21-100247-ADU Application-02-19-2021-V1U
reuefdl VYdy, VVH 78UU3-03LD
253-835-2607; Fax 253-835-2609
www.citvoffederalway.com
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Applicant Information
NAME ` �
PRIMARY PHONE
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CITY
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ADU Information
ADU Site Address:
RIMOV M, i
Zoning: Rs. 7 .2 Lot Size in Square Feet: ,::?.'0 5/y
Type of ADU: ❑ Attached VDetached Is this a: New ADU ❑ Existing ADU
Existing ADU was: ❑ Approved by King County (provide a copy of the permit.) ❑ Other
Construction of existing ADU completed in 19 _/20
Construction of existing residence completed in 19 12016 .
Which is the owner -occupied unit: V Primary Dwelling Unit or ❑ ADU
Number of square feet: Primary Dwelling Unit 7ADU
S
DiscLmmER: I certify under penalty of perjury that the information furnished above is true and correct to the best
of my knowledge and further, that I am the owner of the above premises and allow the work for which the
permit application is made. In addition, I presently occupy and will continue to occupy one of the two dwelling
units at this location as my principal and permanent residence for six months or more of the calendar year.
O�-off- 2c7,/
Sign a of er Date
WAIVER: Approval of the ADU land use application does not constitute approval of the building permit.
Application and approval of the building permit is a separate process.
Bulletin #049— August 13, 2020 Page 1 of 3 k:\Handouts\ADU Application