Application - Historic LandmarkCITY OF City of Federal Way
A% Federal Way33325 8th Avenue South
�.� Federal Way, WA 98003
Centered on Opportunity www.citvoffederalway.com
Application for City
Historic Landmarks Commission
Please complete the ENTIRE application. You may attach a cover letter and/or resume.
NAME:
First
ADDRESS:
Street Address
MAILING ADDRESS (if different):
PHONE 111
E-MAIL:
DATE:
Last
City
PHONE (21
M.I.
Zip
HAVE YOU PREVIOUSLY SERVED ON A CITY CITIZEN BOARD OR COMMISSION? ❑YES ONO
If "yes", please list:
ARE YOU ABLE TO ATTEND EVENING MEETINGS? ❑YES ONO
ARE YOU ABLE TO ATTENDDAYTIME MEETINGS? ❑YES ONO
MEMBERSHIP REQUIREMENTS: The membership requirements are established by the Federal Way
Revised Code (FWRC) 19.285.030 which states members "shall have a demonstrated interest and
competence in historic preservation" which may include experience in fields such as historic
preservation, history, architecture, planning or other related disciplines. By signing below, you are
stating: "1 confirm 1 meet the membership requirements for the Historic Landmarks Commission."
Applicant Signature:
SUBMIT COMPLETED APPLICATIONS TO: City of Federal Way
City Clerk Department
via email 33325 8th Avenue South
CK@cityoffederalway.com Federal Way, WA 98003
Applicants may contact the City Clerk Department at 253-835-2540 with any questions.
Historic Landmark Application Page 1 of 2
Last Updated February 2023
Why do you want to serve on the Historic Landmarks Commission?
What are your prior experiences historic preservation or similar?
How do you see your role as a Commissioner?
Describe anything in your past or recent activities that may be of concern to the city or public:
PUBLIC DISCLOSURE: This application and each attachment submitted are subject to public
disclosure. If requested, they will be provided without redaction or notice.
Interview Date / Time:
APPOINTED: ❑YES ❑ NO
Term Expires:
FOR CITY USE ONLY:
POSITION: ❑VOTING ❑ ALTERNATE
Historic Landmark Application Page 2 of 2
Last Updated February 2023