12-101291 1►
.
RECEI or COMMUNITY DEVELOPMENT SERVICES
ii'.'.. L•• 33325 8"'Avenue South
4111/
PO Box 9718
CITY of MAR 2 2 20'2 Federal Way WA 98063-9718
253-835-2607;Fax FederalVVay
TY OF FEDERAL WAY www.citvoffederalway.com
CDS
ACCESSORY DWELLING UNIT (ADU)
FEE: S17&50 (Not required if legal nonconforming status is established.)
FILE# (�J (O(V ' t OO /It) RELATED FILE#s: I a-" (U(
Owner's Name: Alf—VI c) L-e..-=0 5
Address: % 5�o u)-(1 /0 S f"r IF-cd ,may, Welt -P8 00
Daytime Phone: 9-5-3- 9L(( -des, Tax Parcel#: ?98 1.Hy 6 6 f/S—•'
Zoning: I?5 >. Z— Lot Size in.Square Feet:, //, /00
Type of ADU:A Attached 0 Detached Is this a: ,E New ADU 0 Existing ADU
ng,ADU :0 _ 'pro lug 0 , •. • ` * . er
-. • -- istin: • : comp e - • in 19_ 0
Construction of existing residence completed in 19/20__
Which is the owner occupied unit:0 Primary Dwelling Unitor,lADU
Number of square feet: j/?'v Primary Dwelling Unit h/4'5— ADU -- 31 .-7t-C7,7
the following information:
r ehaven Utility District Water& Sewer Certificatesf approval for the New ADU
■ "n' Oun• alio . .• i,= .ci4.,- . • , ie -,
■ °eating type:. Electric 0 O. 0 Other
(?Electrical Capacity: Z�� < ( I 'Pin. Dwelling Unit tat( 1" ADU
toI , ^ ) cZC 6pe
ADU FLOOR PLAN DRAWINGS (Provide the following;refer to page 3 for an example.)
Ici4ri.or plan of the primary dwelling unit and the ADU
dumbing(existing&proposed)
Ij'M,• ical Heating/Ventilation/Air Conditioning(existing&proposed)
■ n• • ces of primary dwelling unit and ADU(existing&proposed)
oiling Heights/Room Sizes for ADU
levation of the proposed ADU with the primary dwelling unit
Bulletin#049-January 1,2010 Page 1 of 3 k:\Handouts\ADU Application
• •
ti,
ADU SITE PLAN DRAWINGS (Provide the following;refer to page 3 for an example.)
m�Scale/north arrow treet/driveway location
E /Lot dimensions /rimary dwelling unit
r • 'U footprint(if detached) (,1J'f /Building setbacks from property line
e ocation of utilities&easements►" CT Show location of three onsite parking stalls
do ocate the entrance ofthe primary dwelling unit and the ADU
0 alculate the total impervious surfaces coverage for the sit4Include the existing and proposed roof area,
driveway,patios,and walkways.)
O Other
1C)t (,aA- ' j^fu's 2/.70 - ? -V':,, S.Qa,,D fa__ 1... .4_eAez
EA,-t c.e_ - Qza�-
--:----u- *----e-- i----0--- i►- 0----6--- 0----;i-- -;R-
DISCLAIMER: I certify under penalty of perjury that the information furnished by me is true and
correct to the best of my knowledge and furtheg that I am authorized by the owner of the above
premises to perform the work for which the permit application is made.
(9(
);LA.---7 . _._.� _ - 22 - / 2 •
Signature of Applicant 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.
A
OFFICE USE ONLY
❑ ADU Status: 0 Legal Nonconforming per FWRC 19.30.140)5(
New ADU
❑ Assigned Address of ADU
O Deed Restriction/Letter of Application Rec'd 0 Recording Number
❑ Other
Approved by it� /hictc*_ "Date (9\ \7Al2--
Conditions of Approval ) d Ce- '\c- eve S SP• lc\ i1/42(2--31 -d 1
/ t. i mac ' A fl ?rLof `�c �Ql 1/4 cc 2- 7
Bulletin#049—January I,2010 Page 2 of 3 k:\Handouts\ADU Application
t
r S
After recording,please return to:
Community Development Services Department
33325 8th Avenue South
PO Box 9718
Federal Way,WA 980639718
CITY OF FEDERAL WAY
ACCESSORY DWELLING UNIT
f LETTER OF APPLICATION&DEED RESTRICTION
I, 1 J/�v i X t-€,'- rJ S ,being first duly sworn,on oath do hereby certify under penalty of
perjury under the laws of the State of Washington:
That I am an owner of the single family dwelling unit located at: A60 I y S o,;moi 3
Federal Way,Washington.
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 mote 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 Public in and for the State of Washington,residing at
My appointment expires:
Falsely,certfing owner occupancy is subject to a civil penalty of$5,000, in addition to any criminal penalties.