22-105684 Operating Licensing Application-02.01.23Signature of Applicant(s) Date 1/24/23
Permanent Supportive Housing and Transitional Housing
Emergency Housing and Emergency Shelter License
All application materials must be submitted electronically. Please visit our website at
https://www.cityoffederalway.com/node/1674 to obtain information on how to successfully prepare your application
materials for submittal and review. Please email all application materials to PermitCenter@cityoffederalway.com. .
License Holder
Name Dan Wise Title Deputy Director Primary Phone 206.324.5401
Business/Organization Catholic Community Services Alternate Phone
Mailing Address 100 23rd Ave South Email danw@ccsww.org
City Seattle State WA Zip 98144
Business Location (if license application is for more than 1 location, provide site-specific address and information for each
location as Attachment 3.)
Name of Facility
Stevenson Hotel
Primary Phone 206.324.5401
Mailing Address 33330 Pacific Highway South Email
City
Federal Way
State
WA
Zip 98003
Total # of Rooms: 24 Maximum # of Occupants: 48
Check 1: Permanent Supportive/Transitional Housing
X Emergency Housing/Shelter
UBI#
Federal Way Endorsement: Yes No
Point(s) of Contact (if more than 1, please provide additional sheets as attachments)
Contact Name Dan Wise Title Deputy Director Primary Phone 206.324.5401
Mailing Address 100 23rd Ave South Email danw@ccsww.org
City Seattle State WA Zip 98144
Attachment 1: Operational Plan in compliance with FWRC 12.35.070 and 12.35.080
Attachment 2: Operator credentials meeting requirements of FWRC 12.35.030(g)
Attachment 3 (if needed): Additional site addresses and site specific information. Operational plan must
apply uniformly access all sites.
License Fee: $300 or $0 for governmental or non-profit License holders.
Signatures
I (we) the undersigned, declare under the penalties of perjury and the denial of a license or revocation of any license granted, that I
(we) am (are) the applicant(s) or authorized representative(s) of the firm making this application and that the answers contained,
including any accompanying information have been examined by me (us) and that the information set forth is true, correct, and
complete. I also understand that I am responsible for notifying the City Clerk, in writing, of any change in location or mailing address
within 30 days. All licenses are non-transferrable. I understand my place of business must comply with all federal, state, and local
codes and ordinances.
FILE NUMBER: - Check# Date