HomeMy WebLinkAboutA 20220705000201 Instrument Number• 20220705000201 Document:AFF Rec: $208.50 Page-1 of 6
Record Date:7/5/2022 10:28 AM
Electronically Recorded King County, WA
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Retur��ddr�ss:
City Clerk's Office
City o�Rentan
1055 Sotath Grady Way
Renton, WA 98057
Please print or type information W/�SF$fI�IC�a1��IV$���E �E����EI�''S COVC'C�iI'18�t(RCW 65.04�
C)OCUYit@Itt'fB$IL(S�(or transactions contained therein):(all areas applicable to your document must be filled
in)
IVo#ice and Affidavit of�4�G Owner Oc�upancy
Reference Nurnber(s�of Documerats assigrted�r reieasec4: �
Additionak reference#'s on page _af document
GrarttAr(��(Last name first name, initials)
1. Luzdivin� Gil Vargas �.
2. _�. 4.
Additional names on page_ �of document. �
Grantee�s){Last name first,then first name and initials) `
1. City of Renton
Lega!descri�ation(abbreviated:i.e.Iot block,plat or secYion,township,range) � �
The wesfi 100 fe�t of 1ot14, block 7, ,4ker's farm fVo.6, accarding to the plat
thereof recorded in volume 42 of plats, p�ge 15, records of k�ing county,
Washing�an.
Additional legal is on Exhibit A, page__ �of document, '
Ass�ssar's Property Tax Pdree/Accaceng l�luer�b�r: ❑Assessor Tax 8#not yet assigned
0088000592
The Audrtor/Recorder will rely on the information provided on the form. The staff will not read the
document to verify the accuracy or completeness of the indexing information provided herein.
NOTICE AND AFFIDAVIT OF ADU OWNER OCCUPANCY—Page 1
Instrument Number: 20220705000201 Document:AFF Rec: $208.50 Page-2 of 6
Record Date:7/5/2022 10:28 AM King County, WA
NOl`ICE l�ND PaFFiDA1/Il'OF ADU OiAPNER OCCl1Pee►l�IGY
IJwe the undersigned are all of the current owners of the property legally described in the
attached Exhibit A,which is commonly Icnown as 10935 SE 164TH ST, Renton,WA 98055
.,, (the "Property"). I/we applied �for a
permit Ya construct an accessory dwellin� unit ("ADU") on the Praperty. The approved
site/floor plan for the ADU is attached as Exhibit B. I/we understand and agree that the
Renton IVlunicipal Code requires that as a condition of the constructian and use of an ADU,
the owner af the Property will and is required to occupy either the primary dwelling or the
ADU. I/we understand this means I/we and rny/our successors in interest may not ren�C out
both the primary dwelling unit and ADU to separate tenants unless the City of Renton's owner
occupancy requirements are waived by applieable provisions in the Rentan Municipal Code.
(/we understand and agree that I/we and any successors in interest �re required to comply
with all applicable restrictions and limitations regarding ADUs in the Renton fviunicipat Code.
i jwe agree this Notice and Affidavit of ADU Ovvner Occupancy will be recorded by the City of
Renton, at my�our cost, in real estate records main�kained by the King Caunty Recorder`s
Office.
/�
� �
�
�rrTier's Signature Owner's Signature
Luzdivina Gil Vargas
Name � Name
-/ 1 �,�
�
Date Date
(Instructiore�: ,4c9d additioreal lines,fA�any acfddtd�na/cawner�o]
Approved by the City Attorney's Office;approval expires January 31,2023
Approved by Risk Management;approval expires lanuary 31,2023
NOTICE AND AFFID,4VIT OF ADU OWNER OCCUPANCY—Page 2
Instrument Number: 20220705000201 Document:AFF Rec: $208.50 Page-3 of 6
Record Date:7/5/2022 10:28 AM King County, WA
Individual form of acknowdedgement:
STATE OF WASFiI(VGTON )
)
COUNTY OF KING )
On this�day of ;0,�m 20 �.'2. , before me, a Notary
Public inand for the State of Was ington, duly commissioned and sworn, personally
appeared i °` � � � persanaily known to me
(or proved to m on the basis of satisfactory e idence) to be the person wha executed
this instrument and acknowledged it to be a free and voluntary act and deed for the
uses and purposes mentioned in the ins�rument.
(N WITNESS WHEREOF I have hereunder set my hand and official seal the day and year
first written above.
�����;���
Signature
SHUfiHKARAPI pHILLON �
Notary Public �`l���j��O,(�`°�(��'� �'���\ �,,,
State of Wasfiington Print or Type fVame
Cammission#208502
My Comm. Expires Jun 2, 2023
NOTARY PUBLIC in and for the State of Washington,
__...�..,.
�`ti�xm�- °�-- �� "��
My commission expires
j/ns#ruei�i�nse If�r►Are than one o�nrn�r, add ar��d�i�ional►�o�ary bloc��'�e°eaeh���ft�or�eal
orrvrrer.)
NOTICE ANb AFFIDAVIT OF ADU OWNER OCCUPaNCY-Page 3
Instrument Number: 20220705000201 Document:AFF Rec: $208.50 Page-4 of 6
Record Date:7/5/2022 10:28 AM King County, WA
Corporate/LLC/RepresenCative form of pcknawledgevneret:
STATE OF WASHIIVGTON )
1
�OUIVTY OF KIIVG )
On �his day of _�, 2p . before me, a (Vo�ary
Public inand far the State of Washing�ton, duly cammissioned and sworn, personally
appeared and said person acknowledged
that they signed this instrument, and on oath stated that he/she/they were authorized
to execute the instrument and acicnowledged it as the
a#�
to be the free and voluntary act of such party far the uses and purposes men�ioned in
the instrument.
IN WITNESS WHEREOF I have hereunder set my hand and official seal the day and year
first writte� above.
Signature
Print or Type Name
NOTARY PUBLIC in and for the State pf Vi/ashingtan,
My commission expires
(Insfr�actions: If rr►c�re than one ov�nerp a�dcl e�rr additi�na/natary block for eacd►adc�ftiona!
owner.)
NOTICE AND AFFIDAVIT OF ADU OWNER OCCUPANCY—Page 4
Instrument Number: 20220705000201 Document:AFF Rec: $208.50 Page-5 of 6
Record Date:7/5/2022 10:28 AM King County, WA
EX�-11�9T�4 T'O NOl'ICE�ND�1FFiDAVI�
OF�4DU �VUNER OC�UPWI�CY
Compfete 1e��6 descriptio�of th� Properri��:
THE WEST 100 FEET OF LOT14, BLOCK 7, AKER'S FARM N0.6, ACORDING
TO THE PLAT THEREOF RECORDED IN VOLUME 42 OF PLATS, PAGE 15,
RECORDS OF KING COUNTY, WASHINGTON.
NOTICE AND AFFIDAVIT OF ADU OWNER OCCUPANCY—Page 5
Instrument Number: 20220705000201 Document:AFF Rec: $208.50 Page-6 of 6
Record Date:7/5/2022 10:28 AM King County, WA
E�Ff1�9T B T�lV�TI�E��tE���FI�Ai/9T OF�1DU
OU9tNE6����i�PA�CY
Approved Site Plan
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NOTICE AND AFFIDAVIF OF ADU�WNfR OCCUPANCY—Page S
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