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13-102474MASTER L,ND USE APPLICATION RECEIVED DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES 33325 8'h Avenue South CITY OF G' Federal Way, WA 98003-6325 Federal Way J U N 0 5 2013 253-835-2607; Fax 253-835-2609 www.citypffcderakva .com CITY OF FEDERAL WAY CDS APPLICATION NO(S) —Z 3 — ( 0 d-q 6 q — '4" Date Z Project Name Property Address/Location i S O Parcel Number(i) Project Descriptia PI.F.ACF. PRINT -74a-d-qO Onin Type of Permit Required Annexation Binding Site Plan Boundary Line Adjustment Comp Plan/Rezone Land Surface Modification Lot Line Elimination Preapplication Conference X Process I (Director's Approval) Process II (Site Plan Review) Process III (Project Approval) Process IV (Hearing Examiner's Decision) Process V (Quasi -Judicial Rezone) Process VI SEPA w/Project SEPA Only Shoreline: Variance/Conditional Use Short Subdivision Subdivision Variance: Commercial/Residential Required Information Zoning Designation Comprehensive Plan Designation Value of Existing Improvements Value of Proposed Improvements International Building Code (IBC): _Occupancy Type Construction Type Applicant Name: r�t4 y1r,7 h Address: 3O`f0 L �= jowc S� City/State: 7i�waly I La1 Zip: 45 80 -)-3 Phone: aol.0 431 o8Lo Fax: Email: GSi���, @ Signature: Agent (if different than Applicant) Name: Address: City/State: Zip: Phone: Fax: Email: Signature: Owner Name: Address: City/State: Zip: Phone: Fax: Email: Sign re Bulletin #003 —January 1, 2011 Page 1 of 1 k:\Handouts\Master Land Use Application SUBMITTAL REQUIREMENTS FOR PROCESS I Project Name: N -1 to - FF Project Description: 1N 1 , Applicant: File #: 07o l pir=A Ci ihmiffarl ON JUN 0 5 2013 - - /- - ,g - - - - - ❑ F FEDERAL WAY Master Land Use Application, signed by o%Vn ❑ A narrative description of the project, on a separate 8'/2" x 11 " sheet XJ ❑ Application fees ❑ Six copies of the site plan (folded to 9" x 12") Six copies of existing & proposed building elevations (folded to 9" x 12") ❑ ❑ ❑ ❑ Color & materials indicators (photos or color & materials board) STAFF USE ONLY Please consider this as a Notice of Completeness. As of , 20_, this Process I application is determined to be complete based on the minimum submittal requirements. Review of the project will begin upon application assignment. The City of Federal Way will take action on the application upon the determination that all applicable requirements are met. Please note that City review will be halted at any time City staff requests additional information. Intake by: THIS FORM SHALL ACCOMPANY THE LAND USE APPLICATION AND A COPY SHALL BE PROVIDED TO THE APPLICANT. Bulletin #053 — February 3, 2011 Page 2 of 2 k.\Elandouts\Process 1 Submittal Requirements 41k CITY OF Federal Way COMMUNITY & ECONOMIC DEVELOPMENT DEPARTMENT 33325 8`" Avenue South Federal Way, WA 98003-6325 253-835-2607;Fax 253-835-2609 w.,nv. ci tyoffederalway.com SUBMITTAL REQUIREMENTS FOR PROCESS I DIRECTORS APPROVAL WHEN USE PROCESS I IS USED A project involving improvements to an existing developed site may be reviewed using Process I criteria if: • There is no change of use: • It is exempt from requirements of the State Environmental Policy Act (SEPA) There is no reduction, material change or adverse impact to: o Landscaping, buffering, open space or public areas; o Required parking: o Location of utilities, easements or pedestrian connections; o Approved architectural design; or o Environmentally critical areas (as defined by Federal Way Revised Code [FWRC) 19.145). WHO MAKES THE DECISION Under Process I, the Director of Community Development Services makes the decision based on review and analysis of the submittal documents and decisional criteria (FWRC 19.55.010). APPEALS Any decision issued by the director can be appealed by the applicant, anyone who submitted written comments during the review, or anyone who requested copies of the decision. Appeals of Process I are decided by the City of Federal Way Hearing Examiner after a public hearing. See FWRC 19.55.050 for detailed information regarding appeals of Process I decisions. How To APPLY + This form is to be used by an applicant as a guide in determining what constitutes a complete application for Process I, Directors Approval. All checked items must be submitted to constitute a complete application. • Process I applications that contain all checked items will be determined complete at intake. The applicant or agent will be notified immediately if an application is considered complete. • A complete application does not imply compliance or conformance with applicable codes. Bulletin #053 — February 3, 2011 Page t of 2 k:\Handouts\Process I Submittal Requirements .. .. May Y7 2013 4:13PM HP�SERJET FAX P•1 "C,O Uftn -PT MA-1 Ca icizit + '"VVtps �s & LeMR, TO Cc+P-MiAT PEPMTSsUvJ }i*S Raw• 11 SWE -2ai3 To 24 . 01 L:PA%T LXT-j x ► Su*mcc, 4Rwx*O T" Fcfl-� TtAc- a :!�u Aotew c 4SEA-0-S FL5 I SEW Whi WA ` 10b3 `floe ?Ram s DF 1)4e AB" tM6#vT-"" OF Awre Z"efw. RECEIVED JUN 0 5 2013 CITY OF FEDERAL WAY CUS CERTIFICATE OF LIABILITY INSURANCE /05/20 3n THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: IF the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 1-425-454-3386 CONTACT Joanne Manion NAME: Arthur J. Gallagher Risk Management Services, Inc. PHONE FAX 425-454-3386 N9,425-451-3716 P.O. Box 367 pp°pLas a: Bellevue, WA 98009-0367 INSURERS AFFORDING COVERAGE NAIC0 INSURED Funtastic Ride Co., Inc. 3407 SE 108th Avenue Portland, OR 97266 INSURERA: T.H.S. Insurance COM INSURERS: T.H.E. Insurance Co. INSURER E : rcDTrrrr-ATr M11RAMr-O- 34035628 RFVLSION NUMBER: y 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. TYPE OF INSURANCE146_IFUS116Rl POLICY EFF POLICY P� LJMITS POLICY NUMBER D O A GENERAL LIABILITY CPP0100924-04 04/05/1 04/05/14 EACHOCCURRENCE $ 1,000,000 PREMISESE occ ce $ 100, 000 X COMMERCIAk GENERAL LIABILITY MED EXP (Any one person) $ CLAIMS -MADE M OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPUFS PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ POLICY PRD LOC A AUTOMOBILELIABILITY CFPOIO0924-04 00 0 COMBINED 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED PPROPERTY DAMAGE $ HIRED AUTOS A UMBRELLALIAB X OCCUR 04/05/1 04/05/14 EACH OCCURRENCE S 4,000,000 ^$ AGGREGATE EXCESS IUAB CLAIMS -MADE �ELP0010212-04 4,000,000 DED RETENTION$ $ B WORKERS COMPENSATION CPP0100924-04 04/05/1 04/05/14 WCSTATU- R 0c E.L. EACH ACCIDENT $ 1,000,000 AND EMPLOYERS' LJABILMY ANY PROPRIETORIPARTNER/EXECUTIVE � E_L. DISEASE - EA EMPLOYE $ 11000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A E.L. DISEASE - POLICY LIMIT $ 1, 000, 000 If yes, downbe under DESCRIPTION OF OPERATIONS below ,T' DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Weduie, If more space Is required) RE: NINGlobalFest Sears Holdings Management Corporation and its subsidiaries and affiliates are included as additional insureds but only as respects the operation of the named insured per policy terms and conditions - policy form C0133C 07/95. L;t:H:I It'IL;A I t MULLJCit 'k nrar. r iv=ry Sears Roebuck and Co. MS A2-379B 3333 Beverly Road Hoffman Estates, IL 60179 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE z/01t*rl' I +an ©198S-ZU70 A(:UXL) L;UKF'Urw I IUty. All ngnis reservea. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD jomanion 34035628 ADDITIONAL INSURED — CARNIVAL This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The policy Is amended to include as an additional insured: 1. The fair or exhibition association, sponsoring organization or committee for the carnival covered under the policy; 2. The owner or lessee of the carnival site used by the Named Insured; and 3. The municipality granting the Named Insured permission to operate the carnival, but only as respects bodily injury or property damage caused by or contributed to by the negligence of you or your employees while acting in the course and scope of their employment. All other terms and conditions of the policy remain unchanged. CG133C (07/95) TE(MMIDD/YYYY) CERTIFICATE OF PROPERTY INSURANCEFtI5/05/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. If this certificate is being prepared for a party who has an insurable interest in the property, do not use this form. Use ACORD 27 or ACORD 26. PRODUCER 1-425-454-3386 p Joanne Manion Arthur J. Gallagher Risk Management Services, Inc. PHONE FAX .425-454-3386 e:425-451-3716 P.O. Box 367 E4WAII. Bellevue, WA 98009-0367 INSURED Funtastic Ride Co., Inc. 3407 SE 108th Avenue Portland, OR 97266 at Lloyd's INSU R D INSURER E r�cosicrr•wrc *Il teaoeo. 'lent SFSF RFl/ISIC7 PJ AIIIMRFFt� LOCATION OF PR>=J MES / DESCRIPTION OF PROPERTY (Attach ACORD 101. Additional Remarks Schedule, if more %pact In ruqulmd) Interest Insureds Tractors, Trailers, Rides, Games, Concessions, Generators, Show Equipment and all connected therewith, or for whom they have instructions to insure. $2,000,000 Any one accident or occurrence any one show/transit $6,000,000 Combined show limit for named major shows Valuation: Per schedule of values on file with underwriters plus 20% 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. ,INSR TYPE OF INSURANCE POLICY NUMBER POLICY UMDN EFFECTIVE POLICY EXPIRATION COVERED PROPERTY LTR DATE (MIDDfYYYl7 DATE (MMIDDIYYYY) LIMITS PROPERTY BUILDING - $ $ CAUSES OF LOSS DEDUCTIBLES PERSONAL PROPERTY —� BUSINESS INCOME S BASIC BUILDING EXTRA EXPENSE $ BROAD SPECIAL CONTENTS $ RENTAL VALUE EARTHQUAKE $ BLANKET BUILDING WIND $ BLANKET PIERS PROP FLOOD $ BLANKET BLDG & PP A X INLAND MARINE TYPE OF POLICY X Equipment S 2,000,000 $ CAUSES OF LOSS Inland Marine POLICY NUMBER $ NAMED PERILS $ X All Risk GENP00215004 04/15/13 04/15/14 CRIME $ $ j TYPE OF POLICY BOILER & MACHINERY / $ _ EQUIPMENT BREAKDOWN S _ Is SPECIAL CONDITIONS / OTHER COVERAGES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: NWGlobalFest rAurcr r A-rr�r,r SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Sears Roebuck and Co. MS A2-379B THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 3333 Beverly Road Hoffman Estates, IL 60179 AUTHORIZED REPRESENTATIVE z116pw -I Yu "'t � USA jomanion W I *z1D-cUtra IINVRV y4,r%rvrvw r last. ,emu 1lid— r—..a... ACORD 24 (2009109) The ACORD name and logo are registered marks of ACORD 34035656