23-104723City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Building - Single Family
Permit #:23-104723-00-SF
Inspection Request Line: (253) 835-3050
Project Name: GENTLE BLISS AFH
Project Address: 32219 23RD AVE SW Parcel Number: 873180 0090
Project Description: Verification of Occupancy for Adult Family Home. ***No construction work allowed under
this permit.***
Owner
Applicant
Contractor
Lender
REUBEN MACHARIA
GEORGE NGANGACSL DESIGNS
32219 23RD AVE SW
30641 11TH AVE S
FEDERAL WAY WA 98023
FEDERAL WAY WA 98003
Census Category: 434 - Residential alt/add - no change in number of units
Includes:
# 1
92
#3
#4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area (sq. ft.)
Additional Permit Information
Mechanical to be Included? ................... I ............... ... No
Plumbing to be Included? ........................................ No
Is this an Online or O.T.C. application? .................. Yes
No Fixtures Associated With This Permit!!
PERMIT EXPIRES Tuesday, 19 March, 2024
Permit Issued on Thursday, September 21, 2023
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
FILr:
City of Federal Way.
Owner or agent: Date:
Adult Family Home (AFH) LOCAL BUILDING INSPECTION CHECKLIST
Code References: 2018 IRC Section R330 (WAC 51-51)
APPLICATION NUMBER: L� to 1 ' 4 �D
SECTIONS 1, 2, 3. AND 4 MUST BE COMPLETED BY APPLICANT BEFORE INSPECTION WILL BE PROCESSED
32219 23RD AVE SW FEDERAL WAY, WA 98023
SITE ADDRESS
MACHARIA REUBEN
PROPERTY OWNER NAME:
AFH LICENSEE NAME (IF DIFFERENT):
873180-0090
ASSESSOR'S TAX/PARCEL#:
DAYTIME PHONE 206 539 9637
DAYTIME PHONE. -
On a separate sheet of paper (81/2x 11) draw a floor plan (including all
floors) of your prospective AFH. Include all sleeping rooms (bedrooms)
indicating which bedroom is: A, B, C D, E and F.
Label all components for exiting i.e., 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.
NAME/TITLE: MACHARIA REUBEN DATE: 09 / 20/ 2023
®PROPERTYOWNER DAPPLICANT DLICENSEE
Implementation Date: 2021 February 01
Updated: 2021 February
(Effective Feb. 1, 2021
WAC 51-51-D330
Section R330 - Adult family homes.
SECTION R330
ADULT FAMILY HOMES
R330.1 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.
R330.2 Reserved.
R330.3 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 with R330.9 is provided.
3. Type NS2 - Where two means of egress are at grade level or ramps constructed in accordance with R330.9 are provided
R330.4 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 with one
hand and shall not require tight grasping, pinching or twisting of the wrist. Pocket doors shall have graspable hardware available
when in the closed or open position.
The force required to activate operable parts shall be 5.0 pounds (22.2 N) maximum. Required exit doors shall have no additional
locking devices.
Required exit door hardware shall unlock inside and outside mechanisms when exiting the building allowing reentry into the adult
family home without the use of a key, tool or special knowledge.
R330.5 Smoke and carbon monoxide alarm requirements. All adult family homes shall be equipped with smoke 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 warning is audible from all areas of the dwelling upon activation of a single alarm.
R330.6 Escape windows and doors. Every sleeping room shall be provided with emergency escape and rescue windows as
required by Section R310. No alternatives to the sill height such as steps, raised platforms or other devices placed by the openings
will be approved as meeting this requirement.
R330.7 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 local jurisdiction.
R330.8 Grab bar general requirements. Where facilities are designated for use by adult family home clients, grab bars for water
closets, bathtubs and shower stalls shall be installed according to this section.
R330.8.1 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 with 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.
R330.8.2 Grab bar installation. Grab bars shall have a spacing of 1 1/2 inches between the wall and the bar. Projecting objects,
control valves and bathtub or shower 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 -up grab bars shall not be required to meet the 1 1/2 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, when mounted, shall not rotate, spin or move and have a graspable surface finish.
R330.8.3 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 swing -up bars. Grab bars shall meet the requirements of R330.8. Grab bars shall mount between 33 inches
and 36 inches above floor grade. Centerline distance between grab bars, regardless of type used, shall be between 25 inches
minimum and 30 inches maximum.
Implementation Date: 2021 February 01
Updated: 2021 February
R330:8.3.1 Fi:ked position grab bars. Fixed position grab bars shall be a minimum of 36 inches in length and start 12 inches from
the rear wall.
R330.8.3.2 Swing -up grab bars. Swing -up grab bars shall be a minimum of 28 inches in length from the rear wall
R330.8.4 Grab bars at bathtubs. Horizontal and vertical grab bars shall meet the requirements of R330.8.
R330.8.4.1 Vertical grab bars. Vertical grab bars shall be a minimum of 18 inches long and installed at the control end wall and
head end wall. Grab bars shall mount within 4 inches of the exterior of the bath tub edge or within 4 inches within the bath tub. The
bottom end of the bar shall start between 36 inches and 42 inches above floor grade.
EXCEPTION: The required vertical grab bar can be substituted with a floor to ceiling grab bar meeting the
requirements of R330.8 at the control end and head end entry points.
R330.8.4.2 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.
R330.8.5 Grab bars at shower stalls. Where shower stalls are provided to meet the requirements for bathing facilities, grab bars
shall meet the requirements of R330.8.
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.
R330.8.5.1 Vertical grab bars. Vertical grab bars shall be 18 inches minimum in length and installed at the control end wall and
head end wall. 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.
R330.8.5.2 Horizontal grab bars. Horizontal grab bars shall be installed on all sides of the shower stall mounted between 33
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.
R330.9 Ramps. All interior and exterior ramps, when provided, shall be constructed in accordance with Section R311.8 with a
maximum slope of 1 vertical to 12 horizontal. The exception to R311.8.1 is not allowed for adult family homes. Handrails shall be
installed in accordance with R330.9.1.
R330.9.1 Handrails for ramps. Handrails shall be installed on both sides of ramps between the slope of 1 vertical to 12 horizontal
and 1 vertical and 20 horizontal in accordance with R311.8.3.1 through R311.8.3.3.
R330.10 Stair treads and risers. Stair treads and risers shall be constructed in accordance with R311.7.5. Handrails shall be
installed in accordance with R330.10.1.
R330.10.1 Handrails 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 with R311.7.8.1 through R311.7.8.4
R330.11 Shower stalls. Where provided to meet the requirements for bathing facilities, the minimum size of shower stalls for an
adult family home shall be 30 inches deep by 48 inches long.
[Statutory Authority: RCW 19.27.031 and chapters 19.27 and 34.05 RCW. 13-04-068, § 51-51-0325, filed 2/1/13, effective 7/1/13. Statutory
Authority: Chapter 19.27 RCW. 10-18-036, § 51-51-0325, filed 8/25/10, effective 9/25/10. Statutory Authority: RCW 19.27.190, 19.27.020, and
chapters 19.27 and 34.05 RCW. 09-04-023, § 51-51-0325, filed 1/27/09, effective 7/1/10. Statutory Authority: RCW 19.27.074, 19.27.020, and
chapters 19.27 and 34.05 RCW. 07-01-090, § 51-51-0325, filed 12/19/06, effective 7/1/07. Statutory Authority: RCW 19.27.031 and 19.27.074. 04-
01-109, § 51-51-0325, filed 12/17/03, effective 7/1/04.][Statutory Authority: RCW 19.27.031 and 19.27.074. WSR 20 03-023, § 51-51-0330, filed
1/6/20, effective 7/1/20.]
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 C D E AND F AND CLASSIFICATION CODE S, NS1 OR NS2.
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.
SLEEPING ROOM A
OType S I LVType NS1 10Type
NS2
YES
NO
Closet door/s are readily openable from the inside JaYes 0 No ON/A I Smoke alarm is installed in the bedroom
0
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 openin ; no steps under window allowed
0
SLEEPING ROOM B 10 Type JEOType NSl Type NS2
YE
NO
Closet door/s are readily openable from the inside 13 Yes 113No JIMNIA I Smoke alarm is installed in the bedroom
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 openi ; no steps under window allowed
M
0
SLEEPING ROOM C
10 Type S Type NS1 71-3
Type NS2
YES
NO
Closet door/s are readily openable from the inside JEJ 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
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
Id
0
Sleeping room window has a maximum sill height of 44" above floor to clear open.iqj, no steps under window allowed
Wr
0
SLEEPING ROOM D
10Type S I IRType NS1
113Type NS2
YES
NO
Closet door/s are readily openable from the inside 1p Yes 0 No ON/A Smoke alarm is installed in the bedroom
0
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" hove floor to clear open.irk no steps under window allowed
0
SLEEPING ROOM E
10Type S 110 Type NSi
10Type N52
YE
NO
Closet door/s are readily openable from the inside I P Yes 0 No I ON/A I Smoke alarm is installed in the bedroom
EV
0
Bedroom door opens easily and quickly from the outside when locked
El
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 F
IV0
Sleeping room window has a maximum sill height of 44" ove floor to clear openi ; no steps under window allowed
0
SLEEPING ROOM F
10Type S Type NS1
10Type NS2
YE§r
NO
Closet door/s are readily openable from the inside Yes ICINo C]N/A I Smoke alarm is installed in the bedroom
/
0
Bedroom door opens easily and quickly from the outside when locked
13Z,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 opening; no steps under window allowed
0
Implementation Date: 2021 February 01
Updated: 2021 February
GENERAL
YES
NO
Bathroom doors are easily and quickly openable from the outside when locked
(]
Carbon Monoxide alarms are installed as required in R315 on each level of the home.
0
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 (R314).
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.
13
Access road and water supply meet local fire jurisdictional requirements.
0
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 -type).
0
Pocket doors shall have graspable hardware available when in the closed or open position.
R311.8 Ramp
YES
NO
Inside Ramp
I N/A
0
13
R311.8.1 Maximum Slope one unit vertical in twelve units horizontal (8.3% slope). (Exception R311.8.1 Not allowed in
13
13
AFH R330.9)
R311.8.2 Landing Requirements: min. 3X3 foot landing at top/bottom, where doors open onto ramps, and where
ramp changes directions.
13
0
R330.9.1 Handrails required on both sides of ramp.
13
0
Outside Ramp I N/A 0
YES
NO
R311.8.1 Maximum Slope one unit vertical in twelve units horizontal (8.3% slope). (Exception R311.8.1 Not allowed in
AFH R330.9)
R311.8.2 Landing Requirements: min. 3X3 foot landing at top/bottom, where doors open onto ramps, and where
13
ramp changes directions.
R330.9.1 Handrails required on both sides of ramp.
a-
R312.1.1 Guards shall be located along open -sided walking surfaces, that are located more than 30 inches measured
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.
Guard
36" min
rHandrail both sides
Less than 4" 1 34" - 38"
�� I l i f C J I I I j II 3'x3'min
t I ! 1 JI JI III landing
3'x3'min
landing
— 3' One unit vertical in twelve units horizontal �— 3
minimum is an 8.3%slope all along surface ofthe ramp. minimum
Implementation Date: 2021 February 01
Updated: 2021 February
R311.2 Means of Egress
YE
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
and shall not require tight grasping, pinching or twisting of the wrist (lever -type).
R330.4 Required exit door har # are shall unlock inside and outside mechanisms when exiting the building allowing re-entry
0
without use of key, tool or s cial knowledge.
R311.7 Stairways I N/A 12 J
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)
R311.7.5.2 Tread Depth: Min. tread depth shall be in 10 inches (9 inches in structures built prior to July 1, 2004)
0
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 N/A 131
YE5
NO
Grab bars shall be installed for all water closets (toilets), bathtubs and showers according to R330.8.
Water Closets (toilet) shall have grab bars installed on both sides according to R330.8.3
13
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
13
Shovor stalls must be minimum size of 30 inches deep by 48 inches long (R330.11)
0
PASSED
NAME OF AFH:
A\Je SIryc�'
Adult Family Home Project Address
BUIL13IN - EPT. INSPECT ' NAME (PRINT)_
UILd 150T. INSPECTOR'SSIC�'i RE DATE:
BUILDING DEPT. OFFICE ADDRESS OFFICE PHONE 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
EGRESS EGRESS EGRESS
CLOSET
0 O
_ ^^ BEDROOM BEDROOM CLOSET BEDROOM
KITCHEN V
DINING ROOM c -D
1.- F-
S SD
CLOSET
f ChaA
L78'�=c
AA
PANTRY A
STORAGE
BEDROOM
® F
GARAGE
LIVING ROOM
BEDROOM BEDROOM
C S
LEGEND
SD - SMOKE DETECTOR
CMA - CARBON MONOXIDE ALARM MEETING
EGRESS - EMERGENCY ESCAPE PLACE
C-CLOSET
CITY OF Building Division
33325 Eighth Avenue South
Federal Way Federal Way, Fax
98003-V::%�L6325
Phone 253-835-2607 Fax 253-35-609
CORRECTION NOTICE
ADDRESS: �-Z�j q Z/ 'QC, 5W PERMIT#: '�5 -10 T�� -0®
F Ae Ar _1 01V'0tb bar rV3-e17\ lnrt-�-
r�
IF YOU HAVE QUESTIONS CALL )me (253) 835- ?i� l
WHEN CORRECTIONS HAVE BEEN MADE, CALL (25 835-3050 FOR RE -INSPECTION. SEE BACK OF CARD
FOR DETAILS. NOTE: ELECTRICAL CORRECTIONS ARE REQUIRED TO BE MADE WITHIN 15 DAYS.
DATE INSPECTOR
DO NOT REMOVE THIS NOTICE
Page of
RECEIVED
CITY OF _ --
Federal Way
L�PERMIT NvMSER
SEP 2 0 2023
COM UTY NITY DEtiELOPMENT
PERMIT APPLICATION
PERMIT CENTER + 33325 8th Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenterCzcityoffederalway.com
` TARGET DATE
SITE ADDRESS
SUITE/UNIT #
32219 23RD AVE SW FEDERAL WAY, WA 98023
PROJECT VALUATION
$ 0 NO CONSTRUCTION
ZONING ASSESSOR'S TAX/PARCEL #
8 7 3 1_ 8 0 J_ 0 0 9 0,
TYPE OF PERMIT
Wi BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
GENTLE BLISS AFH
WABO APPLICATION FOR ADULT FAMILY HOME
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
REUBEN MACHARIA
PRIMARY PHONE
206 539 9637
PROPERTY OWNER
MAILING ADDRESS
32219 23RD AVE SW FEDERAL WAY, WA 98023
E-MAIL
rpmacharia88@gmail.com
CITY
FEDERAL WAY
STATE
WA
ZIP
98023
HOME OWNER DOING THE WORK
PHONE
MAILING ADDRESS
E-MAIL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
UBI #
NAME
G_EORGE NGANGA
PRIMARY PHONE
206 548 6798
LINGADDRESS
32219 23RD AVE SW FEDERAL WAY, WA 98023
E-MAIL
csldesi ns21 mail.co
APPLICANT
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME
CSL DESIGNS
PRIMARY PHONE
206 548 6798
MAILING ADDRESS
32219 23RD AVE SW
E-MAIL
csldesigns21 @gmail.com
(The individual to receive and
respond to all correspondence
concerning this application)
FEDERAL WAY
WA
I ZIP98023
I FAX
PROJECT FINANCING
NAME
REUBEN
is OWNER -FINANCED
When value is $5,000 or more
(RCW 19.27.095)
MAILING ADDRESS, CITY, STATE, ZIP
32219 23RD AVE SW FEDERAL WAY, WA 98023
PHONE
206 539 9637
I certify under penalty of perjury that I am the property owner or authorized 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 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 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 to the city as apart of this application.
SIGNATURE:DATE D v/nn "nn 3
PRINTNAME:OEAN A
Bulletin #100 — February 19, 2020 Page 1 of 2 k:\Handouts\Permit Application
11
MECHANICAL PERMIT
Indicate how many of each typ
AIR HANDLING UNITS
AIR CONDITIONER
BOILERS
COMPRESSORS
DUCTING
PLUMBING PERMIT
Indicate how many of each typ
BATHTUBS (or Tub/Shower Combo)
DISHWASHERS
DRAINS
DRINKING FOUNTAINS
HOSE BIBBS
o be installed or relocated as,
FANS
FIREPLACE INSERTS
FURNACES
GAS LOG SETS
GAS PIPING
to be installed or relocated as
LAVS (Hand Sinks)
RAINWATER SYSTEMS —
SHOWERS —
SINKS (Kitchen/Utility)
SUMPS
f this project. ❑o not in
GAS PIPE OUTLETS
HOODS (Commercial)
HOT WATER TANKS (Gas)
REFRIGERATION SYST
WOODSTOVES
l f this project. Do not in
TOILETS
URINALS
VACUUM BREAKERS
WATER HEATERS (Electric)
WASHING MACHINES
VALUE OF MECHANICAL WORK
g fixtures to remain.
OTHER (Describe)
VALUE OF PLUMBING WORK
ig fixtures to remain.
WATER PIPING
OTHER (Describe)
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?
n Yes n No
PROPOSED FIRE SUPPRESSION SYSTEM?
n Yes n No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet)
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
BASEMENT'
FIRST FLOOR (or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER (describe)
Area Totals
EXISTING
PROPOSED
TOTAL
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE $
I # OF BEDROOMS
COMMERCIAL - NEW/ADDITION
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
a
# of
Stories
Additional Information
NEW BUILDING
ADDITION
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area in
Square 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