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09-103419
• o..iilding - Single Ally City of Federal Way Community Development Services � " Permit #. 09-103419-00-SF P.O. 7 Box 9718 # Federal Way,WA 98063-9718 ec Ins tion Request Line: (253) 835-3050 Ph:(253)835-2607 Fax (253)835-2609 p q Project Name: ALPHA ADULT FAMILY HOME Project Address: 30654 11TH AVE S Parcel Number: 091900 0160 Project Description: Inspection of single family residence to establish occupancy as an Adult Family Home. Owner Applicant Contractor Lender JIN WOOK LEE JOSEPH&FRANCISCA KARANJA MICHELLE LEE 2622 S 296TH PL 30654 11TH AVE S FEDERAL WAY WA 98003 FEDERAL WAY WA 98003-4121 Census Category: 999 - Unknown Includes: #1 #2 #3 #4 Occupancy Class: R-3 Construction Type: Type V-B Occupancy Load: Floor Area(sq. ft.) 3,200 0 0 0 Additlii itial ermit ftlftkilifiti6n New/Additional Sq.Feet-3rd Floor 0 Occupancy,#1 -Area(Sq. Feet) 3200 New/Additional Sq. Fcet-Basement 0 Occupancy#I -Construction Type Type V- B Mechanical to be Included? No Occupancy#1 -Class R-3 Plumbing to be Included9 No Occupancy#1 -Use Residence (Care/Assisted Living) No`F aures Associated with This permit!! PERMIT EXPIRES Tuesday, March 2, 2010 Permit Issued on Thursday, September 3, 2009 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: ltir �' �, Date: (°n 7/0.. .?/0 FIN 4U#D �l/3Of'O' City of Federal WT-111 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: ALPHA ADULT FAMILY HOME Permit#: 09-103419-00-SF Address: 30654 11TH AVE S Includes: #1 #2 #3 #4 Occupancy Class: R-3 Construction Type: Type V-B Occupancy Load: Floor Area(sq. ft.) 3,200 0 0 0 Owner Name: JIN WOOK LEE MICHELLE LEE Owner Name: Owner Address: 30654 11TH AVE S FEDERAL WAY WA 98003-4121 _ _ I ///1.41 q /�� =udi 'O"al 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 severly 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. ,/ i NAME OF AFH: /4' l o1!( a Aida a/ Fa-144l`./(� l l 1 &.Q_ SECTION 5 MUST BE COMPLeTED BY THE BUILDING DEPARTMENT INE JURISDICTION THE HOME WILL BE LOCATED. . PLEASE CHECK ALL APPLICABLE BOXES. PLEASE ALSO INDICATE ON THE FLOOR PLAN DRAWN BY APPLICANT. WHICH BEDROOM IS#1,2,3,4,5,OR 6 AND THE CLASSIFICATION CODE: S, NS1, OR NS2 (TO MATCH THE LIST BELOW) 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 only means of egress contains stairs to evacuate. Type NS1—where one means of egress does not have stairs to evacuate. T •e NS2—where two means of e•ress do not have stairs to evacuate. SLEEPING ROOMS Sleeping Room #1 Type S i ❑ Type NS1 g Type NS2 YES Closet door/s are readily openable from the inside IYESre NO Smoke alarm is installed in the bedroom gIr Z) Bedroom door is easily and quickly openable from the outside when locked 0 Sleeping room window has minimum dimensions at least 24" high; at least 20"wide—(NET OPEN-ABLE AREA OF 5.7 SF**) [If I tl **EXCEPT PER R310.1.1:AT-GRADE ESCAPE WINDOWS-(MAY HAVE NET CLEAR OPENING 5 SFi_ Sleeping room window has a maximum sill height of 44"above floor;no steps under window permitted 0 Sleeping Room #2 ; 0 Type S ❑ Type NS1 , gType NS2 YES NO Closet door/s are readily openable from the inside YES ti" NO ❑ 1 Smoke alarm is installed in the bedroom Er,e_:,1k Bedroom door is easily and quiqkly openable from the outside when locked E i 0 Sleeping room window has minimum dimensions at least 24"high; at least 20" wide —(NET OPEN-ABLE AREA OF5.7SF*") E' 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 window permitted Pi Sleeping Room #3 0 Type S _1 0 Type NS1 i A Type NS2 , YES O Closet door/s are readily openable from the inside YEs 5r. NO 0 j— Smoke alarm is installed in the bedroomr 'C%P Bedroom door is easily and quickly openable from the outside when locked 0 S..l... . 0 Sleeping room window has minimum dimensions at least 24" high; at least 20"wide —(NET OPEN-ABLE AREA OF 5.7 SF**) ' � **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 #4 0 Type S 0 Type NS1 i Type NS2 YES Closet door/s are readily openable from the inside YES 0'L NO 0 Smoke alarm is installed in the bedroom ,�,,, Bedroom door is easily and quickly openable from the outside when locked ©' ' 0 Sleeping room window has minimum dimensions at least 24" high; at least 20" wide —(NET OPEN-ABLE AREA OF 5.7 SF**) ❑►' i 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 window permitted i © 0 Sleeping Room #5 I ❑ Type S I ❑ Type NS1 Type NS2 i YES ► • Closet door/s are readily openable from the inside YEs- NO 0 Smoke alarm is installed in the bedroom l -i Bedroom door is easily and quickly openable from the outside when locked 3' Sleeping room window has minimum dimensions at least'k4" high; at least 20"wide —(NET OPEN-ABLE AREA OF 5.7 SF**) Er 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 Sleeping Room #6 0 Type S 0 Type NS1 1. 0 Type NS2 YES NO Closet door/s are readily openable from the inside YES❑ I NO 0 Smoke alarm is Installed in the bedroom ❑ ❑ Bedroom door is easily and quickly openable from the outside when locked 0 0 Sleeping room window has minimum dimensions at least 24" high; at least 20"wide —(NET OPEN-ABLE AREA OF5.7SF**) 0 0 **EXCEPT PER R310.1.1:AT-GRADE ESCAPE WINDOWS NAY HAVE NET CLEAR OPENING 5 SF Sleeping room window has a maximum sill height of 44"above floor; no steps under window permitted , 0 ❑ GENERAL YES NO Bathroom doors are easily and quickly openable from the outside when locked [Ti 0 Smoke alarms are installed on all levels of the dwelling, in each bedroom and common areas 1 al g Any smoke alarm must be audible throughout the home when activated. 0 Access road and water supply meet local fire jurisdictional requirements 811109 . • , • APPLICATION it INSPECTION CHECKLIST - A ult Family Home Code References: 2006 IRC Section R325(WAC 51-51) 'L APPLICATION NUMBER: D' '/D 3 7 / q f4 SECTIONS 1,2,3,AND 4 MUST BE COMPLETED BY APPLICANT BEFORE INSPECTION WILL BE PROCESSED SECTION'1 - PROPERTY INFORMATION /1 %H4 ' 'STAX/ SITE ADDRESS: C/',; ' t 6 UU h :`j �C, i u 3 TABSSSORARCEL#: SECTION 2 APPLICANT INFORMATION PROPERTY OWNER NAME: 01 i J1-€1, L DAYTIME PHONE: LICENSEE NAME(IF DIFFERENT): F-44 N 1 l S 14,4/2.41,4 j' AYTIME PHONE: L SECTION:3—FLOOR PLAN APPLICANT MUST DRAW A COMPLETE FLOOR PLAN ON THIS FORM. PLEASE INCLUDE ALL SLEEPING ROOMS(BEDROOMS). **ON THIS DRAWING,THE BUILDING INSPECTOR MUST THEN IDENTIFY WHICH ROOM IS SLEEPING ROOM#1,2, 3,4, 5,AND 6 AND LABEL ALL COMPONENTS FOR EXITING i.e.STAIRS,RAMPS,PLATFORM LIFTS&ELEVATORS,(USE BACK OF THIS PAPER IF YOU NEED MORE ROOM) 6.-t,/1-0-St/7 'iv-- 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 further certify that I have made application to the Department of Social and Health Services for an adult family home license and that I have also made application to the applicable jurisdiction for the appropriate license(s) to conduct such business at this location. I further agree to hold harmless the jurisdiction conducting such inspections,at my request,as to any claim(including costs,expenses,and attorneys'foes 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 •!icgrs and employees,upon the accuracy of the information supplied to the jurisdiction a p of this application. i NAME/TITLE: ,i s„ �_ , J� DATE: 7' 0 PROPERTY OWNER APPLI JNT 0 LICENSEE ECEIVC ror ERMIT 4_ _Z_ LL .Y / ? 41,1 erSF IMF CO ME EL PL DE EN FP Federal Way COMMUNITY DEVELOPMENT SERVICES U 3 APPLICATION / / 253-835-2607•FAX 253-835-2609 www.cituof(ederalwau.com P11F.RAL WAY alliSiggi:LiAliiigilli-41LiiLkiiAMlitifiVOliti.alifaititattaiiiiAltitatitgaitleide!ilie SITE ADDRESS �- - : `'5-4 j // ( _f,6,7c„,,A,,,,W,„),,,dwskisSUITE/UNIT# ZONING ASSESSOR'S Tw--4ARCEL# o 9 I ? 00 _ 0 L Coo 7+,0a.> .,a puig., s,€k,.•><. . 5,,,,, : . ii4uvw'..43;3f.�` ,Y"- pkoJ Q .� .'�� . .. � 3, f h 3 `� 0,,,.:4::\ NAME OF PROJECT _ (Tenant or Homeowner Name) l G l & ACL( ( +- FC-�V✓L'` L }--f - UILD1NG 0 PLUMBING 0 MECHANICAL TYPE OF PERMIT 0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION PROJECT DESCRIPTION r�_. Pr/ CA-A i � ( . 17 1 Detailed description of work to be included on this permit only 5';/ r Sdr 4 NAME PRIMARY PHONE PROPERTY OWNER 14'1.i C l/tet '4. i F",-0-- (✓`�t) 4/2 it S MAILING ADDRESS,CITY,STATE,ZIP E-MAIL `30c 1 f / 114V f r-lwQ w 49 ,3 OWNER IS ALSO: 0 CONTRACTOR 0 APPLICANT 0 PROJECT CONTACT NAME -_ -_-- PRIMARY PHONE CONTRACTOR MAILING ADDRESS,CITY,STATE,ZI / FAX S WA STATE RACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# / / NAME PRIMARY PHONE✓ . APPLICANT - a)S€A. 1 Ct -- lre'r7 .Tl,a t om- ()7c() _,21-7/- L/' S ,.MAILING ADDRESS,CITY,STATE,ZIP FAX 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 PRIMARY PHONE E-MAIL 1 PROJECT FINANCING NAME0 OWNER-FINANCED Required for projects with value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE (RCW 19.27.095) I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best of my knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit.I understand that the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating construction or environmental laws. I further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred in the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the information supplied to the/ city as a part of this application. �/ -_ ,?/re - SIGNATURE: %�. � DATE y7 / PRINT NAME: y ''.,. /•I C 1--__.' Bulletin#100-4/17/2009 Page 1 of 4 k:\Handouts\Permit Application 4011 MECHANICAL FIXTURES Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE PROVIDED) Indicate number of each type of fixture 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(Commercial) BOILERS FURNACES HOT WATER TANKS(Cas) 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(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 PROJECT VALUATION 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 AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE BASEMENT FIRST FLOOR(or Mobile Home) SECOND FLOOR COVERED ENTRY -- — DECK GARAGE ❑ CARPORT 0 OTHER(describe) EXISTING PROPOSED TOTAL — — — Area Totals **NEW HOMES ONLY** ESTIMATED SELLING PRICE$ # OF BEDROOMS COMMERCIAL -NEW/ADDITION AREA DESCRIPTION Area Construction # of in Square Feet Occupancy Group(s) Type Stories Additional Information NEW BUILDING ADDITION — COMMERCIAL - REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area Construction # of in Square Feet Occupancy Group(s) Type Stories Additional Information TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY Bulletin#100—4/17/2009 Page 2 of 4 k:\Handouts\Permit Application