03-105348 • •
` CITY OF CITY HALL
Fe d e ra I Way 33530 1st Way South• Box 9718
Federal Way,WA 98063-9718 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-
David Lee
Development Specialist
cc:
Cathleen Rossick,Licensing Specialist
Kari Cimmer,Lead Development Specialist
File
daycarekapprovaI.ltr
Doc.I.D.
•
410 i
RECEIVED P RTMENT OF COMMUNITY DEVELOPMENT SERVICES
33530 First Way South
CITY OF COMMUNITY DEVELOPMENT DEPARTMENT PO Box 9718
Federal WayFederal Way WA 98063-9718
� , ) • j/�� 253-661-4000; Fax 253-661-4129
www ciryoffed'ralway com
IN-HOME CHILD CARE
LAND USE APPROVAL APPLICATION
Application Fee: $35.50
Name of Child Care: I`�-\I Ca re _ -TS �V\tt r�'(1 ��S)
Name of Applicant: Tee �� k4('I'
Address of Child Care: nd
Mailing Address(if Different): I
Phone Number: 53—is 1 J4 (0( Opening Date of Child Care: JaRlidrg i ac
FOR DEPARTMENT USE ONLY
Zone: File No:
s:.
Tax•Parcel Number:
Application Fee: Date Paid:
Business License Fee: Date Paid:
Special Conditions or Restrictions:
PLEASE PROVIDE THE FOLLOWING: l
• Name of family member who resides on-site& operates child care: TI el I Pt-L-ers
' Copy of license from the Dept of Social & Health Services: O Enclosed
'fend ivl — per 1:0514S t a weeks.
A sketch of your lot that shows your home in relationship to your loOlines. 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.
Bulletin#029—December 26,2002 Page I of 4 k:\Handouts—Revised\ln-Home Child Care Application
• 4
'Hours and days of operation: 1 a rA- 630 prig
'Maximum number of children you will take care of on any given day: t_0
'Number 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.): Please explain:
I on&y € Q+ e.v,s-tonf(s Ugh( Cies I tol haoc
ro .CrhOoy2-sa
Describe any fencing& other buffering devices around the play area (height& materials):
vJe hNe (P,ho;n- I;n k -funct Q q -kc-4, some 6, -ke+
ht 6--F04 sec-LiUvt Is also i'•31A4, ObSCC {(A .
The 1997 Washington State Uniform Building Code has special requirements for in-home child care
centers. Please provide the following information:
1. What type of house is it? O One story . rrwo story O Tri level O Split-level CIw/Basement
El Other:
2. A smoke detector shall be provided in all sleeping/napping areas and on each level of the home. Has a
smoke detector affidavit(enclosed) been completed? ..l(Yes O No
3. Does the home have an automatic fire suppression system (sprinklers): O Yes .- No
4. Each floor level used for child care purposes shall be served by two remote exits. Child care will be
located: O Basement ,First story El Second story O Level:
5. If in the basement, is there an exit at ground level (no steps, porches, or decks outside the door):
O Yes El No .ANot 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): O Yes O No , Not Applicable
7. If in the basement, is there an emergency escape window or door which leads to a public way:
O Yes O No XNot 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: O Yes O No KNot 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: Cl Yes El No , Not Applicable
Bulletin#029—December 26,2002 Page 2 of 4 k:\Handouts—Revised\In-Home Child Care Application
410
. ..
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): . Yes O No
11. Do the sleeping or napping rooms have a door directly to the exterior of the building: Cl Yes ANo
12. Do any one of the following uses occur next to the child care area: commercial-type(restaurant)
cooking kitchen, boiler, maintenance shop,janitor closet, laundry, woodworking shop, flammable
or combustible storage, or a painting operation:
O Yes No Which one?
13. If you answered yes to question#12, is there a one-hour fire-resistive separation between the rooms or
spaces? O Yes O No KNot Applicable
14. If you answered yes to question#13,are there one-hour rated and labeled doors or windows in the wall:
Cl Yes O No ONot Applicable
15. Building Division Comments: /I"
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,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.
�r e k CS
Full Printed Name
" ► Pktvin 1 i S/().b03
Sig . . - Date
Planning Representative D to
b(611
Building Division Representative Da e
Bulletin#029—December 26,2002 Page 3 of 4 k:\Handouts—Revised\ln-Home Child Care Application
• •
.
SITE PLAN EXAMPE
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
4) Adjacent streets
5) North arrow
n
35 '
PL
2 0' PL = Property Line
< f o
8 '
House
Garage
N
'Driveway
Gtl� Gr2
30 '
Gr)1 c.r 4
PL- 1114\
70 '
1st Street
Bulletin#029—December 26,2002 Page 4 of 4 k:\Handouts—Revised\ln-Home Child Care Application
. S
0
DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES
33530 First Way South
CITY OF rr"'j PO Box 9718
Fed e ra I WayFederal Way WA 98063-9718
253-661-4000; Fax 253-661-4129
www cityofferderalway corn
NEIGHBOR NOTIFICATION
IN-HOME CHILD CARE
1'6,C\i -Le CS is proposing an in-
(Applicant's Name)
'p home child care at 19 3S- S cg-Sol, n'`i I`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 6,0 children at any one
time, including ca children already residing on the premises.
Please call the Federal Way Department of Community Development Services at 253-661-4115
if you have any question or concerns.
Agent 6%
Are you the property owner?" Tenant? Please sign your name as an acknowledgement
of notification.
PlICU2 i pDs6.:-Ao .
1111111
_r;dir,& ,l ttiu �-�Iela d/a ent foe 111210 16
-gn Name) ( ,Q,tPrint Name) (Date)
2E3120 to I' (Wentz S `
(Street Address)
i ecierc& Lc ) lb A 01'6005
(City, State p)
Return to the Department of Community Development Services at the above address.
Bulletin#30—December 26,2002 Page 1 of 1 k:\Handouts—Revised\Neighbor Notification
! .
COMee,, VREC DIVED
BY
DEPAR414 Fill, UNITY DEVELOPMENT SERVICES
�
,,,,� DEC 0 9 2003 33530 First Way South
CITY OF PO Box 9718
Fed e ra I WayFederal Way WA 98063-9718
253-661-4000; Fax 253-661-4129
www rityoffederalway corn
NEIGHBOR NOTIFICATION
IN-HOME CHILD CARE
I r Ikkc rs isP p g osro in an in-
(Applicant's Name)
home child care at i 9 3 S 5 a:S/a " I SGC . 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 Co children at any one
time, including a children already residing on the premises.
Please call the Federal Way Department of Community Development Services at 253-661-4115
if you have any question or concerns.
Are you the property owner? K Tenant? Please sign your name as an acknowledgement
of notification.
e• 4I•►'r ALBERT C . Barra i z (6 f 3
Sign Name) / (Print Name) (Date)
Zatzl tpTN AVE. s.
(Street Address)
Ft4EtkAL wAl WA la
(City, State,Zip')
Return to the Department of Community Development Services at the above address.
Bulletin#30—December 26,2002 Page 1 of I k:\Handouts—Revised\Neighbor Notification
•
DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES
CITY OF r..rOr 33530 First Way South
Federal WayP9 Box 9718
Federal Way WA 98063-9718
253-661-4000; Fax 253-661-4129
wwwsityoffederalway coin
SMOKE DETECTOR AFFIDAVIT
IN-HOME CHILD CARE
Date: ItIaXlaoO3
Print Owner's Name: I c a l 1 3-.. iLf(S Permit No:
Print Street Address: (q 3 S n �-ga ivi N'ace_
Print City, State, Zip: FeLk (/-a l W / 1 4A 9$U23
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.
rii4CAA )002/vcP 0
Owner's Signature:
Bulletin#031 —December 26,2002 Page 1 of 1 k:\Handouts—Revised\Smoke Detector Affidavit
•
DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES
Ais 4111114116..., 33530 First Way South
CITY OF . PO Box 9718
Fed e ra I inlayFederal Way WA 98063-9718
253-6614000;Fax 253-661-4129
www rityoffederalway cnm
NEIGHBOR NOTIFICATION
IN-HOME CHILD CARE
is proposing an in-
(Applicant's Name)
home child care at . 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 253-661-4115
if you have any question or concerns.
Are you the property owner? Tenant? Please sign your name as an acknowledgement
of notification. .
(Sign Name) (Print Name) (Date)
(Street Address)
(City, State,Zip)
Return to the Department of Community Development Services at the above address.
Bulletin#30—December 26,2002 Page I of I k.\Handouts—Revised\Neighbor Notification
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