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22-101017City of FederaE(253)835-2]609 Community Develop 33325 8th A Federal Way, WA Ph: (253) 835-2607 Fax: Project Name: AGENES PURITY LLC Project Address: 32418 51STAVE SW Building - Single Family Permit #:22-101017-00-SF Inspection Request Line: (253) 835-3050 Parcel Number: 189830 0030 Project Description: Verification of Occupancy for Adult Family Home. ***No construction work allowed under this permit.*** Owner Applicant Contractor Lender STANLEY LIAM & RACHEL VAN STANLEY LIAM & RACHEL VAN HORN LEONARD HORN LEONARD 24032 SE 21ST ST 24032 SE 21ST ST SAMMAMISH WA 98075 SAMMAMISH WA 98075 Census Category: 434 - Residential alt/add - no change in number of units Includes: # 1 #2 #3 #4 Occupancy Class: R-3 Construction Type: Type V - B Occupancy Load: Floor Area (sq. ft.) Additional Permit Information Occupancy #1 - Construction Type ......................... Type V - B Mechanical to be Included?..................................... No Is this an Online or O.T.C. application?................... Yes Plumbing to be Included? ........................................ No Occupancy #1 -Use ................................................ Residence (1 or 2 family) No Fixtures Associated With This Permit 11 PERMIT EXPIRES Sunday, 4 September, 2022 Permit Issued on Tuesday, March 8, 2022 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: Date: Adult Family Horne (AFH) LOCAL BUILDING INSPECTION CHECKLIST Cade References: 2015 IRC Section R325 (WAC 51-51) APPLICATION NUMBER; 05 a- 1 o% d) 7 SEcnoNS 1. 2. 3. AND 4 MUST BE COMPLETED BY APPLICANT BEFORE INSPECTION WILL BE PROCESSED 3.2418 51 st Ave SW, Federal Way, WA 98023 189830-0030 SITE ADDRESS:-- ASSESSOR'S TAXIPARCEL#------------ Stanley Liam Leonard and Rachel Van Horn Leonard Trust PROPERTY€ OWNER NAME: AgenesPurity LLC AFN LiCENSEI=NAME (iria:rwrrtErr): _ . - - -. ----- . - - - - —• --- -- DAYTIME PHONE: DAYTIME PHONE: 805/405-7913 253/258-5541 On a separate sheet of paper (8 1/2 x 11) draw a floor plan (including all floors) of your prospective AM Include all sleeping rooms (bedrooms) indicating which bedroom is: A, B, C ®, E and F. Label all componentsfor exiting i.e., stairs, ramps, platforms, lifts and elevators. I certify under penalty of perjury that the information furn(shed by me is true and correCtto the best ❑f my knowledge, and that I am requesting or I am authorized by Cie owner of the above premmses to request inspection for U-m operation of an Adult Family Name at this location. I agree to Bold harness the Jurisdiction conducting such inspections, at my reque as to any claim (inciuding costs', expenses, and attorneys' fees incurred in the investigation of such claim), which may be made by any person, ineiuding tie undersigned and riled against Uie Jurlsdiction� t onjy where such claim arises out of a reliance of the juril"I'Iion, including a officers arx� employees, upon the,accurac the information supplied to Uie ' coon as a part of this application. 10, NAMEITITLE: Di 7E: - QPROPERTY OWNER (Effective July 1, 2013.) ®APPLICANT ®LICENSEE Effective: 2013 July 01 Updated: 2017 February WAC 51-51-0325 Section R325—Adult family homes. SECTION R325 ADULT FAMILY HOMES R325.1 General. This section shall apply to all newly constructed adult family homes and all existing single family homes being converted to adult family homes. This section shall not apply to those adult family homes licensed by the state of Washington department of social and health services prior to July 1, 2001. R325.2 Re s e rve d. R325.3 Sleeping room classification. Each sleeping room in an adult family home shall be classified as: 1. Type S - Where the means of egress contains stairs, elevators or platform lifts. 2. Type NS1 - Where one means of egress is at grade level or a ramp constructed in accordance w ith R325.9 is provided. 3. Type NS2 - Where tw o means of egress are at grade level or rarrps constructed in accordance w ith R325.9 are provided. R325.4 Types of locking devices and door activation. All bedroom and bathroom doors shall be openable from the outside when locked. Every closet shall be readily openable from the inside. Operable parts of door handles, pulls, latches, locks and other devices installed in adult family homes shall be operable w ith one hand and shall not require tight grasping, pinching or tw isting of the w rist. Pocket doors shall have graspable hardw are available w hen in the closed or open position. The force required to activate operable parts shall be 5.0 pounds (22.2 M maximum Required exit doors shall have no additional locking devices. Required exit door hardw are shall unlock inside and outside mechanisms w hen exiting the building allowing reentry into the adult family home without the use of a key, tool or special knowledge. R326.6 Smoke and carbon monoxide alarm requirements. All adult family homes shall be equipped withsmoke and carbon monoxide alarms installed as required in Sections R314 and R315.1. Alarms shall be installed in such a manner so that the detection device w arning is audible from all areas of the dwelling upon activation of a single alarm R326.6 Escape w indows and doors. Every steeping room shall be provided w ith emergency escape and rescue w indow s as required by Section R310. No alternatives to the sill height such as steps, raised platforms or other devices placed by the openings w ill be approved as meeting this requirement. R325.7 Fire apparatus access roads and water supply for fire protection. Adult family homes shall be served by fire apparatus access roads and water supplies meeting the requirements of the focal jurisdiction. R325.8 Grab bar general requirements. Where facilities are designated foruse by adult family home clients, grab bars forwater closets, bathtubs and shower stalls shall be installed according to this section. R325.8.1 Grab bar cross section. Grab bars with a circular cross section shall have an outside diameter of 1 1/4 inches minimum and 2 inches maximum Grab bars w ith noncircular cross section shall have a cross section dimension of 2 inches maximum and a perimeter dimension of 4 inches minimum and 4 5/8 inches maximum R326.8.2 Grab bar installation. Grab bars shall have a spacing of 1 112 inches between the wall and the bar. Projecting objects, control valves and bathtub or show er stall enclosure features above, below and at the ends of the grab bar shall have a clear space of 1 1/2 inches to the grab bar. EXCEPTION: Swing-upgrab bafsshall not be required to meetthe 1 112 inch spacing requirement Grabs bars shall have a structural strength of 250 pounds applied at any point on the grab bar, fastener, mounting device or supporting structural member. Grab bars shall not be supported directly by any residential grade fiberglass bathing or showering unit. Acrylic bars found in bathing units shall be removed. Fixed position grab bars, w hen mounted, shall not rotate, spin or move and have a graspable surface finish R325.8.3 Grab bars at water closets. Water closets shall have grab bars mounted on both sides. Grab bars can be a combination of fixed position and sw ing-up bars. Grab bars shall meet the requirements of R325.8. Grab bars shall mount betw een 33 inches and 36'Inches above floor grade. Centerline distance between grab bars, regardless of type used, shall be between 25 inches Effective: 2013 July 01 Updated: 2017 February minimum and 30 inches maximum R326.8.3.1 Fixed position grab bars. Fixed position grab bars shall be a minimum of 36 inches in length and start 12 inches from the rear wall. R326.8.3.2 Swing -up grab bars. Sw ing-up grab bars shall be a minimum of 28 inches in length from the rear wall. R325.8.4 Grab bars at bathtubs. Horizontal and vertical grab bars shall meet the requirements of R325.8. R326.8.4.1 Vertical grab bars. Vertical grab bars shall be a minunum of 18 inches long and installed at the control end w all and head end wall. Grab bars shall mount within 4 inches of the exterior of the bath tub edge or within 4 inches withinthe bath tub. The bottom end of the bar shall start between 36 inches and 42 inches above floor grade. EXCEPTION: The required vertical grab barcan be substituted with a floorto ceiling grab bar meeting the requirements of R325.8 at the control end and head end entry points. R326.8.4.2 Horizontal grab bars. Horizontal grab bars shall be provided at the control end, head end, and the back wall within the bathtub area. Grab bars shall be mounted between 33 inches and 36 inches above floor grade. Control end and head end grab bars shall be 24 inches minimum in length. Back wall grab bar shall be 36 inches minimum in length. R325.8.5 Grab bars at shower stalls. Where showerstalls are provided to meet the requirements forbathing facilities, grab bars shall meet the requirements of R325.8. EXCEPTION: Shower stalls with permanent built-in seats are not required to have vertical or horizontal grab bars at the seat end wall. A vertical floor to ceiling grab bar shall be installed within 4 inches of the exterior of the shower aligned with the nose of the built-in seat R326.8.5.1 Vertical grab bars. Vertical grab bars shall be 18 inches minimum in length and installed at the control end walland head end wail. Vertical bars shall be mounted within 4 inches of the exterior of the shower stall or within 4 inches inside the shower stall. The bottom end of vertical bars mount between 36 inches and 42 inches above floor grade. R325.8.5.2 Horizontal grab bars. Horizontal grab bars shall be installed on all sides of the show erstall mounted between33 Inches and 36 inches above the floor grade. Horizontal grab bars shall be a maximum of 6 inches from adjacent walls. Horizontal grab bars shall not interfere with shower control valves. R326.9 Ram ps. All interior and exterior ramps, w hen provided, shall be constructed in accordance w ith Section R311.8 w ith a maximum slope of 1 vertical to 12 horizontal. The exception to R311.8.1 is not allowed foradult family homes. Handrails shall be installed in accordance w ith R325.9.1. 3R 26.9.1 Handrails for ramps. Handrails shall be installed on both sides of rams between the slope of 1 vertical to 12 horizontal and 1 vertical and 20 horizontal in accordance w ith R311.8.3.1 through R311.8.3.3. R325.10 Stair treads and risers. Stair treads and risers shall be constructed in accordance with 1`311.7.5. Handrails shall be installed in accordance w ith R325.10.1. &3�G,1Q Handralls for treads and risers. Handrails shall be installed on both sides of treads and risers numbering from one riser to multiple risers. Handrails shall be installed in accordance w ith R311.7.8.1 through R311.7.8.4 R325.11 Showerstalls. Where provided to meet the requirements forbathing facilities, the minimum size of showerstalls foran adult family home shall be 30 inches deep by 48 inches long. (Statutory Authority: RCW 19.27.031 and chapters19.27 and 34.05 RCW. 13-04-068, § 51-01-0325, filed 2/1/13, effective 7/1/13. Statutory Authority: Chapter 19.27 RCW. 10-18-036, § 51-51-0325, filed 8125110, effective9/25/10. Statutory Authority: RCW 19.2719a, 1 .27 20, and chapters19.27 and 34,05 RCW. 09-04-023, § 51-51-0325, filed 1127/09, effective7/1/10.StatutoryAuthority: RCW 19,27.074,1 0, and chapters19.27 and 34.05 RCW. 07-01-090, § 51-51-0326, filed 12/19/06, effective 7/1/07. Statutory Authority: RCW 19.27.031 and 19.27.074.04- 01-109, § 51-01-0325, filed 12/17/03, effective 7/1/04.j Effective: 2013 July 01 Updated: 2017 February NAME OF AFH: SECTION 5MUsiBECOMPI. EDBYTHEBUILDINGDEPARTMENTINTHEJURISDICTIONTHFHOMEWILLBELOCATED. PLEASE CHECK ALLAPPLICABLE BOXES; MATCH THE LIST BELOW TO THE APPLICANT'S FLOOR PLAN — USING THEIR PROSPECTIVE RESIDENT BEDROOM DESIGNATIONS OF A B CD E AND F AND CLASSIFICATION CODE S, NSi OR NS2. SECTIONBUILDING INSPECTOR'SINSPECTION nJ�­�al=Pmg nuum ua331T1cao0n: racnsieeping room In an AUUlt ramny Mome snail ne classified as: Type S —where the means of egress contains stairs, elevators or platform lifts to evacuate residents to public area. Type NSi— where 1 means of egress at grade level (has no stairs) or ramp constructed compliant with R325.9Is provided to evacuate residents to public area. Type NS2— where 2 means of egress at grade level (both have no stairs) or rarnns constructed compllant with R325.9 are nrnvirlarl to avanrata mdrluntc r.. n-rbk am SLEEPING ROOM A 113 Type S Type NS1 r] Type NS2 YES NO Closetdoor/sare readily openablefrom the inside JERYes [3No Smoke alarm is installed in the bedroom 0 Bedroom door opens ea slly and quickly from the outside when I ocked 13 SI eepi ng room window has a net opening of 5.7 SF (minimum dimensions at I east 24"high; at I east 20" wide) EXCEPT per R310.2.1: at -grade escape wi ndows —may have net clearance opening 5 SF f 13 Slee i ng room window has amaximums III height of44"abovefloor toclear opening; noste s under window allowec AM a SLEEPING ROOM R 113 Type S Type N51 Type NS2 Y NO Closetdoor/sare readilyo enablefromtheinside IRYes 1E3No Smoke alarm ic installed in thebedroom Q Bedroom door opens easil and quickly from theoutsidewhen locked 13 Sleeping room window has a net opening of 5.7 SF (minimum dimensions at I east 24"high; atIeast 20"wide) EXCEPT per R310.2.1: at -grade escape wi ndows —may have net clearance opening 5 SF 13 Sleeping room windowhasamaximums ill height of44" above floor to clear opening; no steps under window allowe SLEEPING ROOM Type S Appe NS3 113 Type NS2 AS NO Closetdoor/sare readily o enablefromtheinside IffYes 113NIo I Smok larm is installed in the bedroom 0 Bedroom door opens easil and quickly from the outsi ewhenIocked 0 Sleeping room window has a net opening of 5.7 SF (minimum dimensions at I east 24"high; at least20'wide) EXCEPT per R310.2.1: at -grade escape wi ndows—may have net clearance opening 5 SF 1p Sl ee i n room wi ndow has a maximum sill hei htof 44" a bovefloor to clear opening; no steps under window a llowe S.LEEPING'ROOM U 10 Type S JU Type NS1 1 E3 Type NS2 YES NO Closetdoor/sare readily o enablefromtheinside E3Yes 113mn I Smokealarm is installed in the bedroom13 13 Bedroom door opens easily and quicklyfrom the outside when locked 13 1 Sleeping r❑ indowhasa net opening of 5.7 SF (minimum dimensions at I 4"high; at I east 20"wi de) EXCEPT per RR10. . - radeescapewindows—may have net arante enIng5SF © 0 Sleeping room window has am msill heightof44"abovefIoa clear opening; no sop and rwindowallowe SLEEPING RO Type a Ns1 Type NS2 YES NO Cl osetdoor/s are readily openablefromthe inside E3No I Sm6e alarm isinstalled inthe bedroom C] r] Bedroom door opens easily and uickl from the outside when d.- 0 Sleepingroom window has anet opening of5.7SF(minimum dimiehsio least24"high; atIeast 2[Y'wide) EXCEPT per R310.2.1: at -grade escape windows —may hav�eTietclearance open SSF 13 0 Slee i ng room wi ndow has a maximum s III height o 4" a bove fl oor to clear open! ng;iro.ste s under window a Ilowe SLEEPING ROOM FI E3 Type S Type N5 Type NS2 YES NO Closetdoor/sare readily openabfefro eInside LE3Yes JUNn I Smoke alarm isinstalle he bedroom Bedroom door opens easily a nd_qtTrck1yfromtheoutsidewhenIocked E3 0 Sleepingroom window h net opening of 5.7SF (minimum dimensions at I east 24"high; at least 2W w-i de) EXCEPT per R310.2.1: at -grade escape wl ndows —may have net clearance opening 5 SF © 11 E3 Slee i ng room window has a maximum sill height of44"above floor to clear opening; noste sunderwindowallowe E3 Effective: 2013 July 01 Updated: 2017 February GENERAL. YES NO Bathroom doors are easily and quickly o enablefromtheoutsidewhenlocked 13 Carbon Monoxide a larms a re i nstalled as required i n R315 on each level of the home. 19 0 Smoke al arms are installed on all I evels of the dwel I ing, in each resident sleeping room, outside each separate sleeping area in theimmediatevidnityofsleeping rooms (R314). 1� 0 Smoke and Carbon Monoxidealarmsare Installed insuch a manner sothattheaudiblewamingmaybe heard! nail parts of the dwelling upon activation of a single device. 0 Access road and water supply meet I ocal fi re j urisdictional requirements. 0 R325.4 Operable parts of door handles, pulls, latches, locks and other devices installed in AFH shall be operable with one hand and shall not require tight grasping, pinchingortwisting ofthe wrist (lever. -type). 0 Pocket doors shall have graspable hardware available when in the closed or open position. 11311.8 Ramps. ' YES NO i3, Ramp ,..N/A 0 0 R311.8.1 Maximum Slop one unit vertical in twelve units horizontal (8.3%slope). (Exception R311.8.1 Not allowed in AFH) R311.8.2 Landing Requirements: min. 3X3 foot landing attop/bottom, where doors open onto ramps, and where ramp changes directions. 0 0 R325.9.1 Handrails required on both sides of ramp in accordancewith R311.8.3.1—R311.8.3.3. .outslde, Ramp N A YES NO R311.8.1 Maximum Slope one unitvertical in twelve Units horizontal (8.3%slope). (Exception R311.8.1 Not allowed in AFH R311.8.2 Landing Requirements: min. 3X3 foot landingattop/bottom, where doorsopen onto ramps, and where rampchanges directions. 10 0 R325.9.1 Handrails required on both sides of ramp in accordancewith R311.8.3.1—R311.8.3.3. ® 0 Guards below are depicted vertically as an example only. All Ramps must have Guards M. .1 13 Guard 36" min r Handrall both sides Less than 4" 1 34" - 38" Tx3'min landing 3' One unit vertical in twelve units horizontal 3' minimum is an 8.3% slope all along surface of the ramp. minlmum R311.2 Means•of:lgress YES NO R311.2 Door must be side -hinged with min. width of32 inches between face of door and stop. Height not less than 78 inches. AL J2— R325A Operable parts of door handles, pulls, latches, locks and other devices installed in AFH shall be operable with one hand and shall not require tight grasping, pinching or twisting of the wrist (lever -type). 10 0 R325.4 Required exit door hardware shall unlock inside and outsidemechanismswhenexitingthebuildingallowingre -entry without use of key, tool or special knowledge. R311.7 Stairways. N A YES NO R311.7.5.1 Riser Height: Max riser height shall be 7 % inches (8 inches In structures built prior to July 1, 2004) 13 R311.7.5.2 Tread Depth: Min. tread depth shall be in 10 inches (9 inches in structures builtpriorto July 1, 2004) R325.30.1 Handrails for Treads and Risers shall be Installed on both sides of treads and risers numbering from one riser to m ultlple risers. Handralls shall be installed in accordance with R311.7.8.1—R311.7.8.4 0 Effective: 2013 July 01 Updated: 2017 February R325.8 Grab Sars in Bathrooms NIA 131 YES NO Grab bars shall be installed for a I I water closets (toilets), bathtubs and showers according; to R325.8. WaterClosets (toilet) shall havegrib bars installed on both sides according to R325.8—R325.8.31 or 11325.8.3.2. (3 Bathtubs shall have twovertical and three horitorltal grabbars installer) accordingto R325.8-R325.8.4—R325.8.4.2 Showerstalls have two vertica land horizontal grab bars mounted on allsides ofshower accordingto R325.8—R325.8.5 — [� R325.1 ,5.2 Shower stalls mustbe minimum size of30Inches deepby48 incheslong(R325.11) A6203 — AG105 Swimming Pool, Spa, Hot Tub AA YES NO A5105,2 Must be surrounded by a barrier that is 8 inches high, may have doors and orgates that must have audible alarms whe n opened. AGI OS.5 EXCEPTION: Pools, Spas or Hot Tubs with a safety cover which complies with ASTM F 1346 FPASSEG 0 00RRECTIONSREQUIRE❑ 0 PERMIT REQUIRED INSPECTOR'S NAME [PRINT) - __Z Z"I� �2&f76- INSPECTOR'S SIGNATURE DATE: -&U6 aA awew 4m-,7a — S 3 IN SPECTOR'S OF Fla ADDRESS PHONE NUMSER: Application and inspection checkllst developed by Washington Associatlnn of 8uRding 0fRdaIs (wABO), In cooperaIIon with Department of Six ial arrd Heallh Servlcos JOSHSyfar use by bwh departments and licensors. 07/01/2011 Effective: 2013 July 01 Updated-2017 February 3/4/22, 12:25 PM 20220304121741392_001.jpg 73- Z-4 https://mai1.google.com/mai1/u/O/#inbox?projector=1 1/1 CITY OF PERMIT APPLICATION CITY OF FEDERAL WAY PERMIT CENTER + 33325 811, Avenue South + Federal Way, WA 98003-6325 PMEN 253-835-2607 +FAX 253-835-2609 + Federal Way COMMUNUY DEVELOperllnitcelnlerLi;cityvfCedcraldcay,com PERMIT NU]dBBR � � _ / -a � � � L_.- '- S F TARGET DATE Work already completed SITE ADDRESS SUITWUNIT 0 32418 51 st Ave SW, Federal Way, WA 98023 PROJECT VALUATION ZONING ASSESSOit'S TAX/PARCEL 0 $38; #82 189830-0030 TYPE OF PERMIT ❑ BUILDING ❑ PLUNIF31NG ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT See attached GC a eement. No permit needed for this work. PROJECT DESCRIPTION Detailed description of work to Ram2 and deck werepre-existing as home was previously used For disabled people. That's what made this j2rgject attractive. be included on thispernlit only No new additions to the house. Flooring / paint / hardware / new appliances. NAME PRIMARY PHONE Stanley Liam Leonard and Rachel Van Horn Leonard Living T=st 805 405-79 I3 PROPERTY OWNER MAILING ADDRESS E-MAIL 24032 SE 21st St 1iam3eonard(rc_',dmlcap.com CITY STATE ZIP eammamish WA 98075 NAME--=—=�c-z==`--- PHONE Evergreen Kingston Construction 425-405-210S MAILING ADDRESS E-MAIL CONTRACTOR 1516 IOTH CT NW tnfo(gVkgxoaps.com CITY STATE ZIP FAX AUBURN WA 98001 WA STATE CONTRACTOR'S LICENSE I MWIRATION DATE URI i LIVZRQKC794CS 0210212024 603 273 122 NAME PRIMARY PHONE PROPERTY OWNER APPLICANT MAILING ADDREss EMAIL CITY STATE ZIP FAX NAME PRIMARY PHONE PROJECT CONTACT PROPERTY OWNER (The individual to receive and MAILING ADDRESS E-1VUL respond to all correspondence CITY STATE ZIP NAME Owner Financed FAX concerning this application) PROJECT FINANCING ❑ OWNER -FINANCED -YES When Value is $5,000 or more (RCW 19.27.095) MAILING ADDRESS CITY STATE ZIP ' ' ' PHONE I cert{ry under penalty of perjury that I am the property owner or authorized agent of the property owner. I cert(fy that to the best of my knowledge, the irtformation submitted in support of this permtt application is true and correct. I cert(fy that I will comply with all applicable City of Federal Way regulations pertaining to the work authorized 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' fees incurred in the investigation and defense of such claim), which may be made by any person, including the undersigned, and Jited against the city, but only where such claim art es out of the reliance of the city, including its officers and employees, upon the accuracy of the information supplied to t ci as a part of this application. l� / SIGNATURE: lam' —� DATE l y! PRINT NAME: LrAtA Bulletin 4100 — February 14, 2020 Page l of B14andoutAl"ermit Application VALUE OF MECHANICAL WORK MECHANICAL PERMIT Indicate how maykq or each e ❑ txture to be installed or relocated as part of this project Do not include exist;zxtures to remain. AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS (commercial) BOILERS FURNACES HOT WATER TANKS (Gas( COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES VALUE OF PLUMBING WORK PLUMBING PERMIT $ Indicate how many of each e of fixture to be installed or relocated as part of this project Do not include existin rxtures to remain. BATHTUBS (or Tub/shower combo) LAVS (Hand Sinks( TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER (Describe) DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS SINKS (Kitchen/Utility) WATER HEATERS (Electric) HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS EXISTING/PREVIOUS USE LOT SIZE (In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? ❑ Yes ❑ No ❑ Yes ❑ No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL BASEMENT FIRST FLOOR (or Mobile Home) SECOND FLOOR COVERED ENTRY DECK GARAGE ❑ CARPORT ❑ OTHER (describe) Area Totals EX[STING PROPOSED TOTAL .*MEW HOMES ONLY" ESTIMATED SELLING PRICE 1 # OF BEDROOMS FOR OFFICE USE COMMERCIAL - NEW/ADD.ITION AREA DESCRIPTION Area in S uare Feet Occupancy Group(s) Construction a # of Stories Additional Information NEW BUILDING ADDITION COMMERCIAL - REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area in S uare Feet Occupancy Group(s) Construction a # of Stories Additional Information TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY Bulletin #100 — February 19, 2020 Page 2 of 2 k:\Handouts\Permit Application