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08-1060509 0 �n0 Site Address: ,51 &//— lye K et TAm V �, Parcel Number: _ 95Y7M • �� 9 Phone No: oW 97V-419.2- FW Business license:/ _ Payment: Smoke detector affidavit:�Y� N Neighbors Left: 33&o7'Z!* i`A c SkD Right:33 (,r /7 7-(o"l` Cv'- S Le ) Rear: Rear: Other: Other: Copy of DSHS license: � N Notice sent �N y�N Y N Y N Y N Y N Site visit date: Zoning: R S 7 2 Setbacks in compliance? Fencing: —7` -'— Are there: Curbs Y N Traffic impacts: Other issues: Notes: Sign off date: O 7/21/06 Sent letterw/enclosure N tice Rec'd N N Y N Y N Y N Y N Lot size: Y N # of off-street parking: Sidewalks Y N Signs Y N 'I • CITY OF Federal Way o$ - /0& o So -& DEPARTMENT OF QMUNITY DEVELOPMENT SERVICES 33325 8`h Avenue South PO Box 9718 RECEIVED Federal way WA 98063-9718 253-835-2607; Fax 253-835-2609 DEC 2 6 2008 www.cityoffederalway.com CITY OF FEDERAL WAY IN-HOME't.05-IILD CARE LAND USE APPROVAL APPLICATION Application Fee: $46.00 Name of Child Care: M UA) b) L3 1 tJCugaF Name of Applicant: L At) riA Co mo A b O Address of Child Care: :3a Co 11 Zo7A crs w `r7ede,a/ wa e w A . q&zys Mailing Address (if Different): Phone Number: C;t�)82 A -6l C1.2- Opening Date of Child Care: Apn IL L � PLEASE PROVIDE THE FOLLOWING: d Name of family member who resides on-site & operates child care: Iiu �z rkL N AD G @.Copy of license from the Dept of Social & Health Services: 17 Enclosed 1P A 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). 'How many people living outside your home will be working at the child care: ,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, please do not submit metered envelopes. The Federal Way Post Office may refuse such envelopes. Bulletin #029 — January 1, 2008 Page I of 4 k:\Handouts\ln-Home Child Care Application • ❑ Hours and days of operation: MQ __ Fr �9 I hr s ❑ Maximum number of children you will take care of on any given day: ❑ Number of children residing in the home: J_ ❑ Number of vehicles you anticipate coming to your home per day as a result of the child care (include employees, customers, deliveries, etc.): 2 Please explain: �'o Sin merS ❑ Describe any fencing & other buffering devices around the play area (height & materials): 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 � Two story ❑ Tri level ❑ Split-level ❑ wBaserrmt ❑ Other: 2. A smoke detector shall be provided in all sleeping/nappmi areas and on each level of the home. Has a smoke detector affidavit (enclosed) been completed? jo Yes ❑ No 3. Does the home have an automatic fire suppression system (sprinklers): ❑ Yes No 4. Each floor level used for child care purposes shall be served by two remote exits. Child care will be located: ❑ Basement 11 First story ❑ Second story ❑ Level: If in the basement, is there an exit at ground level (no steps, porches, or decks outside the door): ❑ Yes ❑ No INot 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 interior stairway (steps, porches or decks outside the door OK): 10 Yes ❑ No ❑Not Applicable 7. If in the basement, is there an emergency escape window or door which leads to a public way: y Yes ❑ No 9ONot Applicable 8. If on the second -story, is there an exit directly to the exterior of the home that does not go through the first -story: Yes ❑ No ❑ 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 ❑ Not Applicable Bulletin #029 — January 1, 2008 Page 2 of 4 k:\Handouts\In-Home Child Care Application 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): 0 Yes ❑ No 11. Do the sleeping or napping rooms have a door directly to the exterior of the building: Yes ❑ No 12. Do any commercial uses occur next to the child care area: ❑ Yes )qNo If Yes, type of business use: 13. If you answered yes to question #9, is there a fire -resistive separation between the rooms or spaces? O Yes ❑ No ,QNot Applicable If Yes, what is rating? 14. If you answered yes to questi #13, are there rated and labeled doors or windows in the wall: ❑ Yes ❑ No ,Not 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 II," 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. LATA CD W N ADO ,Ajv h a&—> Full Printed Name Signature Date ft Planning Representative 4)�� ilding Division Representative Date Bulletin #029 — January 1, 2008 Page 3 of 4 k:\Handouts\In-Home Child Care Application 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 parldng, loading, and unloading 4) Adjacent streets 5) North arrow st Street Bulletin #029 — January 1, 2008 Page 4 of 4 kAliandoutsUn-Home Child Care Application V CITY OF Federal Way DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES 33325 8`h Avenue South PO Box 9718 Federal Way WA 98063-9718 253-835-2607; Fax 253-835-2609 www.cityoffederalway.com SMOKE DETECTOR AFFIDAVIT IN-HOME CHILD CARE Print Owner's Name: I p U&—Cof �0 N R D O Permit No: j q jj q c Print Street Address: 3 3(oll Ilk TW c -t g W Print City, State, Zip: feAQ M lW CLI W Aq, S qjS, I hereby certify, under perjury, that a properly operating smoke detector has been installed in the dwelling unit within the building for which this application is being made. Owner's Signature: "URA UIQVINIX) Bulletin #031 — January 1, 2006 Page 1 of 1 k:\Handouts\Smoke Detector Affidavit �,t/, //-/ C% -�sa1 14 Print Map Page • � Page 1 of 1 =1 - Parcel Map and Data 01b+�6ta?2oo o1oi�5t�722!J a32�o�909�" 255, �a�a�+a9b d'faabr2-iU 332to.�9o8b 255T000iJ�o .: �'S3TL42o ��'' 1�27o39bl47423039060 e^5u7�Gy.�1:ib w� 255T000a�q 255Toafl92o ,�,'�'`Y' „ "; gFpy,yy,g�y ,M 255TC)oYiil2o 1�,Xo' � C 255T84o 2557oob�lAtl ��� +3 J W ." t�5140iPL+fliL f�� yy�ggn `� 255TooOb80 . ^` 337or8lo 2357060 255T�MX88o 255Too to 2557 90 47225W o 2557DK3oot3o Y 2357G85o' 2557or3U9?o 235Too4b5b 2557000840 � 235TU6o9co 2557007RCt 263ioOW30 255TooJ9� 2357obo9 9" 26670ob828 255T00093t� 255T0008o0 266703o 236Ta?dEillo 2M?OWT90 {C} 2006 Krag County '' r i_ 5 ft � 13 11 Parcel Number 2557000880 Address 33607 26TH CT SW Zipcode 98023 Taxpayer VAN ALSTINE G MICHAEL The information included on this map has been compiled by King County staff from a variety of sources and is subject to change without notice. King County makes no representations or warranties, express or implied, as to accuracy, completeness, timeliness, or rights to the use of such information. King County shall not be liable for any general, special, indirect, incidental, or consequential damages including, but not limited to, lost revenues or lost profits resulting from the use or misuse of the information contained on this map. Any sale of this map or information on this map is prohibited except by written permission of King County" King County I GIS Center I News ( Services I Comments I Search By visiting this and other King County web pages, you expressly agree to be bound by terms and conditions of the site. The details. http://www5.metrokc.gov/parcelviewer/Print—Process.asp 8/22/2008 Print Map Page Page 1 of 1 Parcel Map and Data 01 �12� fe16{7722� 1:3219D95 �1#14769119f1 dJ1i1tl5:1121�3 1321[i390� 256,76=1024210390112421039080 2557d91)i2!'1 '. 2551str)K)136 N 2551=110 `2SS1f73?402b ,�'� 255.?0=30 25570i�014d7 25,5y0fH1i3�i ?55s�009LK0 F+ed4ral tray 257000090 ,'� 255is30C188U �" 2557000000 '' 25510�s3'0 55i0J0690 25570000,"d3 25570009001,66 7 ; 147'2250000 2557 s., 2557'Od713a50'. ' 256700091 `2557000050 +4t'z 2553"0�0�40 �'r 295700092p. 255700MCT` 25a700083tl 2557000930 �� 2657MO� ` 25570W82025570W82025570W820/O� O4�! 2557000950 2553000800 235700073O 2553000790 2557000770 {C214ng Caunty 0>_ 5111 Parcel Number 2557000900 Address 33617 26TH CT SW Zipcode 98023 Taxpayer BRIDGES BLANY The information included on this map has been compiled by King County staff from a variety of sources and is subject to change without notice. King County makes no representations or warranties, express or implied, as to accuracy, completeness, timeliness, or rights to the use of such information. King County shall not be liable for any general, special, indirect, incidental, or consequential damages including, but not limited to, lost revenues or lost profits resulting from the use or misuse of the information contained on this map. Any sale of this map or information on this map is prohibited except by written permission of King County." King County I GIS CenterI News I Services I Comments I Search By visiting this and other King County web pages, you expressly agree to be bound by terms and conditions of the site. The details. http://www5.metrokc.gov/parcelviewer/Print—Process.asp 8/22/2008 CITY OF Federal Way 0 DEPARTMENT OF COMMUNrry DEVELOPMENT SERVICES 33325 8* Avenue South ' PO Box 9718 Federal Way AWA 98063-9718 253-835-2607; Fax 253-835-2609 www.ciVoffederalwgy.com NEIGHBOR NOTIFICATION IN-HOME CHILD CARE (?e CDNA0 O is proposing an m - (Applicant's Name) home child care at 33611 ;Le -deco f flJ9l y W4 C/Ar. 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 children at any one time, including 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? K Tenant? _ Please sign your name as an acknowledgement of notification. /? (Sign Nam N (Print Name) 17 2 G .(-7- yk) (Street Address) % (dr aC k1a y ?KO -12 (City, State, Zip) K. V S- d (Date) Return to the Department of Community Development Services at the above address. Bulletin #30 — January 1, 2007 Page 1 of 1 UliandoutsWeighbor Notification 0 41k CITY OF Federal Way 9 DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES 33325 8s' Avenue South PO Box 9718 Federal Way WA 98063-9718 253-835-2607; Fax 253-835-2609 www.cityoffederalway.com NEIGHBOR NOTIFICATION IN-HOME CHILD CARE EE<v'A,1Aho 1 ►� :3 71 is proposing an in - (Applicant's Name) home child care at : 36 // 167-ffCTSiv 7r?enle 1) gu y LOA. 91Y=3 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 children at any one time, including—.2-L.- 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? X Tenant? _ Please sign your name as an acknowledgement of notification. R C) (Sign Name) (Print Name) (Date) 4 Z4-r�a Ci s�v (Street Address) �En ("?-fj C L r1y i,, >i (City, State, Zip) Return to the Department of Community Development Services at the above address. Bulletin #30 — January 1, 2007 Page 1 of 1 k:\Handouts\Neighbor Notification TAX REGISTRATION REGISTERED TRADE NAMES:. MUNDO DE JUGUETE CHILDCARE 117152 LICENSE ID Washington State Department of . 1.01532 ©o F n r l I o n r n' n SSPS PAYMENT NUMBER FULL LICENSE -FAMILY HOME CHILD CARE In compliance with and pursuant to the laws of the State of Washington in meeting the minimum licensing requirements of the Department of Early Learning (DEL), a license is hereby granted to the provider named below. Further information on the status of this license can be obtained by calling 1-866-482-4325 or (1 -866 -48 -check). -- AURA COW%' to provide child care for children at 33611 26TH COURT SOUTHWEST city of FEDERAL WAY zip code 98023 , county of KING ' , State of Washington, in a family home licensed for a maximum 6 children on the premises including the provider's own children under twelve years when on the premises. The provider may have on the premises at anyone time: 6 children, birth through it Years of age; or When a qualified assistant is present, the provider may have: XX children, two ears through XX Years of age; or g _ Y g XX children, birth through XX years of age. XX children. three vears through XX vears of aqe: or XX children, five years through XX Years of age The allowed number of children under two years of age is: 2. Limitations, if any: This license is issued on OCTOBER 8, 2008 and APRIL 10, 2011 , Dated at KENT ,Washington, this 24TH day of OCTOBER 2008 . LIC OR tDEL"R TT MAR CHARLK. CHOW PRINT YOUR NAME HERE PRINT YOUR NAME HERE (253) 372.5982 (253) 372.6043 TELEPHONE NUMBER TELEPHONE NUMBER NOTE: This license is not transferable, and is valid only for use by the individual(s) to whom it is issued and at the location described. Issued by Authority of Chapter 43.215 Revised Code of Washington. 10.9.1.1 FH LICENSE i U