17-100371 Building - Single Family
City of Development Dept. Permit#:17-100371-00-SF
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: ST. MICHAEL ADULT FAMILY HOME
Project Address: 28211 28TH AVE S Parcel Number: 111700 0150
Project Description: ALT-Verification of Occupancy for Adult Family Home.***No construction work allowed
under this permit.***
Owner Applicant Contractor Lender
MESSAY A MESHESHA ELISABETH T SHEGEN
28211 28TH AVE S 28211 28TH AVE S
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003
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.)
Additional Permit Information
Mechanical to be Included9 No Is this an Online or O.T.C.application? No
Plumbing to be Included9 No
+%
PERMIT EXPIRES Monday,24 July,2017
Permit Issued on Wednesday,January 25,2017
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
Vashington and the City of Federal Way.
/117-1
Owner or agent: Date: ra S
F .,4.0.1cX
Adult Family Home(AFH) LOCAL BUILDING INSPECTION CHECKLIST
Code References:2012 IRC Section R325(WAC 51-51)
1
APPLICATION NUMBER: 1 °3
SECTIONS 1. 2.3.AND 4 MUST BE COMPLETED BY APPLICANT BEFORE INSPECTION WILL BE PROCESSED
SECTION 1—PROPERTY INFORMATION
SITE ADDRESS: Og C2/I (:)&t& A s ASSESSOR'S TAX/PARCEL#: ) /1700 0/5-D
SECTION 2—APPLICANT INFORMATION
PROPERTY OWNER NAME: TI l ed. I S CiIt1V DAYTIME PHONE: % '✓• a r g
s-f AFH LICENSEE NAME(IF DIFFERENT): ► "`iC�'� ,z DAYTIME PHONE: %)) X4Y
C �-
3
SECTION 3—FLOOR PLAN
On a separate sheet of paper (8 1/2 x 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.
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' f s incurred in the investigation of such claim), which may be made by any person,
including the undersigned, and fi agai the jurisdiction, but only where such claim arises out of the reliance of the
jurisdiction, including its of rs empl ees, upon the accuracy of the information supplied to the jurisdiction as a part of
this application.
NAME/TITLE: DATE: � ' j
DPROPE T\O ' E NOAPPLICANT 1:1 LICENSEE
Effective:2013 July 01
Updated:2013 June
NAME OF AFH:
SECTION 5 MUSTBE COMPLETED BY THE BUILDING DEPARTMENT I N THEJURISDI CTION THE HOME WILL BE LOCATED.
PLEASE CHECK ALL APPLICABLE BOXES; MATCH THE LIST BELOW TO THE APPLICANTS FLOOR PLAN—USING THEIR PROSPECTIVE RESIDENT
BEDROOM DESIGNATIONS OF A B CD E AND F AND CLASSIFICATION CODE 5,NS1 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)or ramp constructed compliant with R325.9 is provided to evacuate residents to public area. A.
Type NS2—where 2 means of egress at grade level(both have no stairs)or ramps constructed compliant with R325.9 are provided to evacuate residents to public area.
SLEEPING ROOM°A 0 Type S IZType NS1 0 Type NS2 YES NO
Closet door/s are readily openable from the i nside pat Yes 0N Smoke al arm is installed in the bedroom fa 0
Bedroom door opens easily and quickly from the outside when locked BY 0
Sleeping room window has a net opening of 5.7SF(minimum dimensions at least 24"high;at least 20"wide) E] 0
EXCEPTper R310.2.1:at-grade escapewi ndows—may have net clearance opening 5 SF
Sleeping room window has a maximum sill height of 44"above floor to clear opening;no steps under window allowec RI 0
SLEEPING ROOM B 0 Type S R]Type NS1 0 Type NS2 YES NO
Closet door/s are readily openable from the i nside 114Yes -0No' Smoke alarm is installed in the bedroom Ej 0
Bedroom door opens easily and quickly from the outside when locked 0
Sleeping room window has a net opening of 5.7 SF(mi nimum dimensions at least 24"high;at least 20"wide) 1 0
EXCEPT per R310.2.1:at-grade escape wi ndows—may have netcl earance opening 5 SF 7777����
Sleeping room window has a maximum sill height of 44"a bovefl oor to clear opening;no steps under window a llowec 0 0
SLEEPING ROOM C 0 Type S iitType NS1 0 Type NS2 YES NO
Closet door/s are readily openable from the inside 1E1Yes 0 No Smoke alarm is installed in the bedroom 14 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 I east 20"wide) 0
EXCEPT per R310.2.1:a t-grade escape windows—may have net clearance opening 5 SF
Sleeping room window has a maximum sill height of 44"above floor to clear opening;no steps under window a llowec ili 0
SLEEPING ROOM D 0 Type S ELType NS1 0 Type NS2 YES NO
Closet door/s are readily openable from the inside IBYes 0 No Smoke alarm is installed in the bedroom a 0
Bedroom door opens easily and quickly from the outside when locked RI 0
Sleeping room window has a net opening of 5.7SF(mi nimum dimensions at least 24"high;at least 20"wide) 14 0
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"a bovefl oor to clear opening;no steps under window a llowec ,a 0
SLEEPING ROOM E 0 Type S 0 Type NS1 0 Type NS2 YES NO
Closetdoor/s are readily openable from the i nside IDYes I0 No Smoke a la rm is installed in the bedroom 0 0
Bedroom door opens easily and quickly from the outside when locked 0 0
Sleepingroom windowhas a net opening of 5.7SF(minimum dimensions at least 24"high;atl east 20"wide) 0 0
EXCEPT per R310.2.1:at-grade escape wi ndows—may have net clearance opening 5 SF
Sleeping room window has a maximum sill height of 44"above floor to clear opening;no steps under window allowec 0 0
SLEEPING ROOM F gi:1 Type S 0 Type NS1 0 Type NS2 YES NO
Closetdoor/s are readilyopenablefromtheinside I Yes No' Smoke alarm is installed in the bedroom 0 0
Bedroom door opens easily and quickly from the outside when locked 0 0
Sleeping room window has a net opening of 5.7SF(mi nimum dimensions at least 24"high;at least 20"wide) 0 0
EXCEPTper R310.2.1:at-grade escapewi ndows—may have net clearance opening 5 SF
Sleeping room window has a maximum sill height of 44"above floor to clear opening;no steps under window a llowec 0 0
Effective:2013 July 01
Updated:2017 February
GENERAL YES NO
Bathroom doors are easily and quickly openable from the outs ide when locked Et 0
Carbon Monoxide alarms a re installed as required in R315 on each level of the home. t20
Smoke alarms are i nstalled on all levels of the dwelling,in each residents leeping room,outside each separate
sleeping area i n the i mmediate vi cinity of sleeping rooms(R314). 132
0
Smoke and Carbon Monoxide a larms are i nstalled i n such a manner sothatthe audible wa ming may be heard i all
El CI
parts of the dwelling upon activation of a single device.
Access road and water supply meet I ocalfi re jurisdictional requirements. El 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,pinching or twistingof the wrist(lever-type). El 0
Pocket doors shall have graspable hardwareavailablewhen in the closed or open position. /Jill.- 0 0
R3118 Ramps YES NO
Inside Ramp WA RI , „ 0 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 0
R311.8.2 Landing Requirements:min.3X3 foot landing attop/bottom,where doors open onto ramps,and where rampchanges
directions. 0 0
R325.9.1 Handrails required on both sides of ramp in accordancewith R311.8.3.1—R311.8.3.3. 0 0
Outsideamp NIA 13 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 AFH) gg 0
R311.8.2 Landing Requirements:min.3X3 foot landingattop/bottom,where doors open onto ramps,and where rampchanges
directions. 13 0
R325.9.1 Handrails required on both sides of ramp in accordancewith R311.8.3.1—R311.8.3.3. qui0
Guards below are depicted vertically as an example only.All Ramps must have Guards IN 0
Handrail both sides
34"-38"
Guard
36"mm
NM .....•••WM./Mom .......... . ••• MN am MN Mg am Wm MN
landing
landing °
3' 1- 3'
minimum is an 8.3%slope all along surface of the ramp. minimum
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. 10 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,pinching or twisting ofthe wrist(lever-type). 0
R325.4 Required exit door hardware shall unlock insideand outside mechanisms when exitingthe building allowing re-entry 0
without use of key,tool or special knowledge.
R311.7 Stairways N/A ill,I 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) 8 El
R325.10.1 Handrails for Treads and Risers shall be installed on both sides oftreads and risers numbering from one riser torn ultiple
risers.Handrails shall be installed in accordance with R311.7.8.1—R311.7.8.4
Effective:2013 July 01
Updated:2017 February
R32S.8 Grab Bars In Bathrooms N/A 13 YES NO
Grab bars shall be installed for all water closets(toilets),bathtubs andshowersaccordingto R325.8. 0
Water Closets(toilet)shall have grab bars installed on both sides according to R325.8—R325.8.3.1 or R325.83.2. 13 0
Bathtubs shall have two vertical and three horizontal grab bars installed according to R325.8-R325.8.4—R325.8.4.2 0 0
Shower stalls have two vertical and horizontal grab bars mounted on all sides of shower according to R325.8—R325.8.5— ® 0
R325.8.5.2.
Shower stalls must be minimum size of30 inches deep by48 inches long(R325.11) ® 0
A6103 AGiO5;Swimming Pool,Spa, Hot Tub �,
YES NO
AF105.2 Must be surrounded by a barrier that is 48 inches high,may have doors and or gates that must have audible alarms when 0 0
opened.
AG105.5 EXCEPTION: Pools,Spas or Hot Tubs with a safety cover which complies with ASTM F 1346 0 0
PASSED .. :.'. . D CORRECTIONS REQUIRED 0 PERMIT REQUIRED
INsEçJpR's NAME(PRINT}
INSPECTOR'SSIGNATURE DATE r
13.11.1
INSPECTOR'SOFFICEADDRESS Y PMONENUMBER.
Application;aru »tspection cheek devClope2f by Washington Association of Building Officials(WABO),in cooperation.with De parlment of Sopal'and
Health Services(13SHS)for use<by'botlh departments and licensors ', 07/01/2013
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Effective:2013 July 01
Updated:2017 February
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CITY OF .. I PERMIIPAPPLICATION
Federal Way
PERMIT NUMBER I _ 0 _ 1127//
7
TARGET DATE
SITE ADDRESS SUITE/UNIT#
_ *". 1).\\) ,s Fc.i e:vc . V6041 W A
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# 7 0 (,) - 0 / � a
—f)
TYPE OF PERMIT BUILDING 0 PLUMBING ❑ MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT TI 61P7.; c:;\ u._ 1� Rom e,
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER E Sc 1 _ t4-G-G--n3 234- -342
MAILING ADDRESS E-MAIL
2 20S es to -G
CITY STATE ZIP
'-Pc.eSrc . 4. to c 3
NAME PHONE
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME PRIMARY PHONE
I Scabe4\- 1- SI-NE-GENZo,6-- 2 5-3428
r_j
APPLICANT MAILING ADDRESS E-MAIL
28 2. l l 2- 5'44-' �- S
CITY n STATE ZIP FAX
1'' e-Arcd_ CSJ-p k q Do
NAME l PRIMARY PHONE
PROJECT CONTACT
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
NAME
PROJECT FINANCING 0 OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.095)
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 a part of this application.
SIGNATURE: DATE
PRINT NAME: G-1 I Scdo - T- Sklve✓1
Bulletin#100-February 22,2016 Page 1 of 2 k:\Handouts\Permit Application