02-101386 •
City of Federal Way
Community Development Services Building - Multi Family Permit #:02 - 101M 6 :00 - MF
33530 1st Way S
Federal Way,WA 98003-6210
Ph 253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: OCEAN RIDGE APARTMENTS
Project Address: 1711 S 281ST ST Parcel Number: 332204 9039 ( t 1
Project Description: RES REP-Tear off comp,replace w wcohp.N eeting.
Owner Applicant L on for Lender
COMMUNITY HOUSING ASSISTA PACIFIC STAR ROOFING INC PACIFIC STAR ROOFING INC NONE
28120 18TH AVE S 12902 HIGHWAY 99 S PACLESR179JA(10/31/02)
FEDERAL WAY WA EVERETT WA 12902 HIGHWAY 99 S
98003-3265 EVERETT WA NONE
Includes:
Census category: 555-Non-st #1 #2 #3 #4
Occupancy Group: R-1
Construction Type: Type V-N
Occupancy Load:
Floor Area(Sq.Ft.):
Census Category 555-Non-structural roofing p Mechanical No
Permit for Foundation Only No Plumbing No
Will Certificate of Occupancy be Issued' No Zoning Designation RM 1800
PERMIT EXPIRES September 30,2002,IF NO WORK IS STARTED.
Permit issued on April 3,2002
•
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws,rules and regulations of the State of Washington and
the City of Federal W•y.
Owner or agent: ;_.��� 1 Date:
13IJ IL — / 5 - o-, LJ
MUO pE EELOPMENT DEPARTMENT
DEC 2003 �- ?, ✓ •
(For office use only)
uu c ( tiR �-'
' `�� I L( FW[3L1120- 03 -fo534g t3 t.
BUSINESS LICENSE APPLICATION
Please type or print clearly in dark ink `�-k4°
,Lt New Application ❑Update Application/Address Change
UFederal Way Business ❑Outside Contractor AHome Occupation ❑Other
SECTION A — Business Information - Please complete all information.
Business Name__ _ WA State UBI # (1-800-647-7706)
Ti\ r )( ' M ba C. r. (4.1 ;
Business Location Address (S reet/Suite#-Physical Lo ation Only)
V 135- S aga '4 MVP_
City i State Zip �pj //�/ Business Phone#.
i--.en k(0 ( k) 0\1u3, 9aD3 �-45 -9 qt —q.),(01
Mailing Address City State Zip Business Fax#:
S_,VV\ - City__
5 0FV\t SL Irie /MC__
Is this a Non-Profit Organization established for educational, Number of persons employed in Federal Way:
religious, or charitable purposes? ❑Yes iliNo # I Full Time # Part Time
Is there Liquor served on the premise? ❑Yes . No Is there Gambling activities? ❑Yes --0No
If yes, State Liquor License# If yes, State License#
SECTION B — Description of Business — describe in detail your business activities—including
which category-retail,wholesale, or services.
TV\- kiDt (t hii kii dr Care - eck;i ees
o ISU pay itt e Coot—rem rrn erl/(US
SECTION C — Business Ownership -Attach additional pages if necessary.
Sole Proprietor ❑Partnership ❑Corporation ULimited Liability UNon-Profit ❑Other
Company Name �)��
(As registered with WA State): I eFr, iOCISCS
Number of Owners, Partners, Date Business began
or Corporate Officers: I or will begin in FW: ic1Y1v1K 1 a i Q_0°
Li
Name: Title: Driver License#/State: Social Security#: Birthdate:
-1C- A.\( S Pe-- (-arov;der PETE tZ i t3/ 4 '33.-1,1- /rico(' /a/oa I19&I
Home Address (Street/PO Box, Cit , State, Zip) Telephone Number: % Owned:
1 1 Dc 5 dgandkeee_ R-6.tN), t(LA 6.t C0 Q 3-QUI-cIaII t00%
Name: Title: Driver License#/State: Social Security#: Birthdate:
Home Address (Street/PO Box, City, State, Zip) Telephone Number: % Owned:
SECTION D — Business Location - Some improvements to your business may require separate
permits. Please contact the Community Development permit counter at(253) 661-4115 for more information.
King County Parcel#: . ,i you making tenant improvements? DYes :No
4�a 31 o(,00 (Lok-(co, Lm- i r4 N, #
Building: OSingle Tenant Floor Space Used �/ Name of Busine s Center(if applicable):
UMultiTenant for Business (Sq. Ft.): I o . t��A-
Does building/premise have If Yes, monitored by: City alarm registration no.:
a security alarm system? J�Yes ❑No ,hDZ" Q 1
Name of Emgrgency Notification/Contact: Telephone No.:
e,0101011 M, tkkeCS r 0(p -ciS-3-- (-1 (,).-
.
• • ` � �
1
SECTION E - Hazardous Materials -Required by the City of Federal Way and Fire Department. .
Does your facility currently report to the Federal Way Fire Department under Sara Title III? DYes ANo
Does your facility currently use or store flammable materials? DYes i, o
If,yes, please list.
What types of hazardous materials and /or waste are used, stored, handled, processed, or generated by your
business? If additional space is needed, please attach a separate sheet(s)of paper.
1101tC__
What quantity (in gallons) of the above substance is stored on site at any given time?
(Excluding consumer commodities for household use packaged in quantities of less than five (5) gallons)
*oolil one_ boorkJ'1 /n
SECTION F — Home Occupation - If you are applying for an Adult Family Home or In-Home L,IS;!1 PSS
Daycare please contact Community Development Department at 253-661-4115 for additional requirements.
Name all family members w o resid- at the home and work in the business, include yourself:
Cc('dc ' l va ' e a •i r . 't1
Name of ApartmentiTownhouse " omp e . .•• "cable) Complete Floor Space o Residence:
(A� LSSA Luka,c2 f�2
Will there be any outside storage of goods, display of materials or outside activity?-DYes DNo
If Yes, please explain: IV((Ice (33``l ltd ptA{S i ck d.4- -k;rYlej
Will the business require the use of heavy equipment, IDow4r tools or power sources not common to a residence?
DYes .L to , If Yes, please explain:
Will there be any pick up or delivery by commercial vehicles? DYes No
If Yes, please explain type and frequency:
Will there be any visits to the home by clients, employees, or delivery services?-Wes D No 4 e gvii-f1\ a r cked c tp
If Yes, please explain the number of deliveries expected: per week per month cit-0ri O-i{_
Are there any conditions produced by the home occupation such as noise, vibration, smoke, dust, odor, eat, or glare
which would exceed that normally produced by a single residence, or which could create a disturbing or objectionable
condition in a neighborhood? DYes jallo If Yes, please explain type and frequency:
SECTION G— Temporary Business Activity - Temporary Licenses are granted for a specific
period,and are not to exceed 90 days in a calendar year.
Description of Temporary Business/Activity:
Specific Dates of Temporary Activity:
Is site layout of area/structures provided? DYes DNo Signed Consent of Property Owner must be attached for
(including ingress and egress of area) approval.Copy of lease agreement is acceptable.
SECTION H — SIGNATURES
.1 (we) the undersigned, declare under the penalties of perjury and the denial of a license or revocation of any license
granted,that I (we)am (are)the applicant(s)or authorized representative(s)of the firm making this application and that the
answers contained, including any accompanying information have been examined by me(us) and that the information set
forth is true, correct, and complete. I also understand that I am responsible for notifying the City Clerk, in writing, of any
change in location or mailing address within thirty days. All licenses are nontransferable. I understand my place of
business must comply with all federal,state,and local codes and ordinances.
X > � ^� �V31/Ve� Il /Q&03
Signature of appli•:nt Title Date
t-secs e ry I 406 )
Application ftrepared by(please print) Title Phone Number
For office use only
Amount Received: Check No.: Date Received: Receipt No.:
Business License ft: SIC CODE: Date License Issued:
, t
• •
` CITY OF CITY HALL
Fe d e ra I Way 33530 1st Way South•PO Box 9718
Federal Way,WA 98063-9718
(253)661-4000
www.cityoffederal way corn
January 6, 2004
Tracy J. Peters
1935 S 282nd PI
Federal way, WA 98003-9228
RE: Permit#03-105348-000-00-BL; TJ'S DAYCARE
1935 S 282nd PI
Dear Ms. Peters,
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 parking is permitted only in the driveway area.
4. The maximum number of children allowed in your care is 6, per your DSHS license.
5. The in-home day care shall meet all requirements of the enclosed Uniform Building Code
sections 310.4, 310.9.1.6 and 310.13.
Your city business license will be forwarded to you. Please contact my office at 253-661-4198 if
you have any questions.
Sinc-
ave d Lee
Development Specialist
cc:
Cathleen Rossick,Licensing Specialist
Kari Ommer,Lead Development Specialist
File
daycare\approval.ltr
Doc.I.D.
92838 � NONE -
5i f nu`r"i
LICENSE NUMBER PROVIDER NUMBER
DIVISION OF CHILD CARE AND EARLY LEARNING
INITIAL CHILD DAY CARE HOME LICENSE
In compliance with and pursuant to the laws of the State of Washington in meeting health standards and the minimum licensing
requirements of the Department of Social and Health Services, an initial license is hereby granted to
TRACY J. PETERS to provide child day care for children at
1935 SOUTH 282ND PLACE city of FEDERAL WAY zip code 98003 ,
county of KING , State of Washington, in a family home licensed for a maximum of 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 any one time:
6 children, birth through 6 years of age; or When a qualified assistant is present, the provider may have:
XX children, two years through XX years of age; or XX children, birth through XX years of age.
XX children, three years through XX years of age; or
XX children, five years through XX years of age; or The allowed number of children under two years of age is: 2.
Limitations, if any: ** FIRST INITIAL LICENSE VALID FOR SIX MONTHS **
** LICENSED CAPACITY INCLUDES PROVIDERS'S CHILD OVER AGE SIX **
This license shall be in force from the 16TH day of DECEMBER , 2003 ,
to and including the 15TH day of JUNE , 2004 , subject to revocation for due cause. •
Dated at KENT , Washington, this 17TH day of DECEMBER , 2003 .
./7.' ' _IP' /.
AP
LIC S REGIS A R/SUPERVIS
ROBI HIGH PATRICIA ESLAVA VE Y
PRINT YOUR NAME HERE PRINT YOUR NAME HERE
( 253 ) 372-5966 ( 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 74.15 Revised Code of Washington.
DSHS 10-092A (REV.06/1998)(AC 05/2002)
v. _ _80 _ v. -p v% y
r-t r° g—ecm- o o= rb -"'aa
o `^ Cl..) C• 7C.
=
=1 ebCLJ """C 7 . e•-1: = =- �' ��1 e �- tlin
c_)
r..t . . _
.%
CO O
. . _
141P 111
. . * o4
= �s
= =
4 .....< c=•• �-c
- < -t) .. . .
, e-•,
....<
�• = = = = = = --• _
=' N el)
Orta
*
iih
r---
WV 4110
. N• = -v
• •
—ri rib --� •--c --< --t • ..0 o
--•c =
-` = C ,q T oNI •
P N = _ _ _ _ _
n
s
t
�1 i —J
CIT.OF CONSTRUCTION PERMIT APPLICATION
APPLICATION NUMBER: 15g-- L& 1_ E? -/ F-
v\> FlY L RECEIVED
APPLICATION NUMBER: - -
APR 0 1 2002 APPLICATION NUMBER: - -
**The following is required information-Please print(in ink)or type**
CITY OF FEDERAL WAY
Please note: Electrical,Fire Pregelltipysttand Engineering permits may require a separate application.
• PROPERTY INFORMATION
/ SITE ADDRESS: Ph i ZO I b T`� 44.- 5Ov'14 ASSESSOR'S TAX/PARCEL#: -
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
ocr7,6cr1 R\t e- AP i\nt, rs-
• PRO3ECT INFORMATION
TYPE OF PROJECT(This application): BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
o ELECTRICAL ❑ ENGINEERING o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):-- yam
, ,' f �`� a-r1G \,:r-, Y1rl \ l
r���.?"\_-, , 1\v-- �\ �1_�� ti'1 � . t�fzMou� �,CI J Mle,sri o..) €o0( ( I /
i i\) -c 'S,c. 1.*w CipMPosiT(orJ N)n-c-t Nz(P�,c# /A-Z-Pe=. . )`‘e:7 �E 4 r/�C
etD_iN # &o It o. . Dili, 1a 1-(1z-de,
PROJECT NAME: _eer ,'\ AkG. _ (*4 iC1- 77
• PEOPLE INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
Ntn(.O(T4 ..9, A�(s cz P1 P, (�/`{ ) 4 2' -1(, r
MAILING ADDRESS( EET ADDRESS; STATE,ZIP):
31`43E. C , A �1 ( 4 . 12 " - 5"3y4'
CONTRACTOR: jNNAAME: DAYTIME PHONE:
c.X: (`\ 1 fx11 Y'N� \It A C_ • )--14-E--) &C_No(,. ,
_
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP) ( EVENING PHONE:
\ZG\O \-- c — k G '1 L� �
/ ' -'L - ( )
CITY OF FEDERAL W Y BUST SS LICENSE !7
N MBER: FAX NUMBER:
- ( )
CONTRACTOR'S REGISTRATION NUMBER: nEXPIRATION DATE:
2APPL (copy of card required) P. ( L - cl J A I D / \ / 02—
APPLICANT:
ICANT: NAME: DAYTIME PHONE:
IMAM Pi�1AC ( /2<) ;•_( - </S�i
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
(7401- 141C V)P ` r Jo i/4� ,o. �z0 ( ) -"
RELATIONSHIP TO PROJECT: / FAX NUMBER:
o ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE):eo^1XA- 1t" ( VK ) 2- C2 - /7'S7
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER APPLICANT CONTRACTOR
• DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ 31°l� Z• 00 \40-)1><
SPRINKLERED BUILDING? 0 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: 0 YES ❑ NO . :}
WATER SERVICE PROVIDER: o LAKEHAVEN ❑ HIGHLINE ❑TACOMA ❑ PRIVATE(WELL) iF\i/k 1 5 ,� �(�,
SEWER SERVICE PROVIDER: o LAKEHAVEN 0 HIGHLINE o PRIVATE(SEPTIC) \S l
**NEW RESIDENTIAL CONSTRUCTION ONLY**
• •
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
■ FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING EVAPORATIVE GAS LOG(S) REFRIG.SYSTEM(S)
UNIT(S) COOLER(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC. ( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER VACUUM BREAKER(S) o ELECTRIC oGAS
`
SYS.
DRINKING SHOWER(S) WASH MACHINE
FOUNTAIN(S) OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
■ DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and
further,that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I
further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in the
investigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the City of
Federal Way,but only where such claim arises out of the reliance of the city,including its officers and employees,upon the accuracy
of the informati e n s e ply to the city as a part of this application.
NAME/TITLE: kA I.SIA ' bL ' ' 1 yN Ci DATE: -0
i1cP4'"-rrICCe*r(L�'�.
❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR 11 \)
FOR OFFICE USE ONLY:
o NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION : BUILDING SHELL ONLY? o YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? o YES o NO
PLATTED LOT? o YES ❑ NO CHANGE OF USE? o YES ❑ NO