21-104579-ADU Application pt 1-12jan2022-V17` Accessory Dwelling Unit (ADU)
CITY OF ` DEPARTMENT OF COMMUNITY DEVELOPMENT
FedSouth
eral Way 333ay, WA th Avenue3-6325
Federal way, WA 98003-6325
253-835-2607; Fax 253-835-2609
www.citvoffederalway.com
FILE # — -- —AU DATE
Applicant Information
ADU Information
ADU Site Address: _ � u) J 1 q 3E T h A\; c- s w . 9S o2_� _
Parcel li: 'S 0 M7 0 0 0 9 Q
7 Zoning: IS -• _ Lot Size in Square Feet: I � �10
Type of ADU: ❑ Attached IVDetached Is this a: '-j 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 I�J20
Construction of existing residence completed in 19�r _ _ /20 _
Which is the owner -occupied unit: Primary Dwelling Unit or ❑ ADU
Number of square feet: L Primary Dwelling Unit ADU
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 l am the owner of the above premises and allow the work for which the
permit application is made. In addition, l 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.
0
Signature of Owner Dat
WA1vER: 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 0049—August 13, 2020 Page 1 of 3 k:\Handouts\ACU Application