22-103569City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: GENESIS ADULT FAMILY HOME
Project Address: 29806 18TH PL S
Building - Single Family
Permit #:22-103569-00-SF
Inspection Request Line: (253) 835-3050
Parcel Number: 367440 0137
Project Description: ALT - Verification of Occupancy for Adult Family Home. ***No construction work allowed
under this permit.***
Owner
Applicant
Contractor
Lender
RAI MUMTAZ
LEAH STEARNSGENESIS ADULT
28908 18TH AVE S
FAMILY HOME
29806 18THF PL S
FEDERAL WAY WA
FEDERAL WAY WA 98003
USA
Census Category: 434 - Residential alt/add - no change in number of units
Includes:
# 1
42
#3
#4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area (sq. ft.
Additional Permit Information
Mechanical to be Included? ..................................... No Number of Stories................................................... I
Is this an Online or O.T.C. application? .................. No Plumbing to be Included?............................. ,. No
No Fixtures Associated With This Permit !!
PERMIT EXPIRES Tuesday, 31 January, 2023
Permit Issued on Thursday, August 4, 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
n Ltonthe City of Federal Way.
Owner or agent: Date:
F,u�a l
Adult Family Home (AFH) LOCAL BUILDING INSPECTION CHECKLIST
Code References: 2018 IRC Section R330 (WAC 51-51)
APPLICATION NUMBER:
`1035�-
SECTIONS 1. 2. 3. AND 4 MUST BE COMPLETED By APPLICANT BEFORE INSPECTION WILL BE PROCESSED
SITE ADDRESS:
�,Ir� 80'3 3V7gg0_ 0131
2�j� D� I��� �{�-"�.1�" ►/ hl�:i ASSESSOR'S TAX/PARCEL#:____^__-____
PROPERTY OWNER NAME: —R O-A M u IYI r 4k-- _ DAYTIME PHONE: 3, A--q 9•�3 I
AFH LICENSEE NAME (IF DIFFERENT): Cr �/Y �S1S fILJ _}�{►1/�1DAYTIME PHONE:
On a separate sheet of paper (8 1/2x 11) draw a floor plan (including all
floors) of your prospective AFH. Include all sleeping rooms (bedrooms)
indicating which bedroom is: A, 8, C D, E and F.
Label all components for exiting Le., stairs, ramps, platforms, lifts and
elevators.
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 of this application.
NAM&717ME: STL- hM DATE: 0
13PROPERTY OWNER MAPPLICANT Q LICENSEE
Implementation Date: 2021 February 01
Updated: 2021 February
SECTION 5 MUST BE COMPLETED BY THE BUILDING DEPARTMENT IN THE JURISDICTION 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 CD SAND FAND CLASSIFICATION CODE S, NS1 OR NS2.
SECTIONINSPECTOR'S ' •
R330.3 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) or ramp constructed compliant with R330.9 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 R330.9 are provided to
evacuate residents to public area
SLIMPING RUOM A
13Type S
JMType NS1
[3Type NS2
YES
NO
Closet door/s are readily openable from the inside [] Yes 0 No N A I Smoke alarm is installed in the bedroom
JaL❑
Bedroom door opens easily and quickly 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)
EXCEPT per R310.2.1: at -grade escape windows — may have net clearance opening 5 SF
0
Sleeping room window has a maximum sill height of 44" above floor to clear o eni ;nose sunder window allowed
❑
SLEEPING ROOM 6 I
❑ Type S
Type NS1 ;❑ Type NS2
YES
NO
Closet door/s are readily openable from the inside 113 Yes ❑ No N/A
i smoke alarm is installed in the bedroom
[]
Bedroom door opens easily and quickly from the outside when locked
❑
Sleeping room window has a net opening of 5.7 SF (minimum dimensions at least 24"high; at least 20" wide)
EXCEPT per R310.2.1: at -grade escape windows — may have net clearance opening 5 SF
0
Sleeping room window has a maximum sill height of 44" above floor to clear opening; no steps under window allowed
❑
5L1FEPING RGOM C Typ S Type NS1
Type NS2
YES
NO
Closet door/s are readily openable from the inside 0 Yes 0 No N/A I Smoke alarm is installed in the bedroom
0
Bedroom door opens easily and quickly from the outside when locked
M
❑
Sleeping room window has a net opening of 5.7 SF (minimum dimensions at least 24"high; at least 20" wide)
EXCEPT per R310.2.1: at -grade escape windows — may have net clearance opening 5 SF
❑
Sleeping room window has a maximum sill height of 44" above floor to clear ❑ ening; no steps under window allowed
❑
SLEEPING ROOM D
El Type S Type NS3
113TypeNS2
YES
NO
Closet door/s are readily openable from the inside 113 Yes ❑ No /A I Smoke alarm is installed in the bedroom
Bedroom door opens easily and quickly from the outside when locked
Sleeping room window has a net opening of 5.7 SF (minimum dimensions at least 24"high; at least 20" wide)
EXCEPT per R310.2.1: at -grade escape windows — may have net clearance opening 5 SF
0
9f
0
Sleeping room window has a maximum sill hei ht of 44" above floor to clear opening, no steps under window allowed
SLEEPING ROOM E 10Type S Type NS1 ❑Type NS2
YES
13
NO
Closet door/s are readil o enable from the inside IE3 Yes [] No N/A I Smoke alarm is installed in the bedroom
j]
Bedroom door opens easii and quicklyfrom the outside when locked
Sleeping room window has a net opening of 5.7 SF (minimum dimensions at least 24"high; at least 20" wide)
EXCEPT per R310.2.1: at -grade escape windows — may have net clearance opening 5 SF
0
I
Sleeping room window has a maximum sill height of 44" above floor to clear opening; no steps under window allowed
0
SLEEPING ROOM F ILI Type S 1 E3 Type NS1 Type NS2
YES
NO
Closet door/s are readily openable from the inside ❑ Yes JE3No ON/A I Smoke alarm is installed in the bedroom
[p
p
Bedroom s easily and quickly from the outside when locked
®
❑
Sleeping room window has a ne u east 24"high; at least 20" wide)
EXCEPT per R310.2.1: at -grade esca e — may have net c eara
❑
13
Sleepingroom win a maximum sill height of 44" above floor to clear o enin �nosteps under window a o
❑
4
%
Implementation Date: 2021 February 01
Updated: 2021 February
GENERAL
YES
NO
Bathroom doors are easily and quickly o enable from the outside when locked
0
Carbon Monoxide alarms are installed as required in R315 on each level of the home.
191
13
Smoke alarms are installed on all levels of the dwelling, in each resident sleeping room, outside each separate
sleeping area in the immediate vicinity of sleeping rooms (13314).
13
Smoke and Carbon Monoxide alarms are installed in such a manner so that the audible warning may be heard in all
parts of the dwelling upon activation of a single device.
,,.(�,
,bJ
13
Access road and water supply meet local fire jurisdictional requirements.
R330.4 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, pinching or twisting of the wrist lever- e .
Pocket doors shall have graspable hardware available when in the closed or open position.
R311.8 Ram
YES
NO
Inside Ram N/A
R311.8.1 Maximum lope one unit vertical in twelve units horizontal (8.3% slope). (Exception R311.8.1 Not allowed in]13
R330.9)
R311.8.2 Landing Requirements: min. 3X3 foot landing at top/bottom, where doors open onto ramps, and where
ramp changes directions.
R330.9.1 Handrails required on both sides of ramp.
El
13
Outside Ram N/Alg I
YES
NO
R311.8.1 Maximum Slope one unit vertical in twelve units horizontal (8.3% slope). (Exception R311.8.1 Not allowed in
0
0
R330.9
R311.8.2 Landing Requirements: min. 3X3 foot landing at top/bottom, where doors open onto ramps, and where
ramp changes directions.
R330.9.1 Handrails required on both sides of ramp.
13
13
_
R312.1.1 Guards shall be located along open -sided walking surfaces, that are located more than 30 inches measured
0
0
vertically to the floor or grade below at any point within 36 inches horizontally to the edge of the open side.
Guards below are depicted vertically as an example only.
G
36
minimum is an 8.3% slope all along surtace of the ramp.
Implementation Date: 2021 February 01
Updated: 2021 February
R311.2 Means of Egress
YES
NO
R311.2 Door must be side -hinged with min, width of 32 inches between face of door and stop. Height not less than 78 inches.
R330.4 Operable parts of door handles, pulls, latches, locks and other devices installed in AFH shall be operable with one hand
13
and shall not require tight grasping, pinching or twisting of the wrist (lever -type).
inside when exiting the building allowing re-entry
[3
R330.4 Required exit door hardware shall unlock and outside mechanisms
without use of key, tool or -special knowledge.
R311.7 Stairways
I N/A I
YES
NO
R311.7.5.1 Riser Hei ht: Wx riser height shall be 7 % inches (8 inches in structures built prior to July 1, 2004)
R311.7.5.2 Tread Depth: Min. tread depth shall be in 10 inches 9 inches in structures built prior to July 1, 2004
R330.10.1 Handrails for Treads and Risers shall be installed on both sides of treads and risers numbering from one riser to multiple
risers. Handrails shall be installed in accordance with R311.7.8.1 — R311.7.8.4
R330.8 Grab Bars in Bathrooms I N/A
YES
NO
Grab bars shall be installed for all water closets (toilets), bathtubs and showers according to R330.8.
13
Water Closets (toilet) shall have grab bars installed on bath sides according to R330.8.3
Bathtubs shall have two vertical and three horizontal grab bars installed according to R330.8.4
Shower stalls have two vertical and horizontal grab bars mounted on all sides of shower according to R330.8.5
ri
Shower stalls must be minimum size of 30 inches deep 48 inches Ion (R330.11)
P, PASSED y
NAMEOFAFH: L Y� f� Non,
0-1103
0 U
Adult Famlly Home Project Address
BUILDI DEPT. INSPECr 'S NAME (P INT)
6 I DING DEPT. INSPECTO IGNATURE DATE:
-��-
BUILDING DEPT. OFFICE ADDRESS WA 00 3 OFFICE PH NE NUMBER:
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 in accordance with WAC 388-76-10700,
Implementation Date: 2021 February 01
Updated: 2021 February
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LIVING
ROOM
KITCHEN DINING
ROOM
CAREGIVER
ROOM
CMA
LEGEND:
SO - SMOKE DETECTOR
CMA - CARBON MONOXIDE ALARM
EGRESS - EMERGENCY ESCAPE
C - CLOSET
MEETING
pt a r.F