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18-100111 j J I Building - Single Family City of Federal Way � ' LE Permit #:18-100111-00-SF Commi City o 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: ACTS ADULT FAMILY HOME Project Address: 28604 26TH AVE S Parcel Number:746690 0260 Project Description: ALT-Verification of Occupancy for Adult Family Home.***No construction work allowed under this permit.*** INSPECTION IS FOR BEDROOM "D" ONLY Owner Applicant Contractor Lender NANCY MAINA NANCY MAINA 28604 26TH AVE S 28604 26TH 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 PermitInformation Mechanical to be Included? No Is this an Online or O.T.C.application Yes Plumbing to be Included? No Will Certificate of Occupancy be Issued? No ���' %. � cE2�K'x � �����,���'�r Wa€�`E� ,,. %. �`s� of ��E���,...,z �. �,.. i�,ds ,y�� � €EFft€: f� ✓ � ��g� , 4 z . � PERMIT EXPIRES Sunday,8 July,2018 Permit Issued on Tuesday,January 9,2018 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: 411`.� _ Date: (( cD V FLHALD C 3 f City of Federal Way Certificate of Occupancy This Certificate issued pursuant to the requirements of Section 111 of the International Building Code or Section R110 of the International Residential Code is certifying that at the time of issuan this structure was in compliance with the various ordinances of the City regulating building constr ion or use.This certificate is valid ONLY when endorsed by City staff. Tenant Name: ACTS ADULT FAMILY HOME Permit# 18-100111-00-SF Address: 28604 26TH AVE S Includes: #1 #2 #3 #4 Occupancy Class: Construction Type: Occupancy Load: Floor Area(sq.ft.) Owne 'ame: NANCY MAINA Owne ddress: 28604 26TH AVE S FEDERAL WAY WA 98003 Building Official Date The pri. ty focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which expe •-nce has shown most severely affect the health and safety of the general public. Although the City has made as complete a = dew and inspection as is reasonably possible(within budgetary time and personnel limitations),the City neither guarantees .r 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. J R3Grab,Barsin Bathrooms „�'N/ Q',I YES N O • Grab bars shall be installed for all water closets(toilets),bathtubs andshowers accordingto 8325.8. Q Q Water Closets(toilet)shall have gra installed on both sides accordingto 8325.8—R325.8.3.1 or R325.83.2. 0 0 Bathtubs shall have two vertical and three horizontal grab bars installed according R325.8-8325.8.4-8325.8.4.2 Q Q Shower stalls have twoverticaland horizontal grab bars mounted on allsides of showeraccordingto 8325.8-8325.8.5— 0 0 R325.8.5.2. Shower stalls must be minimum size of 30 inches deep by 48 inches long(R325.11) Q 0 A610 -1CGIEF5 rrtrr ming Pooi.Spa, Hot Vie. '` YES NO AF 5.2 Must be •surrounded bya barrier that is 48 inches high,may have doors and or gates that must have audible alarms when .."- ' il',0?.-4,1„-- ;if?' -,,;,,,,:':,',' opened. AG105 5 EXCEPTION Po Spas or Hot Tubs with a safety cover which complies with ASTM F 1346 Q Q ., i2 �COR.,,_,,,''''''T' 3.;:', ffN'v.RECtUIRa;:emd ; PE#tM[E EQUiRER c INSPE roll's NAI 1 (PF[INT} � IIVSPECTQEI S A E ��,,, , � }��" 1�yr x i 1.NSPEcrOw tcE.ALogEs ` ,-. � � � . NE NUMBED ti Appi tation"andInspection' checklistdeve ped by Wars wgton Assodatk+rt of Bu ng Offic is{WA L n conlaeta t rt"war Depart stent of SSI an� HejltliServices DSH far use by bid del`artrrents "` r�tensors 07/01/2013 Effective:2013 July 01 Updated:2017 February • YES _.[1 - Bathroom o easily and quickly openable from the outside when locked 0 Carbon Monoxide alarm ' stalled as required i n R315 on each level of the home. 0 0 Smoke alarms are installed on all leve e dwelling,i n ea ch resident sleeping room,o • each separate 0 0 sleeping area in the immediatevicinityofsleepin orns(`14). Smoke and Carbon Monoxide alarms are installed insuch a . - • at the audible waming may beheard inall 0 0 parts of the dwelling upon activation of a single•- ' -. Access road a nd water supply me Ifirejurisdictionalrequirements. El 0 R325.4 Operable parts of andles,pulls,latches,locks and other devices installed in AFH shall be operable wi • hand and shall not e tight grasping,pinching ortwistingofthe wrist(lever-type). 0 0 P oors shall have graspable hardware availablewhen in the closed or open position. ■ Ps Ramps YE inside Ramp `• I R311.8.1 Maximum SloplIme.u.nlIvertical in twelve units horizontal(8.3%slope).(Exception R311.8.1 Not allo • H) 0 R311.8.2 Landing Requirements:min.3 of landingattop/bottom,where doors open onto ra where ramp cha nges directions. 0 0 R325.9.1 Handrails required on both sides of ramp in actor a th R3 R311.8 3 3 0 0 Outside Ramp I WA 0 YES NO R311.8.1 Maximum Slope one unit vertical int units horizontal(8.3%slope).(Ex n R311.8.1 Not allowed in AFH) 0 0 R311.8.2 La nding Requirements: ' . foot landing attop/bottom,where doors open onto ra d where ramp changes• 0 0 directions. R325.9 rails required on both sides of ramp in accordancewith R311.8.3.1—R311.8.3.3. ua rds below are depicted vertically as an example only.All Ramps must have Guards u� Handrail both sides f Less than 4" 34"-38" Guard 36"min + 3'x3'min landing 3'x3'min landing _ 3' One unit vertical in twelve units horizontal 1" 3' minimum is an 8.3%slope all along surface of the ramp. minimum R311:22MeEgress 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. 0 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 0 R325.4 Required exit door hardware shall unlock insideand outside mechanisms when exitingthe building allowing re-entry 0 0 without use of key,tool or special knowledge. R311.7 Stairways I N/A 0,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) a R311.7.5.2 Tread Depth:Min.tread depth shall be in 10 inches(9 inches in structures built prior to July 1,2004) a R325.10.1 Handrails for Treads and Risers shall be installed on both sides oftreads and risers numbering from one riser to m ultiple 0 0 risers.Handrails shall be installed in accordance with R311.7.8.1—R311.7.8.4 Effective:2013 July 01 Updated:2017 February minimum and 30 inches maximum. . R325.8.3.1 Fixed position grab bars.Fixed position grab bars shall be a minimum of 36 inches in length and start 12 inches from the rear w all. R325.8.3.2 Swing-up grab bars.Swing-up grab bars shall be a minimum of 28 inches in length from the rear w all. R325.8.4 Grab bars at bathtubs.Horizontal and vertical grab bars shall meet the requirements of R325.8. R325.8.4.1 Vertical grab bars.Vertical grab bars shall be a minimum of 18 inches long and installed at the control end w all and head end w all.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 betw een 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 R325.8 at the control end and head end entry points. R325.8.4.2 Horizontal grab bars.Horizontal grab bars shall be provided at the control end, head end, and the back w all w ithin the bathtub area.Grab bars shall be mounted betw een 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 shower stalls are provided to meet the requirements for bathing facilities, grab bars shaH meet the requirements of R325.8. EXCEPTION:Shower stallswith 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. R325.8.5.1 Vertical grab bars.Vertical grab bars shall be 18 inches minimum in length and installed at the control end w Wand head end w all.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 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. R325.9 Ramps.All interior and exterior ramps, w hen 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 R325.9.1. R325.9.1 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 8311.8.3.1 through R311.8.3.3. 8325.10 Stair treads and risers.Stair treads and risers shall be constructed in accordance with R311.7.5. Handrails shall be installed in accordance with R325.10.1. R325.10.1 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 R325.11 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 chapters19.27 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.] Effective:2013 July 01 Updated:2017 February NAME OF AFH: A S /X17 JL, I 1 10'4 SECTION 5 MUST BE COMPLETED BYTHE BUILDING DEPARTMENT I N THEJU'ISDICTI ON THE HOME WI LL 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 E AND F AND CLASSIFICATION CODE S,NS1 OR NS2. SECTION 5—BUILDING INSPECTOR'S INSPECTION CHECKLIST R325.3 Sleeping Room Oassification: Each sleeping room in an Adult family Home shall be classified as: Type 5—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. 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. t SLEEPING`ROOM A 0 Type S 0 Type NS1 0 Type NS2 YE Close •-•r/s are readily openablefrom the inside I0 Yes 0NSmoke al arm is installed in the bedroom Jd 0 Bedroom doo locked-•enseasilyandquicklyfromtheoutsidewhen0 0 Sleeping room win.•• .asa net opening of 5.7SF(minimum dimensionsatleast24"high;at least 20"wi•- 0 0 EXCEPT per R310.2.1:at-gr.•- - cape wi ndows—may have net clearanceopening55F Sleeping room window has a maxim.•• ill height of 44"a bovefloor to clear opening;no •s under windowallowec 0 0 " SLEEPING R• • 0 Type S • , •e NS1 ID Type NS2 YES NO Closetdoor/s are readilyopenablefromtheinside U Yes I0No ' oke alarm is installed in the bedroom El 0 Bedroom door opens easily and quicklyfrom the outside - Io -. 0 0 Sleepingroom windowhas anet opening of5.7SF(minim .• •l • ions atleast24"high;atleast 20"wide) 0 0 EXCEPT per R310.2.1:at-grade escape windows—m. .venet cleara ••eningSSF Sleeping room window has a maximum sill -': t of 44"a bovefl oor to clear ope ••...•nosteps under window allowec 0 0 SLEEPING : e +' C 0 Type S 0 Typ- 1 I0 Type NS2 YES NO Closetdoor/s arereadilyo •.•'efromtheinsidelDYes r0No I Smokealarmisins . -d in the bedroom 0 0 Bedroom door open lyandquicklyfromtheoutsidewhenlocked 0 0 Sleepingro ndowhasanetopeningof5.7SF(minimumdimensionsatleast24"high;at least 20"wide) 0 0 EXCE R310.2.1:at-gradeescapewindows—may have net clearance opening5SF eepingroomwindowhasa maximumsill heightof44"abovefloortoclear opening;nosteps under window allowec 0 e LEEPINGRII ? : L 0 Type S 0 Type N51 0 Type NS2 YES y0 1 Closetdoor/s are readily openable from the i nside es 0'No I Smokealarmisinstalled inthebedroom ■ Bedroom door opens easily and quickly from the outside when locked 'ie Pi Sleeping room window has a net opening of 5.7 SF(minimum dimensions at least 24"high;atleast 20"wide) s El EXCEPT per R310.2.1:at-grade es cape 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 ftp' SLIEEPI,NG ROOM E 0 Type S 0 Type NS1 O Type NS2 ES NO Closet do• -readilyopenablefromtheinside 113 Yes 0 N I Smoke al arm is i nstalled i • •edroom 0 0 Bedroom door opens-. • and quickly from the outs idewhen locked 0 0 Sleepingroom windowhas ane •=•.'ng of5.7SF(minimum dimensionsatleast " ': •atleast20"wide) 0 0 EXCEPT per R310.2.1:at-grade escape wi n..• — ay have netclearanc- •.-ning5SF Sleeping room window has a maximum sill height of 44 to clear opening;no steps under window allowec 0 0 SLEEPING'Room F ■ ,•- 0 Type NS1 0 Type NS2 YES NO Closetdoor/s are readilyopenablefrom •-• side IDYes I■ No Smo - .rmisinstaliedinthebedroom 0 0 Bedroom door opens easily a • :• c Iyfrom the outside when locked 0 0 Sleeping room win.• as a net opening of 5.7SF(minimum dimensions at least 24"high;atleast 2 • 0 0 EXCEPT pe ' 1.2.1:at-grade escape wi ndows—may have net clearance opening 5SF ping room window has a maximum sill height of 44"a bovefl oar to clear opening;no steps under window allowec EI- Effective:2013 July 01 Updated:2017 February I I E' Adult Family Home (AFH) LOCAL BUILDING INSPECTION CHECKLIST Code References:2015 IRC Section R325(WAC 51-51) APPLICATION NUMBER: / - 1 b 0 I ► I SECTIONS 1. 2. 3. AND 4 MUST BE COMPLETED BY APPLICANT BEFORE INSPECTION WILL BE PROCESSED SECTION 1—PROPERTY INFORMATION SITE ADDRESS: - V^ © /57 c - ) e $ A.e--ir t W A-7 U./ASSESSOR'S TAX/PARCEL#: / SECTION 2—APPLICANT INFORMATION PROPERTYOWNERNAME: l _ C.,,i I V 1 i\ j , DAYTIME PHONE: 4-7 K—7 cl ( '—' ciZ AFH LICENSEE NAME(IF DIFFERENT): 0 I*, DAYTIME PHONE: 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'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 Pc-7v of the information supplied to the jurisdiction as a part of this application. q NAME/TITLE: I V Pc J ( 1 Jti A-1 p iA DATE: 1"Z ( ( i 'PROPERTY OWNER ['APPLICANT Q LICENSEE 6 (Effective July 1,2013.) 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 new y 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 Reserved. 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 with R325.9 is provided. 3.Type NS2 Where two means of egress are at grade level or ramps constructed in accordance with R325.9 are provided. R325.4 Types of locking devices and door activation. All bedroom and bathroom doors shall be openable from the outside w hen 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.Fbcket 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 NO maximum Required exit doors shall have no additional locking devices. Required exit door hardw are shall unlock inside and outside mechanism w hen exiting the building allowing reentry into the adult family home without the use of a key, tool or special know ledge. R325.5 Smoke and carbon monoxide alarm requirements.All adult family homes shall be equipped with smoke and carbon monoxide alarm installed as required in Sections R314 and R315.1. Alarm 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. R325.6 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 platform or other devices placed by the openings w ill be approved as meeting this requirement. R325.7 Are 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. R325.8 Grab bar general requirements.Where facilities are designated for use by adult family home clients, grab bars forwater closets,bathtubs and shower stalls shall be installed according to this section. 8325.8.1 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 R326.8.2 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,w hen mounted, shall not rotate, spin or move and have a graspable surfacefinish. 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 swing-up bars.Grab bars shall meet the requirements of R325.8. 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 Effective:2013 July 01 Updated:2017 February v 0 (0 1 1 , 1 l LI0 ,..,w...., I w1 cc IL;z,..,4 _______.—u---_-_,—r.7 �. Y r • - �, ..__ I ` � e'' 1 Y AC A.A: 1ON FLAN 1/8- 11,4—c, d' FLAN 11/1/ F.F.BROWN voakitt FFOR a.c street wain, NANCY! I ti_I !gip II ab�oawas rr . stvaremM 4630} 26604 26TH AVt.6.FEDElCA L MAY.P4A h0Of58 308.-192-4482 RECEIVE® CITY OF .. /. JAN 09 2018 PERMIT APPLICATION Federal Way CITY OF FEDERAL WAY PERMIT CENTER+ 33325 8th Avenue South +Federal Way,WA 98003-6325 253-835-2607 + FAX 253-835-2609 +permitcenterncityoffederalway.com n COMMUNITY DEVELOPMENT PERMIT NUMBER 1 _ {j 0 `�IT / i ) _ 5 1 r `p pc 111 TARGET DATE SITE ADDRESS ace 6 d i( die k—r' S ,r--e6,0..�t doC,,- W Cil Ogg SUITE/UNIT# PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# © r� N�pc 7 t/`/((JJ - L $ TYPE OF PERMIT BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION NAME OF PROJECT (/ PROJECT DESCRIPTION 1 S +, 'e. G- pY �.�b 6 ivk ,� Detailed description of work to be included on this permit only NAME,I /'1 C-1- A l A PRIMARY PHONE PROPERTY OWNERJAVfrAC�' / EL- '7c/ f#f C MAILING D0�f L /� S mac; n�407P i(�r C. CITY STATE ZIP /^1'd1( Vic y w� -` roO3 '� NAME PHONE MAILING ADDRESS ' ^ E-MAIL CONTRACTOR \y\ CITY V...' STATE ZIP FAX i. WA STATE CONTRACTOR'S LICE SE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# / / N NA N G`{ PA ) N A PRIMARY PHONE was- --ii / - 6(12- APPLICANT- MAILING ADDRESS E-MAIL CITY STATE ZIP FAX r—e---'r6fwct VS Pc -Oo3 NAME 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 ❑ 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 arty 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. -r- / SIGNATURE: ` i DATE t [ I PRINT NAME: 1\ N' C-- \A A l N.) A Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application VALUE OF MECF,ANICAL WORK MECHANICAL PERMIT $ how of type offixture Indicate ...�..�y each c���cu,e 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(Gas) COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES vrLuE-vF PLUMBING WORK PLUMBING PERMIT lr Indicate how many of each type of fixture to be installed or relocated as part of this project.Do not include existing res 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 I RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION(in square feet) EXISTING ` PROPOSED TOTAL FOR OFFICE USE FIRST FLOOR(or Mobile Home) s I eI r� , COVERED ENTRY a:�I � . "3�,. " GARAGE 0 CARPORTAck❑ r. ` Mt , �* ,a s EXISTING PROPOSED TOTAL Area Totals ;�. "f_.•y. .. ,�.:' .� s � ; W.�.���':nom; w s.=`'r..as._" ESTIMATED SELLING PRICE$ L #OF BEDROOMS _ COMMERCIAL—NEW/ADDITION Area in I Construction #of AREA DESCRIPTIONJr I Additional Information Occupancy Group(s) Cn»arP.�cFPP4' '� at 7�� �%::" t ,y,.x. smT` s q, . ADDITION I COMMERCIAL—REMODEL/TENANT IMPROVEMENTS Area in Construction #of AREA DESCRIPTION Occupancy Group(s) Additional Information S uare Feetpe Stories Rat +�, .-T d, of" „� .. .wa e y,,. y. �}�,,� - ,imA `r. t g <.., t a„t ,✓ afin„. L® HX:.x . TENANT AREA ONLY sus v 4 F mvr t . PROJECT`ARE ;ONLY t bib' Bulletin#100—January 29,2016 Page 2 of 2 k:\Handouts\Permit Application