Loading...
1014 C AVE.PDFIIIIIIIIIIIIII 10478 1014 C AVE CITY OF EDMONDS - SIDE SEWER PERMIT WATER ER DEPARTMENT PERMIT N rCall 776-1107 for side sewer inspections BEFORE covering any portion of the construction.) `Inspection will be provided within 24 hours, after request. NO Sat., Sun., or holiday inspections./ ADDRESS LOCATION OF CONSTRUCTION...........:............I-0.I4--- "��a9-.AvranliP PROPERTY LEGAL DESCRIPTION ..... A.,...-��2.-.of LO_t 2 B.Iock 2 YOst°S Pirs.t A.dd.ition to tdmonds • -- • ................. ........-............................................................................................... ..............•----.....---•--..............---....................--------..................------------...-------•----------...................--.......----................................................................---•--......................... ................................................................OWNER AND/OR BUILDER.. Pon F n� i pan ......................••-•-------------............................................................................ �TTRACTOR'S NAME & ADDRESS.AQf --_AK_1_-'n-isackho2•--Service.,...24006_..---92n�....Ave._.t,!.., Edmonds 98020 Permission is granted ... FeL a� �..12........................... 19.72.., for repair and/or connection of a side sewer to the city sanitary sewer systems in accordance with City of Edmonds ordinances. ATTENTION IS CALLED TO THE FOLLOWING: TE No. 1—The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct side sewer in street area. Do not cover any portion of sewer before it has been inspected. OTE No. 2—All work performed in city right-of-way requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office. NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit. NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property line and 12 inches inside property line; minimum grade of 2%. No bends in grade sharper than % will be permitted. .NOTE No. 5--Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper work which may develop within one year of completion. NOTE No. 6—It is unlawful to alter or do any other work than is provided. for in the permit, or to do any work on the main sewer or its appurtenances except to in- sert the pipe into the wye. DISAPPROVED❑ Date ... -................................... By...--- ......... Date .................................... By ................ Date ------------------------------------ By ---------------- APPROVEDDate.... ....................... By y.e� - �:rh.......------......----------..........-----...---..................... Remarks: ...................................................•----------.....-----------•---.....------------.......------...................................... BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection I, .....--•-------------------------------------- hereby certify that the .side sewer installation constructed under this permit (Owner of Contracting Firm Perfcrming Construction) was installed in accordance with all governing ordinances of the City of Edmonds. C� Dated this ...... ?�z .............day of .......... e'`-'............................................. 19?Z I J J Check BEFORE you dig for: Water ❑, Gas ❑, Telephone ❑, Power ❑, Sewer ❑, Other ❑ J V ADDRESS: l Dl / � A Ki!m it, - TAX ACCOUNT/PARCEL NUMBER: 0 b U' 9.40 (3 Z00 Z00 BUILDING PERMIT (NEW STRUCTURE): 11Z 60 o41 56 1 CRITICAL AREAS : DETERMINATION: ❑ Conditional Waiver ❑ Study Required ,® Waiver DISCRETIONARY PERMIT #'S: 19,06t-2,00.3 "" ll3 REV00-p 3 Z3-oS 9�" ZD. i'-6Cg- C " k {;jc, ck�ct'a Abu) DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR: PERMITS (OTHER): �" 1` 7 009 Z anuu� PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DATED: SEWER LID FEE $: LID #: SHORT PLAT FILE: / LOT: z BLOCK: a SIDE SEWER AS BUILT DATED: Z/Zg172, SIDE SEWER PERMIT(S) #: GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: FOR: WATER METER TAP CARD DATED: L:\TEMP\DST's\Forms\Street File Checklist.doc r- r/ Ca{�. !uy��..✓•. xt T i a t; r.. +t ; - l Y� e[7,.rIHrl*�+..,0�`alii..Fry�•/ .' t q -p L f 2tt� 7r ' r c. eDf�1r• 8{- c 1yn f .li t� ro [ o 'v c `1 ,.;-,�.>�.,.y.1,« t'e.:rsc3te7'dT•• --try1 + s. ;rYJ. .�., tr, y •SA Is y�+�s� b Sx 'r•F.•..�y�y:� ..,�b : 'tCsz. - ,o�,,,...e�+r,�w..� n 7. ,2Y.+-'T-''t.4Y"iY•+•.:' , ki j �^i•.L,J+ VO.: CN KRGLL YG9PERYIT" ) (�I r� TED MAP�'1 GJ (JV:1 �4) NV:dBER B,U•ILD1N!3 ,DEPIARrTMENT; APPUcantP9ll l � .� rt 'd� {`` 4 Inalde.Heav};Llnea ---------------- It �uDttEn6.. 1 b / ��- c? , r` NAME IORFf(AY.E OF, BU(IINE68)+- )y`I' SETBACK tcs,n, YARD BETHACh f � •�y �_'S ^ � j It +X - BIDE YARD SE BACK I -+TRE ^ ., j VL n ti A Q MAILING AD 48 LOT AREAr♦ T el, CC } USE zoNs / YES o pN� �, d0� �x� Vie, r p� TE 'PHONE NUMBER 5" tp I ' , y' CITY; / nn BUILDING AREA VARIANCE NUMBER•, 0. ':• h,, 4y+`ti c HEIGHT 4i'$,L°i'!.'� •. :AME PLOT PLAN APPROVED GGG _ 7 ,fir ••p1��1���„y�'\+>�'• l I fyi l ADDRESS = 8T17EET It �(QrT. DEFICIENCY TfPROPERTY Yt <• J�fl fb H t�� c �,++yiy #ad- £ II EXI9TTNG STREET It •Y i' J 'Ii LEPI[ONE I.y .5 C CITY COMP. PLAN ST. R/V.�.tDvr-+' - '.O..FT. i < HEMAItx6 Drivc'.ray slopes not to exceed those ';' NAME _rdi c ated on S [and td Draains �r103 — yjl� — o D ' x 4� :✓ K nt U TELEPHONE NUMBER ' C CITY - 1L,ff,,�"44 I' METER ..... 617.E I CLEARANCE .I CH ED• Y�t � �/ > - • rOj CITY LICENSE NUMBER Ie'w•-` STATE LICENSE NUMBERR _ _ _ 1.'�/+,,,�4,�p �] I y S al 7 �tnch Fou, C.Pill. t Le/Agn't Ue�ac/+iD�ttJlon�o[ i,ropertY /(Show Below.or ;. ` Dg ^r`"; h's•,y55, TYPE CONNECTION Y IF Y (,tj1� T �.yh 5�,� ShY:'.,+�•y�v n l� - {,p F��I )F�,3 C�raaz f4t T'P• I LL 4 i ( �•-. / r . �� PF%HC. TEST I YER I'll UbIP-It - j R'orty r 4L'J--LC CUL- STREET IMPROVED O _ FIRE ZONE i TYYL OF CONSTRUCTION I m [3 YEa .ONO I I SPECIAL I-'18PECTOR REQUIRED OCI.UPANCY OROLP ( �_t q•s'�I y�� dt yff2:,J. I5S� Ott h �YE7 ONUAS I V 1 RE9IDF.NTIAL n 7.LV E PL.AN 1,ffZ %KED BY. •� Pr i� CITY OF EDh,10NJS. !.f'•^Ptf_ S tL S. t tt+Yk�t T' �Yrc NEw r� ❑ TJ6 �i� k'��� r ' NON•RE9IDENTIAI: BIG+. _ RFMARX6 UL UCI 1 r�)3 ,t "9+(i M1a^ ADD RETAINING .J. `I�s ,�: ktrrr 'Sr•. St4 ❑ WALL 7j C - ❑ DEMOLISH ❑ ❑ FENCE ` AT, ' ❑ EXCAVATE ' OR FILL (..........x_.. .... , ,[ t t Y ❑ 1 —i PRE -MOVE ❑ awlM _ r j}� a x" ' lr�: REPAIR L'sp,) 41--oll-I .: `IMBER OF� DV.'v,LLING uNITeNo., iF <nl x . Valuation Fee '� �� Receipt No NA'rURK.TO BE DONE _ - h� Q t,t.i • �••'LS P[nn 7,ock No........_.. • . .+ Y� c•`: 4 BUILDING '�i£. qt•e ti o �t , r 4pYtr �I PROP09EU UBE PLUMBING +1 I HEAT d< GAS LINE buttln ' at: cete) PLOT PLAT: rIac::e[C BufId1�6jj rDn< B 1 FENCE '—_`•` RETAINING WALL SWIMMING POOL DEMOLITION __ A IJ -� Y PRE -MOVE INSPECTION / EXCAVATION OR FILL 7-7 _. V P F O ` s^' —�•� TOTAL. AMOUNT DIIE I ,H I hCMb7 acknowled Se that I beve reed thl. aDDlleatlon: ICat the fL• - - . f - }1 :F y formation given 1. co _t; and that I ►m the owner, or the duly author- ' i:ea agent of th< owner. I ngna to comply with City .nd .t.te i.w. nrn• ATTLNTIox APPLICATION APPROVAL x, toting a•rrtN<tlun: a+.d m doing the work 6uth0rlasd thenDy, no pn'.nn ollcatlon is not a permit tUltL r 't t 'Y• ^ r w "' will be employes[ In violation of the Labor Code of the Slate of Wmh:n,rlmCylBHUEItIT ZRdS 8P. ralntm[ to workmen•. Compensation Imurunee. ZES signed by the Building. Off or -his Dep s}��� o.'vI.Y •It¢ uty; and fees are pald,' and'recl 18 ac f x•F,�t1701 NOTE: Permit Limit one Year (Except DF.MOLITIOY9 whleh WORK NOTE D f lm.owledged in space prow dad }+t , .hell he completed In ninety days: MOVE D-LY BIIILDL'709 hall De com• pitted In six month,.) INSPECTION DIRECTOR'S NATU fl r {' Ui AGENT) DATE SIGNED �+ Y Y• �yl`l� SIGN URE (OR'NE i DEPARTMENT CD CITY OF > I �t y 1 EDISONDS /�, 1 Y. }-ei} jT�r i zlt� NOTE,: Applicant ubject io Plan Check Fee PR a uo Tma Prrtnit <otcn work to be done on Drivato property ONLY. FILE y T• ��. n f 1'. ,� y •! Aay eon.truetlun on the public domain (etrr0., .Idewalk., driveway.. 1 CIS, ,1:•ti4• }'ham .. �'., mnreaue, ete.) ii ream_ .epernte DUmt.elm. . z CITY OF EDMONDS 121 5TH AVENUE NORTH_ • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771-0221 ' Website: wwwo.edmondsma.us GARY HAAKENSON MAYOR DEVELOPMENT SERVICES DEPARTMENT , !nC` 18o�v.r..,_ . Planning".• Bil uding `Engineering " _::. __.....,..... _. �.,..,._ June 11, 2003 - k: Billie B. Stensom 1014 C Avenue Edmonds, WA 98020-3904 Subject: Determination regarding Critical Areas Checklist: CA-03-85 ' Dear Applicant: Enclosed please find a copy of the Critical Areas Checklist you submitted. - SiFtEE7 FILE The 'DETERMINATION" reached by the City is located on the reverse side of the form (bottom of page). IT IS VERY IMPORTANT FOR YOU TO RETAIN A COPY OF THIS CRITICAL AREAS "DETERMINATION" FOR YOUR RECORDS. Please examine this Determination for additional requirements. You may need to submit additional information such as an Environmental Checklist or Critical Areas Study. The Determination for the Critical Areas Checklist you submitted is a site -specific determination, not a project -specific determination: YOU MUST SUBMIT A COPY OF THE CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL PERMIT APLICATIONS OR YOUR APPLICATION WILL NOT BE PROCESSED. Permit applications include the following: Building Permits Conditional Use Permits Subdivisions Variances Applications to the ADB* Land Use Applications Any other development permit applications. RECEIVED Thank you, JUL - 3 `,1d3 Planning Secretary _ PERMIT COUNTER .CC F. Lee Stensom--" -, 'Architectural Design"_Board. Enclosure, " D:mydocuments/spellinan/CACLletter.doc L:temp/jana/CACLletter.doc • Incorporated August 11, 1890 • Sister City - Hekinan, Japan The Critical Areas Checklist contained, on this, form is- to.. A, -property, owner, or, his/her authorizedrepresentative, be filled out by any person preparing a Development .-must, fill out the checklist, sign+and.date it,, and submit it Permit Application' for. the City of -Edmonds prior to- to -the City. -The City will review the checklist, make a his/her submittal of the application to the City. ,_precursory. site' visit, - and rnak& a determimiiori -of the subsequent steps necessary to complete a development The purpose of the Checklist is to enable . City staff to,, _ n , < determine whether any potential Critical Areas are, or Permrt-application. may be, present on the subject property. -The information'' Please 'submit a vicinity map, along with' the signed copy needed to complete the Checklist should be easily of this form'to assist City staff in finding and locating the available from observations of -the site or, data, available at specific piece -of; ,property_ described -'on this form. In City Hall (Critical areas inventories, maps, or soil addition, the applicant shall include other pertinent surveys). information (e.g. site plan, topography map, etc.) or studies in conjunction with this'Checklist'to!assistant staff in completing, their preliminary assessment of the site. The undersigned applicant, and his/her/its heirs, and assigns, -in consideration on the processing of the application agrees to release, indemnify, defend and hold. the City of Edmonds harmless from any ;and ,all damages, including reasonable attorneys fees, arising from any action or infraction based in whole or part upon false, misleading; inaccurate or incomplete information furnished by the applicant, his/her/iis agents or employees. By my signature, I certify that the information and exhibits herewith submitted are true and convect to the best of my knowledge and that I am authorized to filethisapplication on the behalf of the owner as listed below. SIGNATURE OF APPLICANVAGEM,N _ DATE 61103 Property Owner's Authorization By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use! application, and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property �for the purposes of inspection and posting attendant to this appl' ation. SIGNATURE OF OWNER DATE 4/lO le 3 Owner/Applicant: S Teti SO" AgIA41A a Name /O/Z/ e AVE. 6-&7— Street Address ,� ,o M o -V,Os 6VA- 9 reo?G - S 9oy City State Zip Telephone: 4V ` = 7 74 - < 7 7 51 Email address (optional): /V IA. Critical Areas Checklist.doc/4.4.2003 Applicant Representative: Name vo VAAIur;, V145W - /92 S. Street Address DES- City State Zip Telephone: A04 - F2y- 3 9 3y Email Address (optional)'. /-"4-F_E-STEA1J o u • • v Critical Areas Checklist CA�File No: Site Informatim(soils/topq' 'aphy/hydrology/vegetation)` 1. Site. Address/Location: /0./y • ,0--.. 2. Property Tax,A (count Number, _44:6 4 9 y e.0 4 0 6:1? 00 I. Appimdrnat 6' i:Ie'Size �(aeres or square feet): 71 yO 4. Is this site currently developed? eyes; no. If yes; how is° site' developed? ` P S lk 4 4 F f oiN i r y A40mlx� cu�G,va d G S. Describe .the;general site topography. Check all that apply. Flat: less than 5-feet elevation change over entire site. Rolling: slopes on site generally, G less than 15 %. (a vertical rise of 10-feet over a horizontal distance of,66-feet). . Hilly: slopes present'ori-site of more than 15% and less than 30% ( a vertical rise of 10-feet over a horizontal distance of 33 to 66-feet). . Steep: grades, of greater than. 30% present on site (a vertical rise of 10-feet over'a horizontal distance of less than 33-feet). Other (please describe): 6. Site contains areas of year-round standing water: ' ' Al 0 : Approx. Depth: 7. Site contains areas of seasonal standingswater: A10 :: ; Approx. Depth: What season(s) of the.year? . 8. Site is in the floodway floodplain __� r� of a water course. 9. Site coritains_a.creekror an; area where_water..flows across -the grounds surface? Flows are year-round? Flows are seasonal? (What time of year? ). 10. Site is 1primarily: forested I ; meadow ' . ! ; shrubs ; mixed urbanrL- ndscaped (,lawn shrubs$Lik)! ` JX ,4i4uly 11. Obvious wetland is vresent on site: Ott A _ For. -City., Staff Use Only � 53 1. ( Plaii'Ctieck Nuiibe% if applicable? : i , ' 2. Site is .Zoned? 2 b +(fl < . 3. SCS niapped soil type(s)?, S7 r"Y'-,=Z-8`�z 1 4. Critical Areas.inventory,or C.A. map indic ktes,C;ritical Area on site? !J� 5. Site within designated earth subsid_ ence,landslide hazard area? _ N� f y DETERMINATION c r y STUDY REQUIRED -,WAVER Reviewed by:_ _ _ Date: (o A a 103 Critical Areas Checklistdod3.19.2001 PLANNING DATA SITE ADDRESS: PROJECT DESC REDUCED SITE PLAN PROVIDED?: es No MAP PAGE: 1 �3 CORNER LOT: es / o FLAG LOT: Yes / o ZONING: 'W-5-(P CRITICAL AREAS DETERMINATION #: 03-199— Study Required: giver ❑ Conditional Waiver SEPA DETERMINATION: ❑ Fee ❑ Checklist ❑ APO list w/ notarized form ❑ (N eded for 500 cubic yards of grading, Shoreline Area. site within 200 ft. of Puget Sound or Lake Ballinger) Exempt SETBACKS: Required Setbacks: , Of Street: Left Side: c Right Side: Rear: 5 Actual Setbacks: Street:_.7Left Side:_!57 Right Side: S / Rear: Street map checked for additional setback required? (Yes / No / DNA) *,DETACHED STRUCTURES: . ❑ ROCKERIES: ❑ FENCES/TRELLISES: S ❑ BAY WINDOWS / PROJECTING MODULATION: 3. ❑ STAIRS / DECKS: PARKING:. Required: Actual: LOT AREA: C6fi G"L%/ LOT COVE Calculations: '3 7 0 1 `i BUILDING HEIGHT: Datum Poir Maximum Elevation: JG Height: 3. Z�, �G q -7 UBDIVISION�. r- LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: Yes o OTHER: 3. -7V NewBPP1anningDataFormDOC The City of Edmonds APPLICATION for SIDE SEWER PERMIT EASEMENT No .............................. ,lo7 - NEW CONSTRUCTION Er- REPAIRS 0 4 SD Tq� . ... CONTRACTOR IV.jaq�Alzf� V. OWNER ... ...... ................................... ADDRESS ......... 1004* ........... c ......................................................................... LEGAL DESCRIPTION: LOT No. .............................................. BLOCK No .............. ro -7 .11 VA a F A 6 —1 ;z r ,, i3lock .2, yos7`s �:, *s7' 9dol, NAMEOF ADDITION :7a ...................................................................................................... uj ..I U. 0 It Approved: DATE ..--2 ........ ....... 00 Ihc.1890 CITY OF EDMONDS STbEET FILE GARY HAAKENSON MAYOR 121 5TH AVENUE NORTH • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771-0221 Website: www.d.edmonds.wa.us DEVELOPMENT SERVICES DEPARTMENT Planning • Building • Engineering March 23, 2005 Mr. F. Lee Stenson F. Lee Stenson Construction, Inc. 1801 South 93`d Street, C-27 Seattle, WA 98108 Dear Mr. Stenson: This is to inform you that, pursuant to your request, we are revoking the approval previously granted for an accessory dwelling unit (ADU) at 1014 "C" Avenue South, in Edmonds. The approval was granted on November 3, 2003, under file #ADU-2003-113. We understand that you are the legal representative for the property owner and that you are authorized to make this request. Unfortunately, since the permit review was previously completed and the permit issued, there can be no refund of fees paid related to the ADU permit. Also, please be informed that any future approval for an ADU at..this site will necessitate a new application and review by the City, and will be subject to the rules and codes in effect at the time of application. Please feel free to contact us if you require any additional assistance. Sincerely, obert Chave,` AICP Planning Manager • Incorporated August 11, 1890 • STRFJT FILE CITY OF EDMONDS GARY HAAKENSO MAYOR 121 5TH AVENUE NORTH • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 77 1 -0221 Websiie: wwwdedmonds.wa.us DEVELOPMENT SERVICES DEPARTMENT Planning • Building • Engineering Mr. F. Lee Stenson March 23, 2005 F. Lee Stenson Construction, Inc. 1801 South 93`d Street, C-27 Seattle, Washington 98108 RE: '1014 C Avenue South, Edmonds, WA Dear Mr. Stenson: The City is in receipt of your letter dated March 16, 2005 regarding the home your Mother owns at 1014 C Avenue South in Edmonds. You have indicated to City Officials that you are the legal representative of your Mother's property in this matter and have the authority to request that the Planning discretionary Accessory Dwelling Unit permit approval be revoked and that the compliance building permit application be revoked. You have also requested that any fees paid to date be refunded. Enclosed is a letter from the City Planning Manager revoking Accessory Dwelling Unit permit #ADU-2003-113. In prior communications with the City you have attested that the original ADU was created in 1972 as part of the original building construction. You have also informed the City that the ADU is completely separate from the main dwelling unit and contains all. required rooms, including a kitchen area that, under the building code, constitutes a separate dwelling unit. In order to avoid removing the kitchen facilities and separation between units, the,City shall require that the enclosed ADU covenant be executed by the owner of the property or duly authorized agent. This covenant indicates that the property owner understands that in order to rent the ADU portion of the home to someone unrelated to the property owner, a Planning ADU permit and Building compliance permit is required from the City. Be advised, the zoning code allows family members to live together without special regulation (even if a portion of the home is separated as an ADU); however, when a portion of the home is rented to non -family member(s) the zoning code requires the discretionary ADU permit and the building code requires a compliance permit. Please return the executed (signed and notarized) covenant to my office by April 18, 2005. Regarding your request for refunds, because work on the Planning ADU permit has long concluded no refund in any amount is. possible. However, since the building compliance permit has not yet been issued, inspection and City surcharge fees in the amount of $115.00 are available for refund --minus the required recording fee for the covenant. My office will request a refund in the amount of $90.00 ($115 inspection and surcharge fees minus the $25 recording fee = $90) from our Finance Department which will be mailed separately. Sincerely, Jeannine L. Graf Building Official Cc: Billie Stenson, Property Owner Incorporated August 11, 1890 Sister City - Hekinan, Japan Inc. 1o11 • CITY OF EDMONDS f9 V SA9ET'__ L G ARY HAAKENSON MAYOR 121 5TH AVENUE NORTH • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771-0221 Website: wwwdedmonds.wa.us DEVELOPMENT SERVICES DEPARTMENT Planning • Building • Engineering Mr. F. Lee Stenson March 23, 2005 F. Lee Stenson Construction, Inc. 1801 South 93`d Street, C-27 Seattle, Washington 98108 RE: 1014 C Avenue South, Edmonds,, WA Dear Mr. Stenson: The City is in receipt of your letter dated March 16, 2005 regarding the home your Mother owns at 1014 C Avenue South in Edmonds. You have indicated to City Officials that you are the legal representative 'of your Mother's property in this matter and have the authority to request that the Planning discretionary Accessory Dwelling Unit permit approval be revoked and that the compliance building.permit application be revoked. You have also requested that any fees paid to date be refunded. Enclosed is a letter from the City Planning Manager revoking Accessory Dwelling Unit permit #ADU-2003-113. In prior communications with the City you have attested that the original ADU was created in 1972 as part of the original building construction. You have also informed the City that the ADU is completely separate from the main dwelling unit and contains all required rooms; including a kitchen area that, under the building code, constitutes a separate dwelling unit. In order to avoid removing the kitchen facilities and separation between units, the City shall require that the enclosed ADU covenant be executed by the owner of.the property or duly authorized agent. This covenant indicates that the property owner understands that in order to rent the ADU portion of the home to someone unrelated to the property owner, a Planning ADU permit and Building compliance permit is required from the City. Be advised, the zoning code allows family members to live together without special regulation (even if a portion of the home is separated as an ADU); however, when a portion of the home is rented to non -family member(s) the zoning code requires the discretionary ADU permit and the building code requires a compliance permit. Please return the executed (signed and notarized) covenant to my office by April 18, 2005. Regarding your request for refunds, because work on the Planning ADU permit has long concluded no refund in any amount is possible. However, since the building compliance permit has not yet been issued, inspection and City surcharge fees in the amount of $115.00 are available for refund --minus the required recording fee for the covenant. My office will request a refund in the amount of $90.00 ($115 inspection and surcharge fees minus the $25 recording fee = $90) from our Finance Department which will be mailed separately. Sincerely, 61 Jeannine L. Graf Building Official Cc: Billie Stenson, Property Owner Incorporated August 11, 1890 Sister City - Hekinan, Japan -file. 18c10 • CITY OF EDMONDS 121 5TH AVENUE NORTH • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771-0221 Website: wwwxi.edmonds.wa.us DEVELOPMENT SERVICES DEPARTMENT Planning • Building • Engineering March 23, 2005 Mr. F. Lee Stenson F. Lee Stenson Construction, Inc. 1801 South 93`d Street, C-27 Seattle, WA 98108 . Dear Mr. Stenson: 'REFcTRY %� ewve FJLEON MAYOR This is to inform you that, pursuant to your request, we are revoking the approval previously granted for an accessory dwelling unit (ADU) at 1014 "C" Avenue South, in Edmonds. The approval was granted on November 3, 2003, under file #ADU-2003-113. We understand that you are the legal representative for the property owner and that you are authorized to make this request. Unfortunately, since the permit review was previously completed and the permit issued, there can be no refund of fees paid related to the ADU permit. Also, please be informed that any future approval for an ADU at this site will necessitate a new application and review by the City, and will be subject to the rules and codes in effect at the time of application. Please feel free to contact us if you require any additional assistance. Sincerely, u� Cam, obert Chave, AICP. Planning Manager • Incorporated August 11, 1890 • v� CITY OF EDMONDSj�j PLANNING DIVISION !� ACCESSORY DWELLING UNIT PERMIT FILE # ADU-2003-113 APPLICANT Billie Stenson represented by Lee Stenson PROPERTY LOCATION 1014 C Avenue PROJECT DESCRIPTION Accessory Dwelling Unit Permit A. INTRODUCTION: Mr. Lee Stenson has submitted for approval of the accessory dwelling unit under ECDC 20.21. The application must meet the criteria of ECDC 20.21.030. Refer to the analysis below. Note: All code sections referenced in this report can be viewed via the City's website www.ci.edmonds.wa.us. B. ANALYSIS: Section 20.21.030 of the Edmonds Community Development Code provides the criteria by which the Accessory Dwelling Units are to be reviewed. 1. Number of Accessory Dwelling Units: Maximum: 1 Accessory Dwelling Unit Proposed: 1 Accessory Dwelling Unit Size: Maximum Proposed 40% of livable area of the primary dwelling 38.6% 2 bedrooms 1 bedroom 800 sq. ft., or greater, if approved by the Planning 790 sq. ft. Manager, provided it does not exceed 50% of the livable area of the primary dwelling 3. Location and Appearance: The accessory dwelling unit will be located at the rear of the house. The residence should continue to appear as one single-family house from the street. 4. Parking: Required: 3 spaces Proposed: 3 spaces (2 spaces in garage, 1 tandem space in driveway) 5. Occupancy: The owner has signed a notarized affidavit stating she will occupy one of the units for a minimum of six months of the year. She also signed a covenant which will be recorded against the property, so that all future owners will know about the limitations associated with the proposed use. Refer to Attachments 7 and 8. 6. Safety, Light, and Ventilation: As a condition of approval, the applicants must meet receive a compliance permit from the City of Edmonds Building Division. C. PUBLIC COMMENTS 1. No comments were received. • . Stenson ADU File No. ADU-2003-113 D. DECISION: Approved with the following conditions: 1. This permit shall expire automatically if any of the following issues arise: a. The Accessory Dwelling unit is substantially altered and is thus no longer in conformance with the plans and drawings reviewed and approved by the permitting authority and building official. b. The subject site ceases to maintain the required number of parking spaces. c. The property owner ceases to reside in either the primary residence or the accessory dwelling unit or the current (or future) owner fails to file the affidavit required under ECDC 20.21.025.A.1. (see Attachment 4). 2. The Covenant regarding the Accessory Dwelling Unit must be recorded against the property in Snohomish County (see Attachment 5). 3. A building compliance permit and inspection through the City Building Division will be required prior to occupancy of the Accessory Dwelling Unit. 4. The Accessory Dwelling unit permit is transferable to new owners of the subject property unless there is a violation of any conditions of approval listed above. E. ATTACHMENTS: 1. Vicinity Map 2. Application 3. Site Plan 4. Elevation views 5. Floor Plan 6. Affidavit 7. Covenant I have reviewed the application for Compliance with Accessory Dwelling Units pursuant to Chapters 20.21 of the Edmonds Community Development Code. If no request for reconsideration or appeal is filed in a timely manner this Decision shall be come final September 17, 2003. Kathleen Taylp'r�ssociate Planner September 3, 2003 Request for Reconsideration Section 20.95.050.B.2. provides for Staff to reconsider his/her decision or recommendation if a written request for reconsideration is filed by the applicant within fourteen (14) working days of the date of the initial decision. The reconsideration request must cite specific references to the findings and/or the criteria contained in the ordinances governing the type of application being reviewed. Appeals Section 20.105.010.A describes how appeals of a Staff decision shall be made. The appeal shall be made in writing, and shall include the decision being appealed along with the name of the project applicant and the date of the decision, the name and address of the individual or group appealing the decision, their interest in the matter, and reasons why the appellant believes the decision to be wrong. The appeal must be filed with the Development Services Director within fourteen (14) calendar days after the date of the decision being appealed. Appeals are presented to the Hearing Examiner. Timeframes The time limits for Reconsiderations and Appeals run concurrently. If a request for reconsideration is filed before the time limit for filing an appeal has expired, the time "clock" for filing an appeal is Page 2 or 3 • • Stenson ADU File No. ADU-2003-113 stopped until a decision on the reconsideration request is completed. Once the staff has issued their decision on the reconsideration request, the time clock for filing an appeal continues from the point it was stopped. For example, if a reconsideration request were filed on day 5 of the appeal period, an individual would have 9 more days in which to file an appeal after the staff issues their decision on the reconsideration request. Parties of Record Billie Stenson Lee Stenson 1014 C Avenue 21300 Marine View Dr S Edmonds, WA 98020 Des Moines, WA 98198 Page 3 or 3 1 W 410 420 565531103851 5 8ksO H 'mV mma52mm° 5�3C9v"� o'i �m5m4o�6 dm..ua�o. i' � r_e 55 55450510m4m0i68 n :v:—mmoNi 54m456B41000�r932mm 7 o .wMo_mm. m'.o NwWno n^w Auwann`�Nn v mmme mom No$ Oa424 4437Bank 415mER:f 425 504 512 502 660 514 625 528 523 525 CED ST 538 1 57 820 e42G 612 537 mm ' : w'c�oomz a 51Nm5 810 703 705 619 - 817 0 m 608 614 ; 511 n m u� 56d ^ 616 m 703 700 W RUCE ST 839 �� 612 816 €� HOMELAND DR 706 707 m io > _0 716 ;:>. 801 B05 809 620 618 . y:g 910 ' gg 702 ^ o W" o $ 720 723 ^ 718 n �i o2 714 Q� 'Q609 0 : 726 727 629 710 709 - tD- 800 a c ti 721 T; 613 527 535 a m R v _ O 7,6 615 m 711 n N ,F else 617 521 539 'i' vmmi ^ N H $ 714 712 am m w 720 HEMLOCK ST m 73 30 6d3 716 801 829 .. 1821 o m O O o 0 602 m N H n O $ $ o m 806 u1 u1 N ^ m u1 'a g m BOB n a07 ^ n r 809 654 id m 642 830 J ' 631 814 812 LAUREL WAY eta 550 ..... 835 ,1651 515 N a boa 65908 m m 644 �' s Property Location �' m 6� s6,6 oo 5z0 53, 545 s49 656 m m, ise reMy 909 919 917 a am t 525 529 511 547 55a 916 90 10 14 C Avenue 912 � 505 9/B 515 527 N 'V' 811 921 m m m n 916 • m PINE ST ,o g ,0p1 520 -10,0 -Pine S# 3 '� �0 1005 722 74o 1002 816 MN 832 1010 loll 10,0 l006 1009 1020 Park 7015 1924 1015 1010 1005 525 1021 1023 1022 1021 1016 1015 1014 659 i/7 1030 y Co /021 1022 1023 1020 1013 FOR YTH LANE Q 1033 1034 > 1027 c > 1031 1030 W 102B lots W 1029 1028 to W m 11 1029 Q 1036 1034 Q 103t 1034 Q Q 1031 1038 0 c t 620 1040 �. 1037 1040 Q 1031 1048 toll 1040 m 1041 1036 1033 '034 U m 1035 c G tIX19 1044 7037 1050 1049 1048 10d9 1040 0a3 1045 1048 1067 510 i 1054 1 m O 10a1 m m 1 1041 1052 1044 c � m m B45 1053 10a2 0 1f03 1058 0 1061 825 1055 ,082 1083 7a5 809 1062 827 ip�r 1051 � 9e- Continental 535 r FIR ST loet RR PL 10 736 - 7113 io m m m m wg n� ^ _o o a 1105 ill 4 83g 1109 1O t171 1114 7113 708 Z e 1123 1121 1118 1121 ilia 0 1123 Laurel !� 1120 y 1121 710 ills 1124 1125 1136 112d 1122 1128 . W ELM WAY 551 1131 1124 1131 1136 1131 1122 < 1125 / 126 � 1125 IL g 553 573 1138 1137 ,130 114t t140 1137 1126 m 7137 11ffi 1133 1134 1132 F 1131 @ 901 '40 F m� 1142 1140 1151 1142 v% 4 u) 500 1143 1134 1150 1140 1181 1146 1141 W 1141 ELM WAY 1148 to W C7"" 1,3s C AVE 1 900 550 "`E�'� 1159 1103 1146 } Hghland Park n N o lid9 ,158 Q 631 839 = 1152 1153 ' m . 1161 Park 769 1149 7154 w 1157 1147 1160 a 700� 708<>iso _. lzol ets e29 W e41 701 1211 839 zzooa ,,1 0 1a1 62 � 709 715 ^ w ^ '206 823 835 WI `g 09 623 624 "N 1270 1221 c 2201d > 80 �� 622 a� 721 12/4 . ELM WAY::, 1219 w� ADU-03-113 Attachment 1 city of edmonds land use application 0 ARCHITECTURAL DESIGN REVIEW a , 0 COMPREHENSIVE PLAN AMENDMENT 0 CONDITIONAL USE PERMIT FILE # u U3 I I ZONE 0 HOME OCCUPATION DATE % Q�7 ( 0 ' FORMAL SUBDIVISION JZEC'DBY " 0 SHORT SUBDIVISION FEE RECEIPT # _ Zy zqz, 0 ' LOT LINE ADJUSTMENT HEARING DATE 0 PLANNED RESIDENTIAL DEVELOPMENT 0 OFFICIAL STREET MAP AMENDMENT 0 HE 0 STAFF APB 9 ADB 0 CC 0 STREET VACATION 0 REZONE 0 SHORELINE PERMIT Gf ! I Z7. _ 0 VARIANCE / REASONABLE USE EXCEPTION 0 OTHER: PROPERTY ADDRESS OR LOCATION //q / V C A VF PROJECT NAME (IF APPLICABLE) _._ 8/4 1. /FF PROPERTY OWNEROty PHONE #_W_,j - i74 — ADDRESS Ln/y E-MAIL ADDRESS FAX # TAX ACCOUNT # mot/ 002 06Z c'O ` SEC. TWP. RNG. DESCRIPTION OF PROJECT OR PROPOSED USE _ A,Q,q / rf 0 ALf /1 n �, m ' 6 y.-sri/N t /�rrus /sue) - i APPLICANT A/4L/-1C_ PHONE# �2f - 776_ 677f� ADDRESS 16/y e /LVF E-MAIL ADDRESS FAX # CONTACT PERSON/AGENT _ �� �S'TE,tI J.p a7 PHONE # _? ADDRESS .2/?L'>0 /1�/1/C�i✓>� /�i,� p S E-MAIL ADDRESS FAX # _2o6 �? �/• 3 9J'(--` The undersigned applicant, and his/ha/its heirs, and assigns, in consideration on the processing of the application agrees to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable attorney.'s fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or incomplete information furnished by the applicant, his/her/its agents or employees. By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my knowledge and that I am authorized to file this application on the behalf of the owner as listed below. . SIGNATURE OF APPLICANT/AGEN ` DATE Property. Owner's Authorization By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use application, and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the purposes of inspection spection and posting att ndant to this application. SIGNATURE OF OWNER DATE d r This application form was revised on 1/27/00. To verify.whether it is still current, call (425) 771-0220. L:\L1BRARY\PLANNMG\Forrw & HandoutsTublic HandoutAl-and Use Application.doc ADU=03-113. Attachment 2 ACCESSORY DWELLING UNIT COVENANT Property Address: / G / y Q & eG Edmonds, Washington Assessor's Parcel Number: G/Qy pp ,Qap1o� Legal Description: I, the undersigned, have attained approval for an accessory dwelling unit (ADU) at the property address above, in accordance with the provisions of Chapter 20.21 (Accessory Dwelling Units) of the Edmonds Community Development Code. I agree and understand that it is my responsibility to notify all future property owners or long- term lessors of the existence of the ADU and that its existence is predicated upon the occupancy of either the ADU or primary dwelling unit by the owner of the property. Additionally, I will notify all prospective buyers of the limitations on use and maintenance of the ADU. as stipulated in Chapter 20.21 (Accessory Dwelling Units) of the Edmonds Community Development Code. An example of the limitations of the ADU per Chapter 20.21 is the property owner. is required to reside in the primary or accessory dwelling unit for 6 months out of every year. , Finally, this covenant shall be recorded in order to notify all current and future property owners that if any conditions of the ADU approval are violated, the property owner will be required to remove all improvements which were added to convert the primary dwelling unit into anADU and restore the site to a single-family dwelling unit. / Property Owner Signature: Print Name: Property Owner Signature: jK ,Print Name: Date: 617 d 3 STATE OF WASHINGTON ) COUNTY OF SNOHOMISH ) I certify that I know or have satisfactory evidence that ?FA4 d_ -^r .v �Al signed this instrument and acknowledge it to be his/her free and voluntary act for the uses and purposes mentioned in this instrument. Notary's pressure seals must be smudged. Dated: to z, Signature of `A Notary Public: ;�, +,�Rr - Residing at: lrlli��/'!-ram My Appointment " 11 'Expires TIES DOCUMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR. i ADUcovenant,doc AD U — O 3 — 1 13 Attnt-hmPnt 7 i,. i..,ev`'v `-`J•t1iCF,:}.x+,-r �:" Lvir•�i•.v�`%H""t4:.t;.r'iF:-.�,Harti-�r1.w'^yri:. `^+�^PtVs`i�s"4, 41•-f�. �.�."i.-err-.-%sic irn xF,,:,,�,�r'.31:ty ur;.-y`s'vt�'('1?V, ys�/k•(�.�•.. 2n '..�-y,? City of Edmond* S I E F-WAY CONSTRUCTION. PERMIT Permit Number. e— O P li Issue Date: A. Address or Vicinity of Construction: 1014 C Ave ( 9508181 ) 18 B. Type of Work (be specific): Tnsxt al l Npw S arvi. e Gas 90 19 C. Contractor: Washington Natural Gas Co Contact: Frank Swan Mailing Address: 1122 75 St SW Everett Phone: 447-3284 State License #: 98203 Liability Insurance: Bond: $ D. Building Permit # (if applicable): Side Sewer Permit # (if applicable): E. ❑ Commercial ❑ Subdivision ❑ City Project [J Utility (PUD, GTE, WNG, CABLE, WATER) ❑ Multi -Family ❑ Single Family ❑ Other INSPECTOR: INSPECTOR: W �� tW ► l F. Pavement or Concrete Cut : ❑No G. Size of Cut: x . H. Charge $ 1 CILt' ) APPLICANT TO READ AND SIGN� Ly INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the Cit o%Edmonds harmless from injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of its departments or employees, including or not limited to the defense of any legal proceedings including defensecosf 81 and attorney fees by reason of gran'hngthis permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES.WI�L, BE HELD UNTH, THY FINAE STREET PATCH IS COMPLETED BY CITY FORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE, TO THE IePPL&ANT. Construction drawing of proposed work required with permit application. u, A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220. Work and material is to be inspected during progress and at completion. Restoration is to be in accordance with City Codes. Street shall be kept clean at all times. Traffic Control and Public Safety shall be in accordance with City'regulations as required by the City Engineer. All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day; NO EXCEPTIONS. I have read the abOve statements and understand thepermit requirements and the pink copy of thepermit will be available on site at all times-fQr inspection purposes. Signature: Z-- . • I - Date: 01-12-95 for r AW CALL DIAL -A -DIG PRIOR TO BEGINNING WORK L 1 FOR CITY USE ONLY , APPROVED Bl':"`1 ` W� RIGHT OF WAY DEPOSIT TIME AUTHORIZED: VOID AFTER: '! _ODAYS DISRUPTION FEE/FUND 111: SPECIAL.CONDITIONS: A I A- RESTORATION FEE: COMMENTS: PERMIT FEE:, TOTAL FEE: O ' 00 RECEIPT FEE: DATE: ISSUED BY:. NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE M oy� !yam fM A cVJdvxjtonEnergyCompary WNG to window Watermain depth t.t/4 Unknown gas main • r 4 Addendum to: City of Edmonds Right of Way Permit Application Submitted by: Mariamne Kingsbury Engineering Aide Washington Natural Gas 1356-7500 X7596 Rey: -W- -G- -SS- O Water Gas Sewer Water hydrant Water valve Washington Natural Gas Company 1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331 M ' M AvvWj i qon EnerWCar(ww WNG to window Vat ermain depth NIA Unknown -2" gas main u Addendum to: City of Edmonds Right of Way Permit Application Submitted by: Mariamne Kingsbury Engineering Aide Washington Natural Gas 1356-7500 X7596 D13 5O$1al 14- t✓ .A.V G OTT Key: -W- -G- -SS- O Water Gas Sever Water hydrant Water valve Washington Natural Gas Company 1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331 M ' M NaturQ `/ �M Ga AWalwgonEnergyComp" WNG to window Watermain depth nt/q Unknown _ ZZ gas main • Addendum to: City of Edmonds Right of Way Permit Application Submitted by: Mariamne Kingsbury Engineering Aide Washitpgton •Natural Gas 1356-1500 X7596 DFS SO$181 514- c-, AV Key: -W- -G- -SS- O Water Gas Sewer Water hydrant Water valve Washington Natural Gas Company 1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331 fi r 1990 el 1044- 1040 1029 li U s /1 .•y •4 O lz P�•W 692 - 440 52N' N �g c 9, 1 I P �1 , • .. 41k Ohb -169 N �D N ri 0t 01 � h f ' M 't)44- 1040 loze in N -J _ _ _G _ 1` T X1 l z Wk - "s 52WN tc)� 41 '50-31SN a z , :7 N IL 0 Ste Z ul 0ti r, 0) A. - ... ....... F 11 IR k LA N TI "I -%CAtos �ci r-,rtl,.S FL'-; N JS 103 < V ul 3 o 093 2* (� 'a _70.5 C4 S Z N ----4 Ul 1 N rl 1 I5�B 520' • I �... IL o NSte -516,N N 1 - I. 1 10313'N 199¢ N. � 5 l e' 243 N t1y i � 'lfi 2�.3•N - Q Ode N k so9 a- J - S Z N LIN tis F.IR) T 1 �,T i_ _.G• O . S 'f MCA d fV IV N ' N r, 093 Q I 2• 9 v _� r� p "ice o �tiOS I I N I 19� N Slta 1 1 094 N. 51o1963 - -- -- G 1 � � ifs 2v�j�n� • o I y�se N d � a 0 Q� k N C fIQ S 2 N to FIR T I _ 4� N 57 �1993 I � s I 2• 9 �_�CL - . 4 I p vi C • f STRE. T FILE CITY CLERK CITY OF EDMONDS CONFORMED COPY 121 5TH AVENUE NO. 200504270558 1 PG EDMONDS, WA 98020 04-27-2005 12:52pm $19.00 SNOHOMISH COUNTY, WASHINGTON STATEMENT ON ACCESSORY DWELLING UNITS Property Address: _ lj�914 C /g41e1Vu4:57 Edmonds, Washington Legal Description: �,--) /5T 14a) TZi Assessor's Parcel Number: 006l9400T,.002400 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 as defined in ECDC Section 21.05.015 is prohibited until an Accessory Dwelling Unit Permit is approved. I also understand that an Accessory Dwelling Unit 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 Accessory Dwelling Units. Property Owner Signature; ✓ ,j ��,� Property Owner Name (printed): Date: STATE OF WASHINGTON ) COUNTY OF SNOHOMISH) I certify that I know or have satisfactory evidence that P21L-t'a—�- 6 g I E �jS. d"() signed this instrument and acknowledge it to be his/her freeand voluntary act for the uses and purposes mentioned in this instrument. Notary's ,.R ,,au gals must be smudged. Dated: Signature of f% �;��5$1O^' F� • s' '�,�� Notary Public: o e;pr ;R;, �' •� ' % Residing at: v- (P: _ % My Appointment / '41',x • E 2n.G?, .••Gt0� Expires: THIS DOCUMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR. ADUstatement CITY CLERK{ CITY OF EDMONDS 121 5TH AVENUE NO. EDMONDS, WA 98020 SfHL­C";1'T FILE CONFORMED'COPY 200504270558 1 PG 04-27-2005 12:52pm $19.00 SNOHOMISH COUNTY, WASHINGTON STATEMENT ON ACCESSORY DWELLING UNITS Property Address: ! 9/4 6 Allelyme selil7-Al Edmonds, Washington Legal Description: �'`7J"--j %,5T l/b 72) a/1 olvy) 5 i51-x -UCH 4 P - U /V G Assessor's Parcel Number: 006l94602.0 200 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 as defined in ECDC Section 21.05.015 is prohibited until an Accessory Dwelling Unit Permit is approved. I also understand that an Accessory Dwelling Unit 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 Accessory Dwelling Units. Property Owner Signature: Property Owner Name (printed)::' Date: STATE OF WASHINGTON ) COUNTY OF SNOHOMISH) I certify that I know or have satisfactory evidence that P? / L4 1 ez" signed this instrument and acknowledge it to be his/her free and voluntary act for the uses and purposes mentioned in this instrument. Notary's,.R� i�Am gals must be smudged. Dated: S�,%E L G/e "it, Signature of es' Notary Public: Residing at: K `e ' �. cnr,:. �'ti:,`' : 02: My Appointment,//� yjfy�-O Expires: l l� ' THIS DOCUMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR. ADUstatement co O q-I . ......... 1� � W4 pat K - or WAL, 511-7 �;177 ISO mt , ol M, tjgm� V-f I-J-1 T-o 1/' 0 FMM I I I MO. M�WM&= I I I I M ------- ---- .......... tit a .... .. ..... -71 � 0510, MAN I ADU-03-113 Attachment 5