06-105548 RECEIVED BY
COMMUNITY DEVELOPMENT DEPARTMENT
41•V1420U 5—ID 16
‘.. DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES
33325 8th Avenue South
CITY{ F PO Box 9718
Federal Federal Way WA 98063-9718
253-835-2607;Fax 253-835-2609
www.cityoffederalway.com
NEIGHBOR NOTIFICATION
IN-HOME CHILD CARE
J1W is proposing an in-
(Applicant's Name)
home child care at '-2,( -)5` PL SCA) t-Q ki-a . As part of the
(Address)
Federal Way in-home child care application process, notification of adjacent neighbors is required.
Each adjacent neighbor should read and sign this form. (Applicant,please make as many
copies as necessary.) This child care will have a maximum of C.0 children at any one
time, including I children already residing on the premises.
Please call the Federal Way Department of Community Development Services at 253-835-2607
if you have any question or concerns.
Are you the property owner? I Tenant? Please sign your name as an acknowledgement
of notification.
44" s
Arit____
°Oro< /aRvi'J -77r- /1/0 /k ,
(Sign Name) (Print Name) (Date)
3Py/L /5-T4, ar sry
(Str et Address)
r-CI�I r� 1,144-g-676
(City, State,Zip)
Return to the Department of Community Development Services at the above address.
Bulletin#30—January 1,2006 Page 1 of 1 k:\Handouts\Neighbor Notification
• • 1q-4
) OLO - IOSS14-4 FILE
IN-HOME DAY CARE CHECKLIST
Applicant: iMe?-ku■4 U a 5 cirDSe Leum-(--
Site Address: 3 14 ai) - 19'1\ is 5,1
Phone No: si-N-q2 k(p FW Business license: „i-- Payment:
Smoke detector affidavit:0 N Copy of DSHS license: N
Neighbors Notice sent ` b� Notice Rec'd
Left: ly - 1 S`1` Pc. ,e N (O 3 Y N
Right: 34( 4- /51-k? PL SL ) (6 N Y N
Rear: 39013- )S ct Skp Y N Y N
Rear:,3LLU 1'7- IS C+ SI,-) N Y N
Other: Y N Y N
Other: Y N Y N
Site visit date: IV?k, Zoning: Lot size:
Setbacks in compliance? Y N # of off-street parking: a
Fencing: e,5 5 I y,,
Are there: Curbs Y N Sidewalks Y N Signs Y N
Traffic impacts:
Other issues:
Notes:
Sign off date: 1 '-'1 'bf'
7/21/06
Sent letter w/enclosure
•
CITY OF CITY HALL
` 33 325 8th Avenue€outh
AFederal Way Mailing Address:,,PO Box 9718
Federal Way,WA 98063-9718
(253)835-7000
www.cityofederaiway.com
November 7, 2006
Josephine Matthews
Jose Lane
34420 15th PL SW
Federal Way, WA 98023
RE: In-Home Day Care Approval
File#06-105548-BL
Dear Ms. Matthews :
The City's Department of Community Development Services has completed the review of
your in-home day care application. The land use application is approved with the following
conditions:
1. A business sign outside your residence is not permitted. Advertising flyers may be
distributed via approved methods, such as store windows or at the library. Flyers
may not be placed on mailbox clusters.
2. No outside alterations are permitted to accommodate the day care.
3. Drop-off and pick up is permissible in the driveway and other allowed parking areas.
4. The maximum number of children allowed in your care is_, per your DSHS
license.
5. The in-home child day care shall meet all requirements of the enclosed
International Building Code, sections R310, R313.3, and R325.
Your city business license will be forwarded to you. Please contact my office at 253-835-.
2626 if you have any questions.
,a'00‘
;\
Robin Baker
Development Specialist
c: Cathleen Rossick,Licensing Specialist
File
daycare\approval.ltr
0 yibic5lt g%6D-LL
DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES
. mik, 33325 8th Avenue South
PO Box 9718•
CITY OF ��+, Federal Way.WA. 98063-9718
Federal ay 253.835-26.07;Fax 253-835-2609
rT www.cityoffederalway.com
IN-HOME CHILD CARE
LAND USE APPROVAL APPLICATION
Application Fee: $43.00
• Name of Child Care: '3-0 S r? aL-�-
Name of Applicant: .. OS _e ' .
Address of
Child Care:
Mailing Address(if Different): c g 02
Phone Number: as t---7 4 Opening Date of Child Ca? I S -O
tk2gb
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PLEASE PROVIDE THE FOLLOWING:
Name of familymember who rres des 0/1-situ operate s clhzd cr � ,
Co of license from the Dept of Social&Health Services: . inclosed
�Copy . .
,,ZflA sketch of your lot that shows your home in relationship to your lot lines. Show where any off-street
parking is provided as,well as loading and unloading area(see example on page 4). cavil\
• [ How many people living outside your home will be working at the child care: CL
,7 Completed&signed Neighbor Notifications(enclosed)for each neighbor adjacent to your home,or provide
the city with stamped, addressed envelopes of the neighbors' addresses and the city will notify them.Note, IbJ�`!1:a/
please do not submit metered envelopes.The Federal Way Post Office may refuse such envelopes.
Bulletin#029—August 23,2006 Page 1 of 4 k:\Handouts\ln-Home Child Care Application
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/iiHours and days of operation: � ir5 — 3 - - o
number of children you will take care of on any given day: 6 •
umber of children residing in the home:
Number of vehicles you anticipate coming to your home per day as a result of the child care (include
employees,customers,deliveries,etc.): lease explain:
•
4/Describe any fencing&other buffering devices around the play area(height&materials):
f191111
The International Building Code(IBC)has special requirements for in-home child care centers.Please
provide the following information:
1. What type of house is it? ❑One story R'�Two story 0 Tri level a Split-level 0 w/Basement
. ❑Other: ,
2. A smoke detector shall be sl •
provided in all.p eepingfn
appng areas and on each level:of the home.Has a
smoke detector affidavit(enclosed)been completed? .. ❑No
• 3. Does the home have an automatic fires
suppression system(sprinklers): !�.NO
4. Each floor'level used for child care purposes shall be served by two`remote exits.Child care will be
located: 0 Basement 0-First story 0 Second story del:. . .
5. If in the basement,is there an exit at ground level(no steps,porches,or decks outside the dour):
❑Yes ❑No Lot Applicable
6. If in the basement, is there an exit at ground level and a self-closing door at the top or bottom of the
intterior staitw porches-or decks-outside-the he door OI 0 Yes -❑-No
- - ------ ay{stcps,porc �J: Applcab�
7. If in the basement,is there an emer:a cy escape window or door which leads to a public way:
❑Yes ❑No 1614''4 of Applicable
8. If on the second-story,is ere an exit directly to the exterior of the home that does not go through the
first-story: ❑Yes o ❑Not Applicable
•
9. If on the second-story,is there an exit directly to the exterior of the home and a self-closing door at the
top or bottom of the interior stairway: 0 Yes ❑No •:,ot Applicable phcable
Bulletin#029-August 23,2006 Page 2 of 4 k:\Handouts\ln-Home Child Care Application
L
IP •
• 10. Do the sleeping or napping rooms have at least one operable emergency escape or rescue window(5.7
min sq.ft.,20 inch min.width,24 min.height,and 44 inch max.sill height): t -Yes 0 No
11. Do the sleeping or napping rooms have a door directly to the exterior of the building: MI< ❑No
12. Do any commercial uses occur next to the child care area •
0 Yes 'fVo If Yes,type of business use:
13. If you answered yes to question#12,is there a Are-resistive separation between the rooms or spaces?
O Yes 0 No ❑.Not Applicable If Yes,what is rating?
14. If you answered yes to question#13,are there rated and labeled doors or windows in the wall:
0 Yes O No of Applicable If Yes,what is rating?
• 15. Building Division Comments:
•
•
A BUSINESS SIGN OR OUTSIDE ALTERATIONS TO YOUR RESIDENCE ARE NOT PERMITTED.
•
. I have read and understood that failure to comply with Federal Way City Code,Chapter'22,Article XIII,
Division 6,Section 22-1069,."Home Occupations Class.1I,"is,grounds for immediate revocation of the in-
home child care approval.I agree that my child care will be conducted in such a manner that none of these
criteria will be violated and that I will report any changes in the conduct of the above described child care
(including increases in clients) to the Federal Way Department of Community Development Services and
receive approval before the changes take,place:
•
Sps e-P i E 11%1 rcrip. to S
Pull Printed Name
Z'1A-1& . 1 — I
Signature Date
Planning Representative Date
•
Building Division Representative • Date
•
•
Bulletin#029—August 23,.2006' Page 3 of 4 k:\Handouts\ln-Home Child Care Application
0 ... • •fr' .,
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SITE PLAN EXAMPLE
•
Include the following on the site plan:
1) Lot boundaries and dimensions
2) Dimensions between property lines and the house-
3) Any areas used for parking, loading,and unloading
•
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4) Adjacent streets
5) North arrow
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Bulletin#029—August 23,2006 Page 4 of 4 k:\Handoutskin-Home Child Care Application'
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DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES
33325 8`"Avenue South
CITY OF PO Box 9718
Fe,� e Federal Way WA 98063-9718
4futyVay 253-835-2607;Fax 253-835-2609
,_ .,9 . A www.cityoffederalway.com
'II 5 i 410Y tr. 0_6111'
_ Ct ye, fromsoth/".
k vt NEIGHBOR NOTIFICATION
q, ,(� IN-HOME CHILD CARE WA q�zs
"0
g.0 Ill aU4 V ues is proposing an in-
(Applicant's Name)
143A 61 g
home child care at 3 9 - l pi- S 1- e A 010 . As P the X 23.
(Address)
Federal Way in-home child care application process,notification of adjacent neighbors is required.
Each adjacent neighbor should read and sign this form. (Applicant,please make as many
copies as necessary.)This child care will have a maximum of children at any one
time, including G children already residing on the premises.
Please call the Federal Way Department of Community Development Services at 253-835-2607
if you have any question or concerns.
Are you the property owner?,) Tenant? Please sign your name as an acknowledgement
of notific n, y,tA�.,v � r�c�,7 )goO,l'EZ, l/�,i a'•
35 4 .0a Fed efaz -z; r r `t(/.4. 9P? 3
-6a\k''' , os hen- _► 1 _ 10 -i -e 6
(Sign Name) (Print Name) (Date)
/'� 34 Lt tea- IS pi- 5
. �� `� (Street Address)
'� � � ��' redav- � LAe(g023
� \ ' Avg (City,State,Zip)
Return to the Department of Community Development Services at the above address.
Bulletin#30—January I,2006 Page 1 of 1 k:\Handouts\Neighbor Notification
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' • OCT 30 2006
I 56 r CITY OF FEDERAL WAY
BUILDING DEPT.
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