D. to provide construction documents for a residence located on Lot 7, Lorian Woods PRD, Edmonds, WA; Whereas the said property is located in an area designated "Earth Subsidence/Landslide Hazard Area" by the City of Edmonds, Washington; Whereas Architect Rhydes and his consultants have prepared drawings and designed the residence in accordance with the laws of the State of Washington and the ordinances of the City of Edmonds; and certain Earth Subsidence maps and reports required and provided by the City of Edmonds and private geotechnical consultants; Now therefore Mary K. Neering does hereby acknowledge and declare: That Architect Rhydes and his consultants have drawn their own conclusions regarding information contained in the Earth Subsidence/Landslide Hazard reports and maps provided by the City of Edmonds; That the accuracy of all permit submittal information is warranted by Mary K. Neering and does hereby relieve the City of Edmonds and City Staff individuals from any liability associated with reliance on such permit application submittals; That Mary K. Neering understands and accepts the risk of building a residence in an area with unstable soils and that she will advise, in writing, any prospective purchasers of the site, or any prospective lessees of structures or portions of a structure on the site, of the slide potential of the area. Signed Mary K. Neering M.D. Subs ribed and sworn before me this day of 1993. Notary Public in and for the Sta�t-vf Wa hin t residing at T Y C® P y Qa' l.2 10017 4 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. Descriptic., of Subject era::ert-;,. mv,4 i covenant of notification and indemnification/hold harmless relates to a tract of land at the street address of 1 6 1 19 -7 3 rd ( insert street address), Edmonds, Snohomish County, Washington and legally described as: L 0 T -7 1 Lc r c� r� (,�v4 pS PR.D J Per �1cx`i- � �eC Y,)- 3i �<� 4y 2s' S10hom Is4 (0, 0q C;""/ aCCdu-nT -it- 7yOY- 000 -©C,)p5- 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 r 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 -1- RFECEiVE D BUILDING i•7SS/klt 02/08/90 BE 10 1g93 FEB 9 - 1990 PERMIT COUNTER the risks associated with development are contained in building permit file number Q (insert number) on file with the City of Edmonds Building Department. Conditions, limitations, or - prohibitions on 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 9802G. 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/ klt 02/08/90 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/hXs it (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: (insert insurance requirements and time period, if any --if no insurance required, so state.) WSS52079A/0006.040.034 -3- WSS/k1t 02/08/90 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 day of F,-h r(A _ , 199 c OWNERS) By: By: STATE OF WASHINGTON ss: COUNTY OF ) I certify that I know or have satisfactory evidence that �iT QE'r—ir1.P signed this instrument and acknowledged' WSS52079A/0006.040.034 -4- WSS/klt 02/08/90 it to be (his/her) free and voluntary act for the purposes mentioned in this instrument. DATED this day of _epLf r. c _, 19 9i!�! [NOTARY PUBLIC_,�c, My commission expires: 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 ) 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: WSS52079A/0006.040.034 -5- WSS/klt 02/08/90 Design Works 11111 CONSTRUCTION Edmonds Building Department Recedl,Z© N V 2 6 1933 PERMIT COUNTER Enclosed is a copy of the CERTIFICATE OF INSURANCE for DESIGN WORKS CONSTRUCTION. Shown are the amounts of coverage. We request that the amounts be considered sufficient and that a waiver of the required amounts be granted. Tha u, e ruce ' eil dba DESIGN WORKS CONSTRUCTION 9203 15th n.e. • seattle, washington 98115 9 (206) 523-9203 CERTIFICATE 4F INSURANCE ISSUE DATE (MM/DD/YY) PRODUCER STANLEY T. SCOTT k CO., INC. 2312 EASTLAKE AVE. E. SEATTLE, WASHINGTON 90102 INSURED DESIGN WORKS CONSTRUCTION .13030 39TH N E SEATTLE, WA. 98125 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY LETTER A AETNA_CASUALTY. ._. _. COMPANY B LETTER COMPANY `. LETTER COMPANY D - LETTER COMPANY E LETTER 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 POLICY EFFECTIVE POLICY EXPIRATION _TR TYPE OF INSURANCE POLICY NUMBER S DATE (MM/DDIYY) � DATE (MMIDD/YY) ALL LI IN THDU�SA A' GENERAL LIABILITY GENERAL AGGREGATE $ 600 X COMMERCIAL GENERAL LIABILITY t MP 0022534034TWF 7-26-92 7-26-93 ' PRODUCTS-COMP/OP AGG. $ 600 CLAIMS MADE XOCCUR_ PERSONAL & ADV. INJURY $ 300 / X OWNER'S & CONTRACTOR'S PROT. EACH OCCURRENCE $ 300 jl X WA STOP GAP FIRE DAMAGE (Any one fire) $ 300 — ''~_- --- MED. EXPENSE (Any one person) $ 5 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILITY EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS ALL OPERATIONS OF THE INSURED PERFORMED IN THE STATE OF WASHINGTON CERTIFICATE HOLDER STATE OF WASHINGTON DEPT. OF LABOR & INDUSTRIES P. 0. BOX 9687 OLYMPIA, WA. 98504 BODILY INJURY $ (Per person) BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ EACH OCCURRENCE $ AGGREGATE $ STATUTORY LIMITS EACH ACCIDENT $ DISEASE -POLICY LIMIT $ DISEASE -EACH EMPLOYEE $ RECErver) " 6 1�'4' V :,� PEANUT CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOjJQ DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL j DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY FIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPAEbISN� �— ACORD 25-S . ROSS (SM)� 2/13 © ACORD CORPORATION 1990 From MARY NEERIING, M. B. PHONE No. : 744 `'000 ran. 04 1994 9:25AM P02 Mary K, Neering 16119 73rd Pleb Wasf Fdmonds, WA 98026 Denomber 30,1993 qS City of Edmonds Attn: Sharon Nolan T am requesting a waiver to the requirement for Imnoglide insurance . hi=: "t :a Fartta incur&rce Agent, GardAyyrs, leas informed m.e that r iet m Stal.c Farm o; arty other inaumtwo agent vrill -situ a policy including the cityas wi insured, He f#-ej my personal umbrella policy would insure me adequately, Sincerely, Matey K. veering Frorq :,.M_ARY NEERING, M.D. PHONE No. : 744 5000 Jan.04 1994 9:25AM P03 L W YNC4 SOW Fum Sells Lite Ins.urance. GARY AVERS, AGENT * STAPF: ni1T4 & ELAINE uto- ' fe-li lth-•-tome ,�rld pusi re�s _ P 0 BOX 459, 2-38i a ZDMCNDS WAY, STATC FAH' : SELLS LIt L INS ,R tI�:,E ! EDMOND51 WA$HINWIN 9$J20-0459 Qr!= a '/1b-. 1 i01 HOME; 774 °4- -, FAX 67-2-0795 Dweember RB, 19rt' MARY K NEERINR 5014 A 168TH 87 tW LYNNW90D r WA 900`7 Dear Maryi Hi! In response to yt;ur request to list City > Edmonds as as. 6dattivnal ins-Ar-d on your, homeowneor*/par-r _nal. liahillf.y insurance polity . . . State Farm is wi=:ling to list City of EdreAnds for Sectior r coverages on your policy) but will not prIyWe coverage ¢or them for iniury and death a1 outlined in City `rdinartice tl8bb. State Farm is unriliing to proteet the C.ty of Edmonds f-r personal in ur,a, death: property damage -•Jor loss arisfnv. (-rnm or out of the :amity's involvement in the Fermittina process and from warth movamcant. State Farm has no involvement in the ";iarmitti:lg proGwsw," and sh)uld nut have to afford y roteet for the City in regards to tI,i�. process. State Farm }l. unwilling to s•isk up the loyal lint=ility relating to the perm'.• process. p1aasw let me kruw if I may be of further Assistance. Thank.i. Sincerely, �Wc film Ir.. dale fa�� ►�su�an�e o«eNop� �s. ,gin, _z MEMO JC: Garf, 4y4vs) 1979-47 �i8il �100, e ;fit, tAlo i 8 P INEUQwu�� PJC?4hx•n\� Clfryea 46RR 25th'inun, ko�tRitiest Scum, Urr-pall $7$13.t0GR FROG; Camille Dandouh ,Y ExtendedvP&5ou� 3, 1 UnderWrit@r ' 14t. 3735 State garl►I Fire and Casualty CompaAy RE! 47-8A-1691-4 Neering, Mary n Gary; In regards to naming the City of Edmonds as an additional The City of Edmonds can be named os an additional insured: will only provide Section I insured, h It will not Cfor in" as found in the howaownersej' this 42866. Provide coverage for injury and death as outlined in Ordinarc@ HOME OFFI019; 6LOMMINOTON', ILLIR .3 61710-0001