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BLD2006-0354 MISC DOCS03/28/2007 11:21 4254834002 NEVILLE & NEVILLE PAGE 01/02 NEVILLE & NEVILLE INSURANCE 18311 Bothell-Evereft Hwy Suite 180 Mill Creek, WA 98012-6824 (425) 483-8822 F2x (425) 483-4002 J�' 4 TRA NSMI T L JA DATE: 03/28/2007 TO: City of Edmonds RE: Construction Specialties LLC ATTN.- Marie Harrison PAGES (INCL COVER): ( ) FAX# 7 -71 - 6 Per my voicemail, please see the attached certificate of insurance which was faxed and mailed to you on 03/22/2007. If you have any questions, or need any further information, please feel free to call or send an email. Than - ou, Cary-\ Ronnie for I— i�,tk (Y\?+or�, G� Derelynn Williams dwilliams@nevilleins.com Neville & Neville Insurance www.nevilleins.com L i-- LOG ITEM# 6,5. 83/28/2087 11:21 4254834082 NEVILLE & NEVILLE PAGE 02/02 '-� mom 312112007 DO UC ER EXTEND OR 18311 Bothell Everett Hwy #180 CIES BELOW. —COMPANIES AFFORDING COVERAGE Mill Creek, WA 98012 C ON PAN y A UndervOters At Lloyds, London INSU RED CH THIS GO (Pei ectidool) WORKER) COMPENSATION AID TM: P9 Certificate holder is named as additional insured as respects to insureds operations.11 0 day notice for non- I V E D 121 Sth Ave N 2nd Floor DAYS WR TITEM NOTICE TO IN[ C EltffICATE VOIDER NAMED TO TMI LEFT, BUILDING DEPT. �'�_ LOG �~~^" ` ' '-/w#_ Page I of I Harrison, Marie From: Ronnie Cumpton [rcumpton@nevilleins.com] Sent: Wednesday, March 28, 2007 1:58 PM To: Harrison, Marie Subject: Construction Specialties LLC - PFK035027 - certificate of insurance & endorsement Hi Marie, please see the attached certificate of insurance & endorsement adding the city of Edmonds as additional insured on the above named insured's policy. Please let me know if you need anything else. Ronnie for Derelynn Williams �fE, FY F'41JILD"g-NO 11-pT, LC 3/28/200�OG ITEM #_�67 THISENDL .,EMENT CHANGES THE POLICY PLEASE. ADITCAREFULLY. POLICY CHANGE ENDORSEMENT - #1 Policy/Certfficate Number Policy Change Effective Company PFK035027 3/2112007 at 12:01 a.m. Underwriters At Lloyds, London Named Insured Construction Specialties, LLC 17508 71 st Ave W Edmonds, WA 98026 CHANGES In consideration of the additional premium of$100.00, it is understood and agreed that the following change(s) is made to this policy: CITY OF EDMONDS is added as additional Insured per form CG2010(07/04) attached. There are no ftuther changes to this policy. FLAT RATE, FULLY EARNED ADDITIONAL PREMIUM: $100.00 TAXES: $2.25 TOTAL: $102.25 ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. Submission #: 9983343 Date of Issue: Mar 21, 2007 Issued By: dlilly Effective Date of Policy: 1/17/2007 Contract: 06PAT02075 SLA Code: 5.503 cc: Neville & Neville Insurance Inc 18311 Bothell Everett Hwy #180 Mill Creek, WA 99012 Authorized Representative Signature Grifflin Underwriting Services _'IL 69 Policy/Certificate Number PFK035027 - COMMERCIAL GENERAL LIABILITY - CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Location(s) Of Covered Operations I Or Organization(s): I I ,ITY OF EDMONDS 21 STH AVE N 2ND FLOOR :DMONDS, WA 98020 linformation required to complete this Schedule, if not shown above, will be shown in the Declarations. I A. Section 11 — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule. but only with respect to liability for *bodily injury', "property damage or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acfing on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. CG 20 10 07 04 1 B. With respect to the insurance afforded to these additional Insureds, the following additional exclusions apply: This insurance does not apply to "bodily Injury" or Rproperty damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. Q ISO Properties, Inc., 2004 Page 1 of F ILOGITFIV�# e5zl PRODUCER D Wi I W" 12 r 1 07 3 2o TH IS C E R T IF ICA T E IS 15 SU E D AS A MATTER OF INFORMATION Neville & Neville Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 183111 Bothell Everett Hwy #180 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPA NIES AFFORDING COVERAGE IT OMPANY A Undewiters At Lloyds, London Mill Creek, WA 98012 INSU RED Construction Specialties, LLC C OUPARY B 17508 71 st Ave W C 0 UPAR Y C Edmonds, WA 98026 C 0 UPAR T D THIS IS TO CE FIT IF T TH AT TH E PO LIC 1ES 0 F INS U RANC E LISTED BELOW HAVE BEEN ISSUED TO TH E IN SU RED RAM ED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY R EOUIREM ENT.TERN OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.TME INSURANCE AFFORDED BY THE POLICIES OESCR18ED HER EIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CDMOITION$ OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID C LAIMS. IT PE or IN SUR AN CE I PO LICY IV NIGER POLIC T EfFEC TWO a ATE IMMIBC fly I POLE V EXPIRATION DATE (WIMMOMY I I IM ITS A IS ENER AL LIA BILIT V PFK035027 1117/2007 1/17/2008 6 ON E RAL AG GREGAIE S $2,000.000 X C OM M (RC IAL 6 EN E MAIL LIAO WIT C LAIkS MAD E F70 CC UR P R 0 OU C TS�C 0 MPIO P A 66 1 -$2.000.000 PERSONAL& ADV INJURY 1 $1,000,000 oli Coll PROT EAC H 0 C C U RR Ell f I I let DA MAG E IAN 10 go fill) S $50,000 MID EXP (Anyoss poison) I AU TON 06 LE LABILITY ANY AUTO C Oil 621 ED S 2 GIC LOA IT 3 ALL OW NED AUTOS SCHEDULED AU TOS BODILY NJURY (PI I poison) I 9 M I D AU T 0 5 101-OWNED AUTO S BODILY RJURY (PI I Ittill ;1) R 0 PERIY 0 AMAGE HP GARAGE LIABILITY AU TO 0 ITT EA ACC IDEA I I AM Y AU TO 0 1 HER TH AM AUTO ONLY I A C IT A C C 10 E A 1 3 A 6 G A E GA If 3 EIC Ell LIA BILITY EAC H OCCURRENCE S U M B RE LE A 10 R M AGGRECAlf 0 , HER THAN LIMERELLA FORM W ORKERS COMPENSATION AID CMPLO TOM$ ' LLk SILITY SIAIUTORY LIMITS EAC H AC CIDEIT THE Pa a PRIE To A I INC L PAR I KIER SiEXEC V TWO of FIC ER S A RE EAC L OTHER 11 0 BE ASE POLICY tiMiT D BE ASE EACH EMPLOYEE of see PT to N OF OPERATION 1-10—tAVIONSIV6111CLISISPICIAL ITEMS - Certificate holder is named as additional insured as respects to insureds operations. ***10 day notice for non- pay***Revised 3122/07 R SHOULD ANY OF THE A go yj OfStRIOED f LICIES BE CE LED BEFORE THE City of Edmonds EXPIRATION DATE TH ERIC$. THE ISSUING COMPANY VIRL ENDEAVOR TO MAI J 121 5th Ave N 2nd Floor 30 OAYSWRffTEN NOTICE TO THeCIITI;tCAT6 HOLDER NAMED TO THE LEFT. OU T FAILURE TO MAIL 3UC H N OTIC E INA L L IM POSE 00 OBLIGATION 01 LIABILITY Edmonds, WA 98020 OF AN Y KIND UP ON THE C 0 MPA9 Y. ITS AGENTS OR REPRESENTATIVES. BUILDING DEPT. N A 17 N LOG ITEM# i -COMM. DATE MAR-28-201 4(*** TIME 10:49 *** P.01 MODE = MEMORY TRANSMISSION FILE NO.= 206 STN NO. 9PN APBR NO. STATION NAME/TEL.NO 001 /-A OK 94254834002 START=MAR-28 10:48 END=MPR-2e 10:49 PAGES DURATION 002/002 00:00'56" of ED.Ar City of Edmonds Development Services Department Build ing-Engineed ng-Plan ning 121 5'h Avenue North -Z4 Floor Edmonds, WA 98020 Phone: 425.771.0220 Fax: 425.771.0221 COVER PAGE To: From:'-�� Date Transmittedj;V/V ,!��7 1 Recipient's Fax No: I (Including o0ver pagej If there are any problems during transmission or documents are received incomplete, please call 425. 771.0220 and ask for: L;Tomp4ana/foffns/DSFAX 11-OGITEWL 6 __QZ V1, 44 C. I % 9'J City of Edmonds Development Services Department Build ing-Engineeri ng-Planni ng 121 5 th Avenue North -2rd Floor Edmonds, WA 98020 Phone: 425.771.0220 Fax: 425.771.0221 COVER PAGE T o: NX, 5 7z . I zwz:�L From: Date Transmifte I g-c�L�5��?Z—Recipient's Fax No: —INo. of Pages: %. .,.& V1 pc3vt;./ If there are any problems during transmission or documents are received incomplete, please call 425. 771.0220 and ask for: L:Ternpfjana/forms/DSFAX LOG ITEM# (5L-3 3. PROFESSIONAL CONSULTANT REVIEW AND ASSOCIATED FEES The City shall require review of the application by a City retained engineer, geotechnical engineer, geologist, architect, or structural engineer in order to determine whether the submittals were prepared in accordance with generally accepted engineering practices, or the practice of the particular specialty and for compliance to Ordinance #2661 and ECDC 19.05 permit application requriements. This requirement may be waived at the discretion of the Director, The Building Official shall not be required to inquire further into the adequacy of the report, but rather may rely upon the professional submittals as warranted by the owner. Nothing herein shall relieve the owner of the obligation to submit a complete application fulfilling all the requirements of ECDC 19. 10 and the International Building Code. (ECDC 19.10.060) As required by City Ordinance #3108 (effective 9/3/96) the full cost of such review or reviews shall be paid by the applicant as a plan check fee. This plan check fee for professional services shall be in addition to the plan check fees established by ECDC 15.00.020. (Replaces Ordinance #2728) In addition, an administration processin2 fee in the amount of $2,385.00 is collected at the time of permit application submittal to cover City administration and processing costs. 4. SITE RESTORATION SECURITY A surety bond, frozen fund account, or instrument of credit shall be posted by the applicant in an amount to assure the restoration of any area on the site or in the surrounding area --disturbed or damaged by slides during construction, and to ensure completion of the work authorized by the permit. Or, if the work is not completed, to assure that the site will be restored to a safe condition. (Dollar amount established by the City Engineer). This surety bond or cash deposit shall be posted prior to issuance of the pen -nit and held in place until occupancy of the structure is granted and a formal letter of release is issued. Other forms of financial responsibility may be submitted to the City for review in order to fulfill this requirement. (Ordinance #2866) 5. GENERAL CONTRACTOR PUBLIC LIABILITY INSURANCE (Ordinance #2866) The owner's general contractor shall carry general public liability insurance, effective through final occupancy approval, which shall name the City as an additional named insured against the injury, death, property damage, and/or loss, arising from or out of, the City's involvement in the permitting process for the project and the loss due to earth movement. The amount shall be a minimum of one million dollars per incident which represents the potential loss to both public and private property which could be attributable to the development. The insurance policy shall state that the City be notified 30 days in advance of policy cancellation. The Building Official is authorized to stop work during insurance lapses until such time as the policy is reinstated. A copy of the policy shall be provided to the City prior to permit issuance. 6. CONSTRUCTION PERIOD AND SITE ACCESS The Building Official may impose conditions that address site work problems that include: a) Limiting all excavation and drainage installation to the dnier season, normally between May and the end of September, and, b) Sequencing activities, such as the installation of drainage systems, and, c) Securing the Building Official's approval before going onto a site with excavating, grading or clearing equipment to grade or to clear for any purpose, including the creation of access to the site, and, d) Requiring the geotechnical engineer to make a site inspection and submit a letter that states in her/his opinion all requirements of the geotechnical report can be met and that construction work may start. The City must concur with this decision. (ECDC 19.10.080 & 19.05.090) L;temp:bldgfhandout/Meadow/Md—checkjlgP,EV06/07/2005 Page 8 LOG ITEM# 57F RETURN ADDRESS: City of Edmonds, City Clerk 121 5th Avenue North Edmonds, WA 98020 CONFORS COPY 2006W70070 6 PGS ji1j712006 9:09am 3710 SNOgjs� cou__ COVENANT OF NOTIFICATION AND INDEMNIFICATION/HOLD HARMLESS Reference #: "S' Grantor(s): (1) C, VAC (2) J LX(160!2j� Additional on pg. Grantee(s): City of Edmonds Legal Description (abbreviated): Sec__5 Twn __��Rng_y _Qtr,,50 OR Lot —Block Plat— V,5 Assessor's Tax Parcel ID#(s): (1) QS31 -OW-02-14-62- (2) Assessor's Tax Parcel ED# not yet assigned CITY OF EDMONDS APPROVED FOR RECORDING DATE: PAGE j OF BY40L I /__ 4 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 ONVNERS of property do hereby covenant, stipulate and promise as follows: LOG ITEM# "BP V 0 P Y-W A6 I 1. Description of Suboect Property. This covenant of notification and indemnification./hold harmless relates to a tract of land at the street address of 15W-9 -7 �54'-V I - W - Wmo M5, WA- 9W . (insert street address), Edmonds Snohomish County, Washington and legally described as: Parcel Legal Description MEADOWDALE BEACH BLK 000 D-02 TH PTN LOT 24 PLAT OF MAEDOVADALE BEACH & LOT 25 PLAT OF MAEDOWDALE BEACH SUPPLEMENTAL PLAT DAF: COM AT CONC MON IN STEEL CASE AT INT 158TH ST SW & 75TH AVE W TH NO2*48 17E ALG C/L 75TH AVE W 389.15FT TH N87*48 41E 30.12FT TO E LN IOFT STRIP OF LAND DEEDED TO CITY OF EDM VOL 5 OF DEEDS PG 53 REC SD CO & POB TH NO2*48 17E 10.256FT TO S LN SD LOT 24 TH N88*09 43W ALG SD S LN 10FT TO SW COR SD LOT 24 TH NOO*39 53W ALG W LN SD LOT 24 82FT TH S88*09 43E PLW S LN SD LOT 24 120FT TH SOO*39 53E PLW W IN SD LOT 24 49.80FT TH N88*09 43W 18-38FT TH SOO*39 53E 32.20FT TO S LN SD LOT 24 TH N88*09 43W ALG SD IN 20FT TH S76*23 13W 25.50FT TH S87*38 41W 47.34FT TO POB PERCITY OF EDM BLA NO S-3-91 REC AF NO 9105020156 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 the risks associated with development are contained in building permit file number 05 - 1_7 7 .(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 LOG ITEM# APPROVED FOR R.ECORDTNG: DAT PAGE 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 Building Department, City of Edmonds, 121 5th Avenue North, 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 arising from and out of such development. In addition, the OWNERS on behalf of themselves, their succe ssors 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 LOG ITEM# _�a APPROYED, FOR RECORDING: DATE: '*q& PAGE :�/ OF 4:g2 I arising out of any false, misleading, or inaccurate information provided by th 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/has not (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: 5. Covenant to Touch and Concern the Land. This covenant of notification and indemnificationthold 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 intere sts 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. 1� /� LOG ITEM c,;—U APPRQVED, FOR RECORDING: BY: AW DATF/OW PAGE 0 F DONE this day of OWNER(S) E ly: 'Cl By: By STATE OF WASHINGTON COUNTY OF,5R0h0M �5h ss: I certify that I know or have satisfactory evidence that—uA Lo- and, u- t (-'a n ri 29-2d - signed this instru'ment and acknowledged it to be (4is/her) free and voluntary' act for the purposes mentioned in this instrument. DATED this day of L:\TEMPXBUILDING\MEADOVACOVENANT arch 41, My commissi6n expires: (D I -1 0-0-1 4 co---,s N �4 '0 �S%0 N 4�q� '0 140-WASY LEO LOG ITEM # cg�q— 4 4 EXHIBIT "A" LEGAL DESCRIPTION That portion of Lot 24, PLAT OF MEADOWDALE BEACH, according to the plat thereof recorded in Volume 5 of Plats, page 38, and Lot 25, PLAT OF MEADOWDALE BEACH SUPPLEMENTAL PLAT, according to the plat thereof recorded in Volume 5 of Plats, page 42, records of Snohomish County, Washington, described as follows: Commencing at a concrete monument in steel case at the intersection of 158tb Street Southwest and 75dAvenue West; thence North 2*48'17" East along the centerline of 75d' Avenue West 389.15 feet; thence North 87*48'41" East 30.12 feet to the East line of a 10.00 foot strip of land Deeded to the City of Edmonds in Volume 5 of Deeds, page 53, records of said County, and the point of beginning; thence North 2*48'17" East 10.256 feet to the South line of said Lot 24; thence North 88*09'43" West along said South line 10.00 feet to the Southwest comer of said Lot 24; thence North 0*39'53" West along the West line of said Lot 24 82.00 feet; thence South 88*09'43" East parallel with the South line of said Lot 24 120.00 feet; thence South 0*39'53" East parallel with the west line of said Lot 24 49.80 feet; thence North 88*09'43" West 18.38 feet; thence South 0*39'53" East 32.20 feet to the South line of said Lot 24; thence North 88*09'43" West along said line 20.00 feet; thence South 76*23'13" West 25.50 feet; thence South 87*38'41" West 47.34 to the point of beginning. 005131-000-024-02 15625 75' PL W; EDMONDS, WA 980264520 20052901814460 26522980/f LOG ITEM MICROFILM RETURN ADDRESS: City of Edmonds, City Clerk 121 5th Avenue North Edmonds, WA 98020 CONFORg CON 20061J170079 6 PGS 111012W 9:09ap J37-N SWOMIN COUP, COVENANT OF NOTIFICATION AND INDEMNIFICATION/HOLD HARMLESS Reference #: Cg "ede544/ Grantor(s): (1) V=M tC, VALI (2) J U41 160r) )?,64A Additional on pg. Grantee(s): City f Edmonds j Legal Description (abbreviated): Sec__5_TWn_49j__Rng Qtr,5&) OR Lot —Block Plat V15 Assessor's Tax Parcel 1109(s): (1) 00,51311 -00-Ob-14-62- (2) —Assessor's Tax Parcel 1D# not yet assigned CITY OF EDMONDS APPROVED FOR RECORDING BY40-1- DATE: A# PAGE T OF Mond Under the review procedures established pursuant to the State Building Code, incorporating amendments promulgated by the City of Edmonds, and as a ite to the issuance of a building permit for the construction.of a residential prerequis structure and attendant facilities, the undersigned OWNERS o Uproperty do hereby. covenant, stipulate and promise as follows: APPRQ [NG: 0 FOR RECO DATE7q, PAGE_ �Q OF ROO 1. Description of Sub4ect PropertV. This covenant of notification and indemnification/hold harmless relates to a tract of land at the street address of 1562-9 -7 W- W-MeJ5, WA- 9W Z(� (insert street address), Edmonds Snohomish County, Washington and legally described as: Parcel Legai Description MEADOWDALE BEACH BLK 000 D-02 TH PTN LOT 24 PLAT OF MAEDOWDALE BEACH & LOT 25 PLAT OF MAEDOWDALE BEACH SUPPLEMENTAL PLAT DAF- COM AT CONC MON IN STEEL CASE AT INT 158TH ST SW & 75TH AVE W TH NO2*48 17E ALG C/L 75TH AVE W 389.15FT TH N87*48 4 1 E 30-12FT TO E LN 10FT STRIP OF LAND DEEDED TO CITY OF EDM VOL 5 OF DEEDS PG 53 REC SD CO & POB TH NO2*48 17E 10.256FT TO S LN SD LOT 24 TH N88*09 43W ALG SD S LN 10FT TO SW COR SD LOT 24 TH NOO*39 53W ALG W LN SD LOT 24 82FT TH S88*09 43E PLW S LN SD LOT 24 120FT TH SOO*39 53E PLW W LN SD LOT 24 49.80FT TH N88*09 43W 18.38FT TH SOO*39 53E 32.20FT TO S LN SD LOT 24 TH N8,8*09 43W ALG SD LN 20FT TH S76*23 13W 25-50FT TH S87*38 41W 47.34FT TO POB PERCITY OF EDM BLA NO S-3-9 t REC AF NO 9105020156 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 the risks associated with development are contained in building permit file number o 7 7 .(insert number) on tile with the City of Edmonds Building Department. Conditions, limitations, or prohibitions, on .development may have been imposed in accordance with the recommendations of V E D APPRO FOR RECORD[NG: B EY: DATE:&&�W/ PAGE OF the consultants in the course of permit issuance. The conditions, limitations, or prohibitions may require ougoiug 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 Building Department, City of Edmonds, 121 5th Avenue North, 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 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 indemni(y and hold harmless the City of Edmonds, its officers, agents and employees from any toss, claim, liability or damage of any kind or nature to persons or prop erty 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 APPROVED FOR RECORDING: BY: Wwf� DATE: PAGE :�/ OF I 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 has1has not (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: S. 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 andlor 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. ma appear. This provision shall y 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. APPRQVEQ FOR RECORD[NG: BY: - AW DATF/�� PAGE 0 F Z/a I DONE this day of 6dal OWNER(S) By: By: By STATE OF WASHINGTON COUNTY OF ss: -1 certify that I know or have satisfactory evidence thatwu— an& \J(,Ltt,O-nyl 2(2� signed this instrument and acknowledged it to be (4is/her) free and voluntary act for the purposes mentioned in this instrument. DATED this - 01 day of My commissi6n expires: L:\TEMP\BUtLDING�MEADOVACOVENANT (01-10-07 3. C An EXHIBIT "A" LEGAL DESCRIPTION That portion of Lot 24, PLAT OF MEADOIAMALE BEACH, according to the plat thereof recorded in Volume 5 of Plats, page 38, and Lot 25, PLAT OF MEADOWDALE BEACH SUPPLEMENTAL PLAT, according to the plat thereof recorded in Volume 5 of Plats, page 42, records of Snohomish County, Washington, described as follows: Commencing at a concrete monument in steel case at the intersection of 158th Street Southwest and 75h Avenue West; thence North 2*48'17" East along the centerline of 75,h Avenue West 389.15 feet; thence North 87*48'41" East 30.12 feet to the East line of a 10.00 foot strip of land Deeded to the City of Edmonds in Volume 5 of Deeds, page 53, records of said County, and the point of beginning; thence North 2*48'17" East 10.256 feet to the South line of said Lot 24; thence North 88*09'43" West along said South line 10.00 feet to the Southwest comer of said Lot 24; thence North 0*39'53" West along the West line of said Lot 24 82.00 feet; thence South 88*09'43" Past parallel with the South line of said Lot 24 120.00 feet; thence South 0*39'53" East parallel with the west line of said Lot 24 49.80 feet; thence North 88*09'43" West 18.38 feet; thence South 0*39'53" East 32.20 feet to the South line of said Lot 24; thence North 88*09'43" West along said line 20.00 feet; thence South 76*23'13" West 25.50 feet; thence South 87*38'41" West 47.34 to the point of beginning. 005131-000-024-02 15625 75' PL W; EDMONDS, WA 98026-4520 20052901814460 26522980/f