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950326.pdf/� � t'/-IC3Cc ✓[./14-I � ���tl�- '�Gc� �ru�.. ✓L�n��T ja � ,,(' �� CITY OF EDMONDS ZONE D PERMIT 4l/_ CONSTRUCTION PERMIT APPLICATION JOB NUMBER JJ IIw NF `R'`LNA M4 L /�NyA�MI: (?I' RUSINIISS ADDRESS / S / Slty K16 LEGAL DESCRIPTION CHECK SUBDIVISION NO LID N IZ MAILING ADIIRLSS 0 ( -5 60m) VnN5oac ADDRESS 193 LAye 5T .66. :ITY ZIP ILI 12KIA 1.1D WA 18033 t523 Z I CITY 'ItffiTT k FT ATE LICE NSF: NUMBER 01 Sr✓ I 7 Leqal Description of ELEPHONE NUMBER 67n L PUBLIC RIGHjLL OF WAY PER OFFICIAL STREET MAP A.IIIT �_— EXISTING _'II-�_- REOUIRED DEO CATIO0Y PROPOSED TESCP Apprgvgd ❑ RW Permll Fl g_.d Slreel Use Permll Req'd ❑ I"Pe'l— Regeved Sidewalk Required ❑ a Q 3 i METER SIZE LINE SIZE NO OF FIXTURES PRV REOUIREO YES ❑ NO ❑ nEMMKS //}/ rc /G ELEPHONE NUMBER Ss -6yoy E%PIRA TION DATE 3 -31 _1�(e SIGN AREA SEPI easements ALLOWED U/PROPOSED COMPLETE ,W ExP _ w SET BACKS/- FEET � ProPnrfy Ta%Account ..c' _ R �I©Ob� Parcel Cnt S I3ILy� V� ^ FRONT _IO�—AEAF REMARKS ❑ IIF�v RESIDENTIAL ❑ PLUMBING ❑ ANNI IION ❑ COMMERCIAL ❑ MECHANICAL RI:MOCEI ❑ APT BLDG. ❑ SIGN ❑ GRADING ❑ FENCE K I1 F.PAIR CYDs (_ _FT) ❑ OEMOI.I.SI1 ❑ INSERT TOVE ❑ HOT POOL SPA CHECKED BY TYPE OF CON RU SPECIAL INSPECTOR flEDUIRED AREA HEIGHT l0T OVERA E i 6 4 N o -' ❑GARAGE RETAINING WALL/ CAnPORr ❑ ROCKERY ❑ RENEWAL IJ YES REMARKS PROGRESS INSPECTIONS PER UBC 305 (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: 5�R NUMBFn OF 2 STORIES NUMBER OF DWELLING ' UNITS CnITICAL / AREAS ` NUMBER DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) P-eme-plgL P-CA1195 • /I+ rMCr_ WMODCt_ FINAL INSPECTION REQUIRED GO LLCM VALUATION PLAN CHECK FEE I 9 TIEAI SOUn�X GLAZING BUILDING 12. 3 % PLUMBING Plan Check No. Cam- MECHANICAL This Permit covers work to be done on private properly ONLY. GRADINGWILL Any construction on the public domain (curbs, sidewPlks, driveways, marquees, etc.) Will require separate permission. STATE SURCHARGE Penult Application: 180 Days Permit Limit: 1 Year - Provided Work is Started Within 180 Days STORM DRAINAGE FEE "Applicant, on behalf of his or her spouse, heirs, assigns and END. INSPECTION FEE W successors in interest, agrees to indemnify, defend and hold harmless the City of Edmonds, Washington, its officials, a employees, and agents from any and all claims for damages of a Whatever nature, arising directly or indirectly from the issuance T of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT 9 modify, waive or reduce any requirement of any city ordinance nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE provision." I hereby acknowledge that I have read this application; that the information given is correct; and that 1 am the owner, or the duly ATTENTION authorized agent of the owner. t agree to comply with city and slate laws regulating construction; and In doing the work authoriz- THIS PERMIT AUTHORIZES ed thereby, no person will be employed in violation of the Labor ONLY THE Code of the State of Washington relating to Workmen's Compensa- WORK NOTED lion Insurance and RCW 18.27. INSPECTION SIGN E IOWN AGENTI DATE SI NED DEPARTMENT ,� CITY OF EDMONDS ATTEN N CALL FOR INSPECTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771 - ^ OCCUPANT LOAD APPLICATION APPROVAL This application Is not a permit until signed by the Building Official or his/her Deputy; and fees are paid, and receipt is acknowledged In space provided. RELEASED V DATE O IG!L'AL -- FIe YELLOV.' -� I-Declor I;k� rl Ix C, CLERK - CITY'oF EDMONDS y` jet jr M1 SOS BELL STREET NOTIFICATION OF COVENANT 4U;i i 2 FS EDiv10ND5, WA 98020 INDEMNIFICATION & HOLD HARMLESS {'i';;mF�' Under the review procedures established pursuant to the State Building Code, incorporating 4 t by t r' i� �5ir!Ir 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 r e62;K , (3Q undersigned OWNERS of property do hereby covenant, stipulate and promise as follows: ccl c Y; t , ,t f.^ 1. Description of Subject Property This covenant of notification and indemnification/hold harmless relates to a tract of land at the street address of L nrA Edmonds, Snohomish County, Washington and legally described as J ititj JItd7 irt�, E;a 2. Notification and Covenant of Notification The above referenced site (hereinafter "subject�Y='�awz site") lies within an area which has been identified by the City of Edmonds as having a potential 1. 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 report and 4�� =�T3t :rid``;a •? evaluations 7o�f_the risks associated'with development are contained in building permit file number 9���3 Zlo on file with the City of Edmonds Building Division. 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' CITY -COPY L•temp:foruis:mdcov.doc:2/95 r-I va. 3053PAGE14(73 t y, �...... ... 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 Division, City of Edmonds, 250 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 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/has not 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/time period) I:temp:fonns:mdcov.doc:2/95 2 9F)f 75) 7 0 (1 R VOL. 3053PAGE1174 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 _ C w day o 199 OWNERS) l By: _ By: By: STATE OF WASHINGTON ) COUNTY OF .ss) I certify that I know or have` satisfactory evidence that %4,, m K JOQ/(\ signed this inshvmern'and acknowledged it to be (his/her) free and voluntary act for the purposes mentioned i this instrument.` DATED this day of 19?�j7 OT Y PUBLIC / y commission expires: l9_Ci� STATE OF WASHINGTON) L` ss) COUNTY OF ) I certify that I know or have satisfactory evidence that signed this instrument and acknowledged it to be (Iris/her) free and voluntary act for the purposes mentioned in this instrument. DATED this day of 19 NOTARY PUBLIC My commission expires: l:temp:forms: mdcov.doc:2/95 2 r N i VOL. 3 O 5 3 PAGE 1 d I V t r Z'kil I ` Mier LEGAL DESCRIPTION MILLS LOTS 9, 10 AND THE SOUTH HALF OF LOT 8, BLOCK 58, MEADOWDALE BEACH, AS PER PLAT RECORDED IN VOLUME 5OFPLATS, PAGE38, RECORDS OFSNOHOMISH COUNTY, WASHINGTON, EXCEPT THAT PORTION THEREOF CONVEYED TO THE CITY OF EDMONDS FOR 751h PLACE W. BY DEED RECORDED UNDER RECORDING NO.9010110126 TOGETHER WITH THAT PORTIONOF THE WEST HALFOFVACATED 74th PLACE W. ABUTTING SAIDLOTS 9, IO AND THE SOUTH HALFOF LOTS AS PER SAID DEED RECORDED UNDER RECORDING N0.9010110126 ALSO, TOGETHER WITHTHAT PORTION OF THE WEST 11 FEET OF THE EAST HALF OFSAID VACATED 74th PLACE W. LYING BETWEENTHE EASTERLY PROLONGATION OF THE NORTH LINE OFSAID SOUTH HALF OFLOT8 AND THE SOUTH LINE OF SAID LOT 10 AS PER DEED RECORDED UNDER RECORDING NO.9010120365. MILLER LOT 11, BLOCK 58, MEADOWDALE BEACH, AS PER PLAT RECORDED INVOLUME 5 OF PLATS, PAGE38, RECORDS OFSNOHOMISH COUNTY, WASHINGTON, EXCEPT THAT PORTION THEREOF CONVEYEDTOTHE CITYOF EDMONDS FOR75th PLACE W. BY DEED RECORDED UNDER RECORDING NO.9010110125 TOGETHER WITH THAT PORTION OF THE WEST HALF OF VACATED 74 th PLACE W. ABUTTING SAID LOTAS PER SAID DEED RECORDED UNDER RECORDING NO.9010110125 ALSO, TOGETHER WITH THAT PORTION OF THE EAST HALF OF SAID VACATED 74th PLACE W AS PER DEED RECORDED UNDER RECORDING NO. 9010120363. c r.. U7 N C :r iTl CD i= 1 SCALE: I" = 30' ® II ® 0 30 60 90 BASIS OFBEARINGS VGI. J Q c� PAGE r�ry RECORD OF SURVEY, VOL. 18, PGS. 102 & 103 J ! / I SIC TC'1.. •r.T ems• , TO F/GE: p�E Gt/OiC� /S STXicT�4� L/i�i/l�r> /� 1�v�c.��a�c..,��aa�tr�.K i¢•'"rJ ,GN,oi2ovr,��' sIme oy/-r/�jr �s �i�r�4�rc a�rt1C /�Ci�,oaw►'�y4. ✓q•8Tt1$��i�S/.t?•�vC� i�!//�!R/ %fz'�,ti/D/..'�7 RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ...... ..... ..... . FOUNDATION: Footing ................... .. Wall .......... .... ..... Pier/Porch ........ ..... . �-•� Retaining Wall............ Slabinsulation ............ ,0" PLUMBING: Underground ............. Rough -In ................. PLu,trtg �/� Commercial Final.. ...... 4 1'--T-/4C1"P-_HEATING: Gas Test ................. �'""•'1as Piping ............... Equipment ................ G • '3 -6O Z AA67— Commercial Final. ....... 10?A6 Y� 01/ _ -TPOl? EXTERIOR SHEATHING NAILING ............ ....... oN ono' 844 r. FRAMING .................... 'INSULATION: Floor Insulation .......... Wall Insulation ........... Ceiling Insulation......... SHEETROCK NAILING.. SPECIAL INSPECTION ...... RADON MONITOR AT SITE. FINAL APPROVAL FOROCCUPANCY....... -_�� ^' =rr 2-, 70 llv�I- 503GtG J 1�eettr/leCo,g,3( } wfY 0 "tl � yyyy S'p hfy ate c�¢ �y'Y.pd1�'{tli')py hSt i,� 3 3 rP,�4e$LMt` � x •s i �F� y Yp R" ' i v Y 1e r c Ft�c�h•�Y�u ,t� � x �`�je •iF ±�w�i ;e'SSr 7i. 33i.� a `a•� F x Y {{N t �e7s �• n fix. �' R J i •� j'�yYaifga .�ii .� 1Adr16�c �js S frY�'i'va4 t s y 4i k�e`j i4 t�� tt(v�q