Letter of Application and Deed RestrictionAfter recording, please return to:
Community Development Department
33325 8th Avenue South
Federal Way, WA 98003
CITY OF FEDERAL WAY
ACCESSORY DWELLING UNIT
LETTER OF APPLICATION & DEED RESTRICTION
I, ___________________________________, being first duly sworn, on oath do hereby certify under penalty of
perjury under the laws of the State of Washington:
That I/we am/are owner of the single-family dwelling unit located at: ________________________, Federal Way,
Washington,
Parcel #___________________________________________.
Property Legal Description: _____________________________________________________________
____________________________________________________________________________________
That I have made application and received City of Federal Way land use approval for an accessory dwelling unit
at this location.
That 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.
That this certification will remain in effect during the period of my ownership of the property unless I record a
certification with the King County Office of Records and Elections that the use of the property for an accessory
dwelling unit has been discontinued.
_________________________________________________________
Signature of Applicant
State of Washington )
)ss
County of _________)
On this day personally appeared before me _________________________________ to me known to be the
individual described in and who executed the within and foregoing instrument, and acknowledge that he/she signed
the same as his/her free and voluntary act and deed, for the uses and purposes therein mentioned.
GIVEN under my hand and official seal on this day of _____________, 20________________
Notary’s signature _____________________________________
Notary’s printed name _____________________________________
Notary Public in and for the State of Washington.
My commission expires__________________
Falsely certifying owner occupancy is subject to a civil penalty of $5,000, in addition to any criminal penalties.