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11-100266 City of Federal Way • oBuilding - Single Family Community Development Services Permit #: 11-100266-00-SP P.O. 1-100266-00-S>- P.O.Box 9718 1 Federal Way,WA 98063-9718 Inspection Request Line: Ph.(253)835-2607 Fax (253)835-2609 p a (253)835-3050 Project Name: AMG HOME HEALTH CARE AFH Project Address: 3921 S 337TH ST Parcel Number: 618143 0260 Project Description: Code inspection and verification of occupancy for adult family home.***NO CONSTRUCTION ALLOWED UNDER THIS PERMIT*** Owner Applicant Contractor Lender JEANETTE VANCE GINA ACORDA 35032 41ST PL S 32112 32ND AVE SW FEDERAL WAY WA 98001-9050 FEDERAL WAY WA 98023 • Census Category: 434-Residential alt/add-no change in number of units Includes: #1 #2 #3 #4 Occupancy Class: Construction Type: Occupancy Load: Floor Area(sq. ft.) 0 0 0 0 � � e�aY3IMNMMI�i�� �1�! II ya..t:n• yAlbrn; New/Additional.Sq.Feet=1st Floor 0 New/Additional Sq;Feet-2nd Ffacr, ;..:.0, New/Additional Sq:Feet-3rd Floor - 0 .New/Additional Sq.Feet-Basemen : .»:..0.;.n,, Basic Plant No New/Additional Sq.Feet-Deck 0 New/Additional Sq.Feet-Garage 0 Mechanical to be Included' No New/Additional Sq.Feet-Other 0 Plumbing to be Included? `No . New/Additional Sq.Feet-Total 0 • • • y�k•S;,. ''�•:� � '' ' ty] S �/4,7E'.v; fQ% + �.v • ttru mut-lure / •• 't x a•f �> :•'f��: t�� . y , � .3`: • �3 PERMIT EXPIRES Wednesday, July 20, 2011 Permit Issued on Friday, January 21, 2011 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 Way. Owner or agent: f t Date: I ' . /i 1/314 (t r ` 1 , City of Federal Way • Certificate of Occupancy This Certificate issued pursuant to the requirements of Section 110.2 of the International Building Code certifying that at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building construction or use. This certificate is valid ONLY when endorsed by City staff, Tenant Name: AMG HOME HEALTH CARE AFH Permit#: 11-100266-00-SF Address: 3921 S 337TH ST Includes: #1 #2 #3 #4 Occupancy Class: Construction Type: Occupancy Load: Floor Area(sq.ft.) 0 0 0 0 Owner Name: JEANETTE VANCE JEANETTE VANCE Owner Name: Owner Address: 35032 41ST PL S FEDERAL WAY WA 98001-9050 Building Official Date The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which experience has shown most sever!),affect the health and safety of the general public. Although the City has made as complete a review and inspection as is reasonably possible(within budgetary time and personnel limitations), the City neither guarantees nor warrants to the owner/occupant or to any other person that this Certificate evidences strict compliance with each and every ordinance or regulation of the City or the State of Washington affecting the construction or use Of said structure or the land upon which it is situated. Such compliance is the responsibility of the owner and/or occupant of the premises. 1, r • `dolt Family HomeLOCAL BUILDING(AFH) ING INSPECTION CHECKLIST Code References: 2009 IRC Section R325(WAC 51-51) APPLICATION NUMBER: /1 — /0° SECTIONS 1,2,3,AND 4 MUST BE COMPLETED BY APPLICANT BEFORE INSPECTION WILL BE PROCESSED �+ SECTION 1 - PROPERTY INFORMATION SITE ADDRESS: ,13(:?(;)/ J' .33 7"44/ T - • N AX/PARCEL#�: SECTION 2 - APPLICANT INFORMATION �_p-� PROPERTY OWNER NAME: �hG � ��(KC�f/ DAYTIME PHONE:"6 7 3/5-Z9Z O AFH LICENSEE NAME(IF DIFFE BM: 40/ 11/41/(4409614 fr/l I1Fj54 DAYTIME PHONE: SECTION 3 — FLOOR PLAN APPLICANT MUST DRAW COMPLETE FLOOR PLAN/s ON THIS FORM(ALL FLOORS). PLEASE INCLUDE ALL SLEEPING ROOMS(sEDRooIls). ON THIS DRAWING.INDICATE WHICH BEDROOM IS A. B. C. D. E.AND F. LABEL ALL COMPONENTS FOR EXITING i.e.: STAIRS. RAMPS. PLATFORM LIFTS&ELEVATORS. Aftaclu_ce SECTION 4— 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 that I am requesting or I am authorized by the owner of the above premises to request inspection for the operation of an Adult Family Home at this location. I agree to hold harmless the jurisdiction conducting such inspections,at my request,as to any claim(including costs,expenses,and attorneys'fees incurred in the investigation of such claim),which may be made by any person, including the undersigned,and filed against the jurisdiction,but only where such claim arises out of the reliance of the jurisdiction, including its officers and employees, upon the accuracy of the information supplied to the jurisdiction as a part f Yis application. NAME/TITLE: ' �4 4_60' f DATE: / 0 PROPERTY OWNER .,0 APPLICANT 0 LICENSEE 08101/10 05‘• - ) / . . • v cir Cal- cc 0 0 u. \_,• . . . • cc o 0 . '- ' \‘'t\\)1" ,. -co. O 0 , 06--\`' . 111 11 J 0U Q W o �y� u.W Q a co •M W co IL • • • U1 (I Lie d` ' . ' fg . . p A . / l� c` ,' Tc' -' -- . I -1 .., ('-' , ,,r, . !,,,I 5,, ,. • ` Inside/Z 7,,..0 R311.8.1 Maximum Slope one unit vertical in twelve units horizontal(8.3%slope).(Exception R311.8.1 Not allowed in AFH) 0 , i R311.8.2 Landing Requirements:min.3X3 foot landing at top/bottom,where doors open onto ramps,and where ramp e(r'S I❑ • changes directions: . R325.9.1 Handrails ., fired on both sides of ram' in accordance with R311.8.3.1—R311.8.3.3. - El 0 - -' R' i-. .i' �,it , f � ::, q.,:- , . itort to t ----t.:;', «) ) t:' "c - M � -•,,.)r al?�. .-I`' j ±,. i • 5 ' a -fTi7,- ,,:„7,-,- _ - F:.:4t .1! r,'T'" Mit+o _ tytotW; ':,..;��t ?'::. .". 15?_ - ,.,', ) -1_�' -c. i, - XY-' `�k " "� - _-- - 14 _ 4j j1i . - .y: :,.:-",;,_-,..4;,-,.;-;-4',:.:.„,-.. - €-c . .- ....-.,,,,.-„, ,,;,--i.:''..'wK , --. . ..,..-:-.--_,-4,.,..-L--..- --$:' .. r. .,-4,... cLv .- --$-d --...4'"-,,--J:-. %; '- ,,_-,,,.,,,_„..---<„,,,,..4,..„.- " I;-. , ��i ��p� 'iim, ---1,,,,,,‘:- 7 : .Li ; 3 _.!h.= a �ikrS _ �� nCe 'OAll.--1 -4.. I � . : +� }� P 4,4 „t ;lg 4,r,„,,..„, ,, .;'t' wz'i, . ,,,,.t_—. , . £• ,_..„.0._,-,„..x4 _., %., ,,tr, .,-, .. t,.. .s4..1,t ,te , t .- Ar.:'' i4.4.,•n' Y. } •410 _ ,✓, ,l` a�ewmleV -. :.;fk l r17 - A/ZIlT7.i' Y ...w,. : _:..- "less than 4' Handrail both sides ®A., 34"-38” Guard 36"min , ��r'j�.�;fir. i' 3'x3'min 3'X3'min �,..........." ,. <landing :area 1:12 max slope --- •` ' - _ v mj ' n i \ I - • . - ADULT FAMILY . HOME RAMP --pet- 2009- -IRC -wi-th WA. ST. AMENDMENTS *ALL:IiAMPS, REQUIRE A BUILDING PERMIT* _ R311.2 Means of Egress - a.-,.:,ns YES 0 R311.2 Door must be side-hinged with mm .width of.32 inches between face of door and stop.Height not less than 78 inches.' - ❑ ''' R325.4 Operable parts of door handles,pulls,latches,locks and other devices installed in AFH shall be operable with one hand r, :: and shall not require tight grasping,pinching or twisting of the wrist(lever-type,emergency egress hardware). The-Exit doors g3/ 0 shall have no additional lockin• devices. 17; �'. _ _ K�x 'Q'f..riJ K: ` Dir,`15��� KMre ft4.+.;r,a ' :,'`-,YES, . . '>`_ 01,3:01','-:-,:-, µ',;> r'L.'_i`• � ,_; -__1:-- .-,*__.,_i i1 ,;_:,. �wi i3,�i i.1,� Ii' �-.: .-1. .y.:',•� .r..- =,..,4fic...r.:-E : _ fl Ott a' •-r.t 3 '. ead' :tw !.t a ' Inches D Sint [ 5 bili ' _' te-Jui 1,. #l' 0, 0 R325:'lOt q�i,�` 7‘', t : ', ::`' '`, 'litStOreilbil both sides:of'# tis al ar ;ritih l tij from one irseell - - ' Whip ple shalt be installed in accordance with R311.7.7.1—R311J:7, ,,A--A _, _ R 325.8 Grab Bars in Bathrooms Ma -,vire"alternate"a e e royal in accordance with IRC Sec.R104.10 and.11 YES NO R325.8 Grab bars shall be installed for all water closets(toilets),bathtubs and showers. Bathing facilities such as tubs and showers;and 0 On both sides of the toilet(shall comply with ICC/ANSI A117.1 Sections 604.5,607.4&608.3) 0 AGIO3`-AG-105 Switntning Pool.Sias.Hot Tub • - ® YES -NO Ad185-2hoist be surrounded by a barrie_r,that is 48 inches high,may have doors-and or gates that must have audible' ❑ ❑ alarms when opened. AG1055 EXCEPT/ON:Pools,Spas or hot bs with a safety cover which compiles with_ASTM F,1346 0 0 ❑ PASSED . ' CORRECTIOiNS REQUIRED 0 PERMIT REQUIRED INSPECTOR'S SIGNATURE: DATE: INSPECTOR'S ADDRESS: PHONE: Application and Inspection Checklist developed by Washington Association of Building Officials (WABO), in cooperation with Department of Social and Health Services(DSHS)for use by both departments and licensors. 08/01/10 • ebF;hr;sr};ti - 3' '1114!4 *r Pl • SECTION 5 MUST BE COMPLET 4' =Y THE BUILDING DEPARTMENT IN THE JURIS I ION THE HOME WILL BE LOCATED. PLEASE CHECK ALL APPLICABLE BOXES;MATCH THE LIST BELOW TO THE APPLICANT'S FLOOR PLAN—USING THEIR PROSPECTIVE RESIDENT BEDROOM DESIGNATIONS OF A.B.C,D,E,AND F AND CLASSIFICATION CODE:S,NSI,OR NS2 ' SECTION 5 — BUILDING INSPECTOR'S INSPECTION CHECKLIST R325.3 SLEEPING ROOM CLASSIFICATION. Each sleeping room in an adult family home shall be classified as: Type S-where the means of egress contains stairs,elevators or platform lifts to evacuate residents to public area. Type NS1-where 1 means of egress at grade level(has no stairs),ora ramp constructed compliant with 8325.9 is provided to evacuate residents to public area. Type NS2-where 2 means of egress at grade level(both have no stairs),or ramps constructed compliant with 8325.9 are provided to evacuate residents to public area SLEEPING ROOMS Sleeping Room A 0 Type Spe NS1 0 Type NS2 YES ' NO Closet door/s are readily openable from the inside YES f� NO ❑ ' Smoke alarm is installed in the bedroom Er Q Bedroom door is easily and quickly openable from the outside when locked ' 0 Sleeping room window has a net opening of 5.7 SF* (minimum dimensions at least 24"high: at least 20'wide) Er 0 *EXCEPT PER R310.1.1:AT-GRADE ESCAPE WINDOWS-MAY HAVE NET CLEAR OPENING 5 SF Sleeping room window has a maximum sill height of 44"above floor;no steps under windowy.unitted ' ❑ Steeping Room B _ Type NS1 - ❑[ Type NS2 YES NO Closet door/s are realitlipenah ylerfte n the inside YES NO ❑ Smoke alarm is installed in the bedroom EZK' 0 Bedroom door is*hand quickly openable from the outside when locked-: ; , ❑ Sleeping room windoyirittas ainet opening of 5.7 SF* (minip uh`di r pns idleast 24''hieb:-at least iri }' • if?' ❑ : - # «' - -. *ExcEprP&rrl frlt:,AT1 lIQk 111RID01Ms-AIPtY iLAVE NET CLEAR+4 rrNIG5$F Sleeping room window h a um*(theight 0144'above flo_or;norst modeo:vilndowr ed _, Sleeping Room C 0 Type S Wtype NS1 0 Type NS2 "YES--: NO- Closet door/s are readily openable from the inside YES NO ❑ Smoke alarm is installed:in',thebedreoe'' �� ( ; - Bedroom door is easily and quickly openable from the outside when locked ❑ of,; , = Sleeping room window has a net opening of 5.7 SF* (minimum dimensions at least 24' high; at least 20'wide) . •"' ❑ '' . -, *EXCEPT PER R310.1.1:AT-GRADE ESCAPE WINDOWS-MAY HAVE NET CLEAR OPENING 5 SF Sleeping room window.has a maximum sill height of 44' above floor; no steps under window permitted .: ❑:; Sleeping Room D- Q- Type S -❑ Type NS1 Type NS2 ' 'YEAS:- ; 'c:NOA Closet door's are readily openal to from the inside [YEs❑''' Nt '❑ Smoke alarm is' ailed in the bedroom 0 'r_ ❑ • Bedroom door is easily and-quickly-openable from the outside when locked - ❑ ❑' Sleeping room window has a net opening of 5.7 SF* (minimum dimensions a I t 24`high: at least 207wldei- 0 0 *ExCEPT PER R310.1.1:AT ,MiINDOWD-MAY HAVE NET CLEAR OPENING 5 SF Sleeping roc*window has a maximum sill height of 44" above if o steps under window permitted-.- 0 ❑ Sleeping Room E P ype S 0 Type NS1 0 Type NS2 YES NO Closet door/s are readily openable from the inside y = • NO ❑ Smoke alarm is installed in the bedroom -❑ 0 Bedroom door is easily and quickly openable f : the outside when locked 0 0 Sleeping room window has a net openi : of 5.7 SF* (minimum dimensions at least 24' high; at least 20'wide) 0 0 *EXCEPT PER R310.1.1:AT-GRADE ESCAPE WINDOWS-MAY HAVE NET CLEAR OPENING 5 SF Sleeping room window has - • aximum sill height of 44" above floor; no steps under window permitted ❑ ❑ - -.., Room F ❑ Type-S •_ -❑-Type NSI ❑'_Type-NS2 YES NO Closet door's are a openable from the inside YES 0 NO ti Smoke alarm is installed in the bedroom 0 0 Bedroom d:. is easily and quickly openable from the outside when locked 0 ❑ Sleep'- . room window has a net opening of 5.7 SF* (minimum dimensions at least 24' high; at least 20"wide) 0 0 *EXCEPT PER 8310.1.1:AT-GRADE ESCAPE WINDOWS-MAY HAVE NET CLEAR OPENING 5 SF Sleeping room window has a maximum sill height of 44' above floor; no steps under window permitted 0 0 GENERAL YES NO Bathroom doors are easily and quickly openable from the outside when locked 0 0 Smoke alarms are installed on all levels of the dwelling, in each resident sleeping room,outside each separate sleeping (D/'r ❑ area in the immediate vicinity of sleeping rooms(R314) Smoke alarms are installed in such a manner so that the fire warning may be audible in all parts of the dwelling upon ❑/ ❑ activation of a single device. Access road and water supply meet local fire jurisdictional requirements i ❑ 08101110 (x1 Ir.1 I � I❑1 Cl. 1 � it > > > > > 611 -.. >- -- 1 i 1 _ to m g E — � , � re 0 • + , ce, ., .,.... 11 ,-, i LL ._, VP 1 se _ __ _ _______-__ ..0.,......t —t§ c _ i. col ...._ R b:L • ,,......„..._. .........._..... .. .. _,--,---- ,' is 0 ra F ax 1a -43 o o -- 4 ,.L . __. .„ .. Jr. _ 0 ,_ ,7 .. . _ _ _1 , . , g . ,,:j., I III lull lit, , 11::::, (al ro ,sp 3 a ---...., t o o 1 -a -gyp a s - © 0 le + a CL N mtsw a c t5 cin Ii :! I-., {l.. 'R� CL Q aC Lf. e2 ff) LL lL ML C N :C •s, ,�•.I. ' , `6 .. 0311, O of C d ..- N ? t} CWG — 4 �Qt C �[�l� N V N Q.. o f W 45 el i is 'k o 13 4• S 6 m E to = E. �.=, co 3 2 o i L_i , 2 = iz N L w C!J ti LL r j d `` _ - _ � EjJ - 7 d aa� 6 Federa, r, •PERMIT f F CO ME EL PL DE EN FP N ti! TINI/Pigriallii "AP I CATI O N COA(14UN71Y DEVELOPMENT SBRVN 253-835-2607•FAX 153-8352609 www.cityoffederalway.com ‘ Pkt. -.1111111111111.111W i"., is ,t "?h. .F ,,+fi'* 'f.h- }v'-',..-e,' ':"kr-- •i- _ •f.: ;fr:aj>r.';i:t`. ;;t,tW"'' . . gra=�F-'. `am ,*1" ',,',";',::'''..,‘:::- � 'e �Z • d;., S•2,;s TIMM' a/ 5- 37 411 Si • EthL_vNIrTE/INIT a ZONINGAX/PARCEL# _3.0 - 'CK l 3 - G Z � z) NAME P (Tenant or Homeowner Name) tkit G w"' pr OV,l 4 /er m ff BUILDING 0 PLUMBING 0 MECHANICAL TYPE OF PERMIT •0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION e. PROJECT DESCRIPTION 4j,c'.P( 4/1 S; 47/241.1.- 7 24 yam ) ') . Detailed description of work to `L�' ,i / be included on this permit only i , t-e 401.0 , /1 ewe, _. ::'.t.:'-.......r.,.5 .,. -... ... , - - z ., _.1:T:.,„,-,„-,_-.z.._, .. .. .. -„:.,,!,,:,..e:-;,, ..- 4•:',.2,..,-,..---..,-,..',':-.--,1 . ...: ...« _i;%1,?..:.,-- - .r,.. .. NAME PRIMARY PHONE PROPERTY OWNER .lauh-C4t.41 V44-C-i 3/f D� MAILING ADDRESS,CITY,STATE,ZIP E-MAIL aro ?-`40 5 7'-p/.s v 446104 4)4 OWNER IS ALSO: ❑ CONTRACT() 0 APPLICANT [3 PROJECT CONTACT NAME PRIMARY PHONE ( ) - CONTRACTOR MAILING ADDRESS,Cr17,STATE,ZIP FAX ( ) WA STATE CONTRACTOR'S LICENSE a EXPIRATION DATE FEDERAL WAY IIDSINSES LICMISS a /; / / APPLICANTNAME PRIMARY MORE � IZ GL� PH ' Ct- 0 Z tea`' (° 0 MAILING ADD5 CITY. 7 9191 .soy-ti►l l ail `14 (dn) ?-3 a/ PROJECT CONTACT NAME PRIMARY PHONE (The individual to receive and ( ) - respond to all correspondence MAILING ADDRESS,CITY,STATE,ZIP FAX concerning this application) ( ) - ALTERNATE CONTACT NAME: PRIMARY PHONE E-MAIL ( ) PROJECT FINANCING NAME ❑ oWNIR TUTAIICSD Required for projects with value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE (RCW 19.27.095) ( ) I ccrtiy under penalty of perjury that I am the property owner or authorised agent of the property owner.I certify that to the best of my knowledge,the information submitted in support of this permit application is true and correct I certify that I will comply with all applicable City of Federal Way regulations pertaining to the work authorised by the issuance of a permit.I understand that the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating construction or environmental laws. I further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fess incurred in the investigation and defense of such claim), which may be made by any person,including the undersigned, and filed against the city,but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the information supplied the city as a part of this application. SIGNATURE: DATE PRINT NAME: allC(it. at. Ckiv tCQ-[/ Bulletin#100-January 1,2010 Page 1 of 4 k:V-Iandouts\Permit Application MECHANICAL FIXTUII Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE PROVIDED) Indicate number of each type off cture to be installed or relocated as part of this project. Do not include existing fixtures to remain. AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS(Cummercies BOILERS FURNACES HOT WATER TANKS pc..) COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES PLUMBING FIXTURES Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. BATHTUBS(orThb/Shower Combo) LAVS(Hurd Sinks) TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe) DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS SINKS(xiteben/uailrty) WATER HEATERS(Electric) HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES GENERAL INFORMATION PROJECT VALUATION WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS $ $ COSTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING SIRE SPRINELER SrSTE't? PROPOSED FIRE SUPPRESSION SYSTEM? ❑Yes❑ No ❑Yes ❑ No RESIDENTIAL AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE BASEMENT FIRST FLOOR(or Mobile Home) SECOND FLOOR COVERED ENTRY DECK GARAGE 0 CARPORT 0 OTHER(describe) MOBTO1Area Totalsa PROVO® rorty. — *1aW HOMES ONLY** ESTIMATED SELLING PRICE$ #OF BEDROOMS COMMERCIAL-NEW/ADDITION AREA DESCRIPTION Area Construction #of in Square Feet Occupancy Groups) Type Stories Additional Information Nzw BUILDING ADDITION COMMERCIAL-REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area Occupancy Groups) Construction #of Additional Information in Square Feet Type Stories TOTAL BUILDING TIDANT AREA ONLY PROJECT AREA ONLY Bulletin#100—January 1,2010 Page 2 of 4 k:\Handouts\Permit Application