BLD2004-0267 LEGAL DOCS....-CITY CLr_RK 200510070096 5 PGS
EOWNDS 10-07-2005 09:31am $36.00
_V
ENM NO. SNOHOMISH'COUNTY. WASHINGTON
9W20
Robert ah"d'Ky-*r_aJk"'_
�Qoy
16510 746'AV 61 W, ..... ......... ..
W'
Edmonds, A-98 26
McCoy Residentia P6ol Addition
Hold Harmless Agreetpent-v.; reference #: 04267
.--`.Grantee: City of Edmonds, WA
Grantor: Robert and !CC.'91y`
Legal description: Meaddiwdalia Beackkk%-.097 D-00 all lots 5, 6, and 7
Parcel ID #: 00 5131 097 005 OQ---"'
.. . ....... .. ..
..............
..........
...... ...... ..
AGREEMENT FOR THE DISPOSITION OF POOL WATER
AND
HOLD HARMLESS AND INDEMNITY AGREEMENT
WHEREAS, the undersigned property owners have applied to the City of Edmonds for
permission to construct a swimming pool;
- WHEREAS, the property owners admowledge that the wastewater and sewage in their
property is disposed of through a Vinder purnping system maintainod- by the City's combined
utility-,
WHEREAS, high volumes of water associated with the swimming pool could cause the
pump to bum out or fail well ahead of its normal useful life arid are prohibited from disposal
through the City's utility system as a condition of service;
. WHEREAS, combined utffity of the City of Edmonds. is willing to provide service and
not oppose issuance of a permit for the construction of the swimming pool so long as the
property owners may make other arrangements for the disposition of water drained fi-oni the
pool; NOW, THEREFORE,
In consideration of the mutual promises contained herein and the benefits to be derived,
Robert McCoy and Kyra McCoy, husband and wife, the undersigned Property Owners, and the
City of Edmonds, Washington enter into the follovang agreement:
1. Undertakinp of rngqy Owners. The following agreement is an agreement
which touches and concerns the subject tract, commonly addressed as 16510 76th Avenue West,
Edmonds, Washington 98026, and as legally descnlxd in Exhibit A-- This Agreement benefits
theaforementioned subject tract and shall bind all successors, heirs, assign and ffiture owners of
the tract. On behalf of theinselves� their successors, heks, assigns, and transferm, the Property
Owners hereby agree that .
1-1 Water contained in or drained from a swimming pool established on the
subject site shall not he released into the CiVs sanitary or stormwater sewer systems. Such
water shall be- removed from the sft at the Property Owners' sole- expense by truck or odxr
private method of transportafion.
1.2 'Me Property Owners promise to indemnify and hold harmless the City of
Edmonds, As officers, agents and employces from any and all loss, claim or liability arismg fi-om
or out of out of the disposition of water fiom the swimming pool or violation of this agreement.
Miis promise to hold harmless and indemnify includes the reasonable costs of legal defense by
counsel of -the. City's choosing. Nothing herein shall requi.m the owners to indemnify the City,
JWSS614S6&D0C- 1100OW9000M
its officers, agents and employees from loss attributable, to the negligence of the City or its
officers, agents oremployees-
1.3 As an agreement which touches and concerns the land, and benefits the
above mentioned subject parcel, die promises contained ut this Agreement and the indemnity
-shall hind any heirs of the current own= as well as all transferees and assigns� and fiftre
owners of the site.
1.4 Ibis Agreement shall remain in full force and effect until the swimming
pool is removed or decommissioned in accordance with the State Building Code.
2. Undertaldno of the City- In consideration of these promises and full compliance
with.the provisions of the State Budding Code, the Citys combined utility shall not oppose
issuance of a permit for the construction of a swimming pool on the subject site and shall
continue utility service to the site so long as the site and its Property Owners comply with all
conditions of servim
I Entire A This is the entire agreement between die partie& It shall not
be amended, except in writing, with the exprew written consent of the parties hereto. Any prior
understandings, written or oraL shall be deemed merged with its provmons.
4. bI9WK9!AfiO_n- The Purpose of this Agreement is to adequately provide for the
disposition of water from the swimming pool in a manner which does not impair the City's
utility system- Nothing herem shall -he inteqn-eted as, nor does it create� a contract for the
issuance of a permit in violation of any provision of the State Building Code, or a contract which
impairs the statutory discretion or ministerial duties given to or required of City officials under
the State Bxnldmg Code This Agreement does not amend the State Budding Code as� adopted by
the City nor shall it be, interpreted to do so.
DATED: — 9 - -� � - 0 -5-
�"ERTY OWMMS
Robert McOly
Kym�&Py
STATE OF WASIENGTON)
COUNTY OF SNOROMISR)
On this day appeared before meROBERT McCOY AND KYRA McCOY, husband and
wife, and stated that they executed this document for ft uses and purposes herein mentioned.
DATED: 9 AA 46 5
ARY MLIC
Name: —60L-!�X,4t tsk-MMM
Mycomrnissionexpire��- 'NZ-05-0t'
CITY OF EDMONDS
BY:
M or II e=s(m
ATTEST/AUTHENITICATED:
.By-
gandra S. Chase, City Clerk
APPROVED AS TO FORM:
By
"(- - -A-
W-. Scott Sn3def� CitY Atlornl� w
LEGAL DESCRIPTION
. - for 16510 76 AVE W
MEADOWDALE BEACH BLK 097 D-00 AM LOTS 5,6 & 7 BLK 97 & VAC ST B-tW TR 90 & SD
BLK 97 TGW TH M VkC SEASIDE AVE AIDI W OF SD LOTS 5, 6& 7 ENCOMPASSED ay WLY.
PRO) OF S LN OF LOT 7 & N IN SD LOT 5 EXC M DAF - BEIG AT NE COR SD LO-I'S TH N89*03
o5W ALG N IN SD LOT 5 DIST t 1"3FT TU 510#43 2OW DIST 49-2 IFT TH S59*04 17E DIST
58,99FTTH S67*49 46E DIST 97-89FF TO W LN OF 75M pL w AS DESC IN QCD REC AF
7712090257 TH NELY ALG SD W LN OF 7STH Pl, W TO fKT OF ELy pROLNG OF N LN SD LOT 5
WH SD W LN OF 75TIF pL W TH NS9*03 o5W ALG SD PROLNG OF N LY SD LOT 5 TO POO (SD
EXC AKA LOT A CffY EDM.-A-S-25-S7 AF g7ji2socr7o) TGW TH VMS LOTS 5 & / OR S BLK 97
DAF -4COM.AT A MON IN CASING AT C/L OF 76TH AVE w & N LN OF BROOK ACRES ESTATES
VOL 40 OF PLAXS PG 179-181 TH N01 *I I 45E ALG NLY PROI OF 76TH AVE W PER SD PLAT
DIST 72-03F]r TO SELY PROJ OF SLY LN LOT A OF TH- BLA RIC MR AF 87 t t 250WO TH N67*49
46W ALG SD SELY PROY & SLY LN DIST 99-92FF TO EXST REBAR Wtt CAP No 456t TH N59*04
I TW ALG BDY SD LOT A DIST Sg_991FTTO EXST REBAR CAP ITO 4561 TH N10*43 20E ALG W. IN
SD LOT A DIST 43-2 tFT TO AN EXST REBAR CAP NO 4561 TH CONr N10*43 20E DIST 5FY TO
NW COR-SD LOT & PORTH NGI *1 t 45E PLW SD PRGJ OF 767111 AVE W DIST LOOFIF TU N85 48
24W DlST99J5FT TAP 504*11 36W DIST 9-00FTFR EXSY REBAR CAP NO 9435 PER SURVY UND
AF 8W-7015002 VOL 27 SURVY PG 61 TH CONT N95-49 24W DIST 26.90FIF TO WLY MGN SD VAC
SEASIDE &VETH S30*54 45W ALG SD MGN DISK 9 42Fr TAP TH BEARS M9*03 OSW Ftr- POB &
N L14 LOT B SD RLA AF 87112WM 1111 S99*03 05E DEST 13 L05FT TPB PER BLA RECAF
9304090676
EXHIBIT A
Home Office:
1213 Valley Street
iWhArk PO Box 9271
1: Limited Power of Attorney Seattle, WA 98109-0271
11111111i 1"SURANCLE (206) 628-7200
KNOW ALL MEN BY THESE PRESENTS that CONTRACTORS BONDING AND INSURANCE COMPANY, a corporation duly organized and existing under the laws of the State of Washington, and
having its principal office in Seattle, King County, Washington, does by these presents make, constitute and appoint MARK NOMA, of Seattle, Washington, its true and lawful Attomey-in-Fact, with full
power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver on behalf of the Company any and all bonds and undertakings of suretyship given for any
purpose, provided, however, that no Aftomey-in-Fact shall be authorized to execute and deliver any bond or undertaking that shall obligate ft Company for any portion of the penal sum thereof in
excess of $6,ODO,000, and provided, further, that no Aftomey4n-Fact shall have the authority to issue a bid or proposal bond for any project where. If a contract is awarded, any bond or undertaking
would be required with a penal sum in excess of $6,ODO,000; and to bind the Company thereby as fully and to the same extent as If such bonds were signed by the President sealed with the corporate
seal of the Company and duly attested by its Secretary; hereby ratifying and confirming all that the said Attomey-in-Fact may do in the premises. Said appointment is made under and by authority ofthe
following resolutions adopted by the Board of Directors of the CONTRACTORS BONDING AND INSURANCE COMPANY on May 20, 2004:
RESOLVED that the President of the Company is authorized to appoint any person as the Company's true and lawful Aftomey4n-Fact with power and authority to execute and
deliver on behalf of the Company any and all bonds and undertakings of suretyship given for any purpose, subject to such limits as shall be determined by the President ofthe
Company-, provided, however, that no such person shall be authorized to execute and deliver any bond or undertaking that shall obligate the Company for any portion of the penal
sum thereof in excess of $10,ODO,000, and provided, further, that no Attomey4n-Fact shall have the authority to issue a bid or proposal bond for any project where, it a contract is
awarded, any bond or undertaking would be required with penal sum in excess of $10,000,ODD. Any Aftomey-in-Fact authorized to execute a surety bond or undertaking may also
be authorized to execute any consent or other documentation incidental to said bond or undertaking, provided such document does not obligate the Company in excess of the limit
set forth above.
RESOLVED FURTHER that the authority of the Secretary of the Company to car* the authenticity and effectiveness of the foregoing resolution in any Limited Power of Attorney
is hereby delegated to the following persons, the signature of any of the following to bind the Company with respect to the authenticity and effectiveness of the foregoing resolutions
as if signed by the Secretary of the Company: Terry N. Thompson, Luther L Hicks, William K. Barbour, Diana Hollingsworth, John T. Pieprzny, Mary Beth Kosw Rita A. Miller,
Gregory P. Bruno, Dorothy Tarka, Michael J. McVey, Phy,nis K Jefferies, Will Finan, Wesley B. Hong, John D. Minto, Brian Schick Eric Sirkin, Chris Rebum, Mark Noma, Wm.
Blair Meixell, Julie A. Schaller, Yolanda Urrutia, Vickie Spence, and Maureen Saccio. Provided, however, that no such person shall have the authority to certify the authenticity ofa
resolution or Limited Power of Attorney document which serves to appoint themself as Aftomey-in-Fact.
RESOLVED FURTHER that the signatures (including certification that the Power of Attorney is still in force and effect) of the President Notary Public and person certifying
authenticity and effectiveness, and the corporate and Notary seals appearing on any Limited Power of Attorney containing this and the foregoing resolutions as well as the Limited
Power of Attorney itself and its transmission, may be by facsimile; and such Limited Power of Attorney shall be deemed an original in an aspects.
RESOLVED FURTHER that all resolutions adopted prior to today appointing the above named as Attomey-in-Fact for CONTRACTORS BONDING AND INSURANCE COMPANY
are hereby superseded.
IN WITNESS WHEREOF, CONTRACTORS BONDING AND INSURANCE COMPANY has caused these presents to be signed by its President and its corporate seal to be hereto affixed this 20th day
of May, 2004. .01SIS21111188,
CONTRACTORS BONDING AND INSURANCE COMPANY
Z
By:
Don Sirkin, President
STATE OF WASHINGTON — COUNTY OF KING Batista%
On this 20th day of May, 2004, personally appeared DON SIRKIN, to me known to be the President of the corporation that executed the foregoing Limited Power of Attorney and acknowledged said
Limited Power of Attorney to be the free and voluntary act and dead of said corporation, for the uses and purposes therein mentioned, and on oath stated that he is authorized to execute the said Limited
Power of Attorney. I
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal the day and year first above written.
Zvi
Notary Public in and for the State of Washington, residing at Seattle
The undersigned, acting under authority of the Board of Directors of CONTRACTORS BONDING AND INSURANCE COMPANY, hereby certifies, as or in lieu of Cerfificate of the Secretary of
CONTRACTORS BONDING AND INSURANCE COMPANY, that the above and foregoing is a full, true and correct copy of the Original Power of Attorney issued by said Company, and does hereby
further certify that the said Power of Attorney is still in force and effect
GIVEN under my hand at Seattle, WA , this 15th — day of Jill y 20 05 -
PoaDS01.14-US052004
—CCMM. RNAL— DATE JUN-24-2r R**** TIME 09:27 *** P.01
MODE = MEMORY TRANSMISSION START=JUN-24 09:25
FILE NO.= 167
STN NO. rord ABBR NO. STATION NAME/TEL.NO. PAGES DURRTION
001 83606692939 004/004 00:01'34"
EbA,
City of Edmonds
Development Services Department
Building -Engineering -Planning
121 5'"Avenue North -2d Floor
Edmonds, WA 98020
-toe. IS910 Phone: 425.771.0220 Fax: 425.771.0221
L
COVER PAGE
To:. N�20,')A& From:
END=JUN-24 09:27
Date Transmitted: Reciplents Fax No - �Wll— 79,�- FNo. of Pages:
(including cover page.)
If there are any problems during transmission or documents are received incomplete, please
call 425. 771.0220 and ask for:
LTempfjana/formS/DSFAX
W,
Grantees, Robert McCoy and Kyra McCoy, or their heirs, legal
representatives, or assigns, or any of them, shall not at anytime during his, her, or
their ownership of the above described property, or any portion of it, dispose of
any swimming pool water into the city maintained sewer grinder pump or other
public conveyance. All swimming pool water shall be removed and disposed of by
truck.
�1 r��A -
Robert McCoy
Subscribed and sworn to before me on
kWnt Nam" e? �S,94"Ilt Zkpc4o
NOTARY PUBLIC for the State of
Washington, residing at 19 vthl
My appointment expires:
Kyra Mc� oy
Subscribed and sworn to before me on ev'5
NOTARY PUBLIC f the State of
Washington, residing at - Yvt&&t4
9
My appointment expires: eV -6-t
999999,2005/1230206.1
HOLD HARMLESS AGREEMENT
In exchange for the City of Edmonds granting a building permit for construction of
a residential swimming pool on their property located at 16510 76 1h Avenue West,
Edmonds, Washington, Robert McCoy and Kyra McCoy agree to indemnify and
hold the City of Edmonds harmless for any damages directly caused by the
granting of the aforesaid permit. As additional consideration for the granting of
the permit, Robert McCoy and Kyra McCoy agree to provide the City with a
recordable document stating that their successors, heirs, and future owners shall
remove and dispose of the pool water by truck and shall not dispose of the water
into the City of Edmonds maintained grinder pump located at said premises or
other public conveyance. Robert McCoy and Kyra McCoy agree to indemnify and
hold harmless the City of Edmonds for any damages for which the City may be
liable arising out of the above -described disposal of pool water by truck caused
solely by their negligence.
Dated this (,,o % day of 2005.
Robert McCoy �Ij
Kyra oy
999999.2005/1230228.1
RECEIVED
FARMER�
75 YEARS SERVING AMERICA C()Py
MAR 17
PERMIT COUNTLEr-
COMMERCIAL
CERTIFICATE OF INSURANCE ISSUE DATE
AGENCY:
03/08/05
MYHR INSURANCE AGENCY
This certificate is issued as a matter of
19515 NORTH CREEK PKY #102
information only and confers no rights upon
BOTHELL, WA 98011
the certificate holder. This certificate
426-402-9300
does not amend, extend or alter the coverqe
St. 79 Dist. 26 Agent 311
afforded by the policies shown below.
INSURED;
COMPANIES PROVIDING COVERAGE;
Comp Letter A TRUCK INSURANCE EXCHANGE
PRESTIGIOUS POOLS, INC.
Comp Letter B FARMERS INSURANCE EXCHANGE
9330 180TH ST SE
Comp Letter C MID-CENTURY INSURANCE COMPANY
SNOHOMISH, WA 98296
Comp Letter D—SCOTTSDALE INSURANCE COMPANY
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.Ltl Type of Ins IPolicy -* 1 Eff. Dtl
Exp, Dtl Policy Limits
D lGeneral LiabICLS0896303 11/20/04
11/20/05[General Aqgregatl$2,000,000
D ICommercial I I I
lProd-Comp/Ops 1 2,000,000
D lGeneral Liab I
lAqgregate 1$2,000,000
D I -occurrence I
IPersonal and Ad-1
1 Version I
Ivertising Injuryl$2,000,000
I I
lEach Occurrence 1$2,000,000
D lContractual- I
IFire Damage I
D lIncidental I
i(Any One Fire) 1$ 100,000
I I
IMedical Expense 1 5,000
D 10 & C Protectl
I(Any One Person)IS 1,000
lAutomotive I
lComb. Single Lmtl$ 000,000
ILiability I
I I
(All Owned I
lBodily Injury I
I Commercial
I(Per Person) Is '000,000
iScheduled I
IBodily Injury I
IHired I
I(Per Accident) 1$ 000,000
INon-Owned I
lProperty Damage 1$ '000
lGarage Liab. I I
lGarage Aggregate[$ 1000
lUmbrella LiabA I
ILimit 1 .000,000
DESCRIPTION OF OPERATIONS/VEHICLES/RESTRICTIONS,SPECIAL ITEMS
CERTIFICATE HOLDER; CANCELLATION Should any of the above de -
ADDITIONAL INSURED scribed policies be cancelled before the
expiration date thereof, the issuing compa-
CITY OF EDMONDS ny will endeavor to mail 30 days written
121 STH AVE NO notice to the certificate holder named to
EDMONDS, WA 98020 the left, but failure to mail such notice
shall impose no obligation or liability of
any kind upon the company, its agents or
, a e i representatives.
46'rvin B or Janet C yhr, Authorized Representative