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11-103369 ilding - Single Family City of Federal Way Community Development Services Permit #: 11-103369-00-SF P.O Box 9718 Federal Way,WA 98063-9718 Ph:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253)835-3050 Project Name: GREEN PINE CARE SERVICE Project Address: 4461 SW 313TH ST Parcel Number: 211650 0070 Project Description: ALT-Verification of Occupancy for Adult Family Home. ***No construction work allowed under this permit.*** Owner Applicant Contractor Lender QING XIU JI-BUDNICK QING XIU JI-BUDNICK 4461 SW 313TH ST 4461 SW 313TH ST FEDERAL WAY WA 98023 FEDERAL WAY WA 98023 Census Category: 999 -Unknown Includes: #1 #2 #3 #4 Occupancy Class: R-3 Construction Type: Type V-B Occupancy Load: Floor Area(sq. ft.) 0 0 0 0 Addtional PermitEIn atio New/Additional Sq. Feet-3rd Floor 0 New/Additional Sq.Feet-Basement 0 Occupancy#1 -Construction Type Type V-B Mechanical to be Included? No Occupancy#1 -Class R-3 Plumbing to be Included? No Occupancy#1 -Use Adult Care Facility No F xtures Associated With This Permit iC PERMIT EXPIRES Tuesday, February 14, 2012 Permit Issued on Thursday, August 18, 2011 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: ��/�ii��et Date: d//d/ -�^// F1MLf) z t 3112. • Adult Family Home (AFH) LOCAL BUILDING INSPECTION CHECKLIST Code References: 2009 IRC Section R325(WAC 51-51) \ APPLICv ATION NUMBER: i/ / a 56 SECTIONS 1,2,3,AND 4 MUST BE COMPLETED BY APPLICANT BEFORE INSPECTION WILL BE PROCESSED SECTION 1 - PROPERTY INFORMATION SITE ADDRESS: i/ c$:JI! 3/3 /' ' 'OW ASSESSORS TAX/PARCEL#: - SECTION 2 - APPLICANT INFORMATION' I /�/�� PROPERTY OWNER NAME: /4/G' x/Lii :- .G7NAN/GIG DAYTIME PHONE. 417 /P'�4p AFH LICENSEE NAME(IF DIFFERENT): DAYTIME PHONE: SECTION 3 — FLOOR PLAN APPLICANT MUST DRAW COAWLETE FLOOR PLAN/s ON THIS FORM(ALL FLoORs). PLEASE INCLUDE ALL SLEEPING ROOMS(t3EDRooMs). ON THIS DRAWING.INDICATE WHICH BEDROOM IS A. B. C. D. E.AND F. LABEL ALL COMPONENTS FOR EXITING i.e.: STAIRS. RAMPS, PLATFORM LIFTS$t ELEVATORS. See a6/6(-c-Le 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 e jurisdiction, including its officers and employees, upon the accuracy of the information supplied to the jurisdiction as a part oft - NAME/TITLE: e/-4„� �,, 4}� ��'Il� � 9d�j��'�""'�” DATE: /18A° ❑ PROPERTY,•J' NER • • CANT 0 LICENSEE 08/01/10 ! 0 . 3R-11'4 frl-—$1,.y .7',"1,4 Rfri - 5.-el t-r: puisibr p9,-Aaiv - if-3 /At t/1, -7-10 +. tIA Waf—11/t fr. -4— ___. ___ L-�4 S?Afr' s-L y fl iONSA0001 /AS 41 [ ] 1I fq V 7 710,0® t O ) n @ — ---. k _ .(,,doji Afii 4-t)Rocom A 20,6°°14 ,7- U. ,�s�' 1 LiNe:. .----b r'n 3 7)'i' ,�E 44, D c _ 0 r° :-. 1,7 ice. 6-hryg ....,„,_ ri: j v 'S : , o SMOKE ALARM ® FIRE EXTINGUISHER LOCATION SYMBOL ONLY NOT SPACE ACTUALLY OCCUPIED EXTERIOR I. ENTRANCE-EXIT INTERIOR CLOSET-CABINET a ' NAME OF AFH: ?rat( / •U &I , elf 4 ce SECTION 5 MUST BE COMPLETED BY THE BUILDING DEPARTMENT IN THE JURISDICTION THE HOME WILL BE LOCATED. PLEASE CHECK ALL APPLICABLE BOXES;MATCH THE UST BELOW TO THE APPLICANT'S FLOOR PLAN-USING THEIR PROSPECTIVE RESIDENT BEDROOM DESIGNATIONS OF B.C.D E.AND F AND CLASSIFICATION CODE:S,NSI,OR NS2 SECTION 5- BUILDING INSPECTOR'S INSPECTION CHECKLIST R3253 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 lilts to evacuate residents to public area. Type NSI-where 1 means of egress at grade level(has no stairs),or a ramp constructed compliant with R325.9 is provided to evacuate residents to public area. Type NM-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 pubic area SLEEPING ROOMS Sleeping Room A ' ❑ Type S iType NSI 1 ❑_ype NS2 YES NO Closet door/s are readily openable from the inside YES NO 0 Smoke alarm is installed in the bedroom f�- 0 Bedroom door is easily and quickly openable from the outside when locked E' 0 Sleeping room window has a net opening of 5.7 SF* (minimum dimensions at least 24'high; at least 20'wide) fa' 0 *EXCEPT PER R310.1.1:AT.( ADE ESCAPE WW(1NS-MAY HAVE NET CLEAR OPENING 5 SF Sleeping room window has a maximum sill height of 44'above floor;no steps under window permitted j' 0 Sleeping Room B 1 0 Type S ; I Type NS1 1 ❑ Type NS2 YES NO Closet door/s are readily openable from the inside YES* NO 0 1 Smoke alarm is installed in the bedroom I 0 Bedroom door is easily and quickly openable from the outside when locked ' r.ir1 0 Sleeping room window has a net opening of 5.7 SF* (minimum dimensions at least 24'high: at least 20'wide) ,ral I 1 *EXCEPT PER 8310.1.1:AT-GRADE ESCAPE WIDOWS-WY HAVE NET CLEAR OPENING 5 SF Sleeping room window has a maximum sill height ci 44'above flow,no steps underwindow,:. ii, 0 -,i ! Room C ❑ T,, -S ,:a T 4, -NS1 1 ❑ T I. . NS2 YES NO Closet door/s are readily openable from the inside_J YFs I NO ❑ I Smoke alarm is installed in the bedroom I n 0 Bedroom door is easily and quickly openable from the outside when locked j 127 0 Sleeping room window has a net opening of 5.7 SF* (minimum dimensions at least 24'hie*: at least 20'wide) It ❑ *EXCEPT PER R310.1.1:AT-GRADE ESCAPE WIDOWS-NAY MW NET CLEAR OPENING 5 SF Sleeping room window has a maximum sill height of 44'above floor; no steps under window permitted ❑ Sleeping Room D O Type S ❑ Type Mils SD ype S2 YE fl� Closet door/s are readily operable from the inside YEs 0 NO Smoke alarm is1 installed inTthe bedroomNi ❑S ❑NO Bedroom door is easily and quickly openable from the outside when locked i 0 0 Sleeping room window has a net opening of 5.7 SF* (minimum dimensions at least 24'high; at least 20'wide) 0 0 *EXCEPT PER 8310.1.1:AT-GRADE ESCAPE Mx/Ns-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 0 Sleeping Room E 0 Type S 0 Type NSI i 0 Type NS2 YES , NO Closet door/s are readily openable from the inside YES❑ TNO ❑ i Smoke alarm is installed in the bedrown ❑ ❑ Bedroom door is easily and quickly openable from the outside when locked 0 0 Sleeping room window has a net opening of 5.7 SF* (minimum dimensions at least 24'high: at least 20'wide) 0 0 — -- *EXCEPT PER R310.1.1:AT-GRADE ESCAPE WIDOWS-MAY HAVE NET CLEAR OPENNI NG 5 SF Sleeping room window has a maximum sill height of 44'above floor; no steps under window permitted j 0 0 Sleeping Room F 0 Type S 0 Type NSI 0 Type NS2 YES NO \Closet door/s are readily openable from the inside Tns 0 j NO 0 Smoke alarm is installed in the bedroom 0 I 0 Bedroom door is easily and quickly openable from the outside when locked 0 0 Sleeping room window has a net opening of 5.7 SF* (minimum dimensions at least 24'high: at least 20'wide) - 0 0 *EXCEPT PER R310.1.1:AT-( ADE ESCAPE wra0115-MAY HAVE NET AFAR OPENING 5 SF Sleeping room window has a maximum sill height of 44'above floor;no steps under window permitted 0 0 GENERAL YES NO Bathroom doors are easily and quickly openable from the outside when locked JO I 0 Smoke alarms are installed on all levels of the dwelling,in each resident sleeping room,outside each separate sleeping lif 1 0 area in the immediate vicinity of sleeping rooms(R314) , Sok me alarms are installed in such a manner so that the fire waning may be audible in all parts of the dwelling upon 0 activation of a single device. Access road and water supplymeet local fire jurisdictional requirements ,,QJ' I -� - 08/01/10 • R311 ' y 7 .8°� am NIA I X YES NO R311.8.1 Maximum Slope one unit vertical in twelve units horizontal(8.3%slope).(Exception R311.8.1 Not mowed in AFH)_ IN 0 R311.8.2 Landing Requirements:min.3X3 foot landing at top/bottony where doors open onto ramps,and where ranp it CIchanges directions. P" R325.9.1 Handrails required on both sides of ramp in accordance with R311.8.3.1—R311.&3.3. Viitlif&Brifii2 ir"e"gha --N/A- I YE NO R311.8.1 Maximum Slope one unit vertical in twelve units horizontal(8.3%slope).(Exception R311.8.1 Not allowed in AFH) +.Er 0 R311.8.2 Landing Requirements: min. 3X3 foot landing at top/bottom,where doors open onto ramps,and where ramp changes directions. ❑ R325.9.1 Handrails required on both sides of ramp in accordance with R311.8.11—R311.&3.3. 14-' ` 1 14. 7/ *Guards below are d ted ver6c Z' epic ally as an example onl�r. All Ramps must have Guards Less than 4" _ — Handrail both sides I Guard - i i g ~ 1♦)r�IIR�i ift 3'x3'min MsINI„ft�MMM MIN ,,� OMNI. , t i 3'x3'min landing L_ landing u== 1:12 max slope o __ �y I 3' 8.3% i mm 7 ' 141( min •"."-- ADULT FAMI_Y HOME RAMP per 2009 IRC with WA. ST. AME\DMENTS *ALL RAMPS REQUIRE A BUILDING PERMIT* R311.2 Means of E!gess YES NO R311.2 Door must be side-If ,ed with mm.width of 32 inches between faced door and -.''' , not less than 78 inches. IPII 0 R325.4 Operable parts of door handles,puts,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,emergency egress hardware). The Exit doors � 53' ' Fe shat have no additional ..4 ' devices. 21/3/t2 -' R311.7 N. . . s NIAlleCal NO R311.7.4.1 Riser Height Max riser height sh l be 7'A i . 8 inches in structures built. '' to . 1,2004 0 0 R311.7.4.2 Tread r .. Ain.tread ,:. . shad be 10 i ► : 9 inches in struct res built. ', to , 1,2004 0 0 R325.10.1 Handrails for Treads and Risers shall be installed on both sides of treads and risers numbering from one riser to" ., ❑ El' risers.Handrals shallbe installed in accordance with —R311.7.7.4 R 25.8 . : . In Bath . , •-•,,, ire°a rn,te• . ttp _ in .' ord.. - 71 !RC Sec.R1 i,.10 and,11 YES NO 8325.$Grab bars shall be installed for all water closets(toilets),bathtubs and showers. Bathing facilties such as tubs and showers;and t, On both sides of the toilet. shall can;f with ICC/ANSI A117.1 Sections 604.5,607.4&608.3 ins AG103—AG 105 Sw immin Pod_ _ H' Tub NI.Mall NO 2 .13`f? AG105.2 Must be surrounded by a barrier that is 48 inches high,may have doors and or gates that must have audible alarms when ,,:; ed. ❑ ❑ AG 05.5 EXCEPTION:Pools, 'as or hot tubs with a saf,- cover which can' es with ASTM F 1346 0 0 P PASSED / CORRECTIONS REQUIRED 0 PERMIT REQUIRED ; 2--�? /2---- I - CTOR'S SIGMA DATE: „d F 4,-,47Z5 3- Vic-- 2Z3 NSPE OR'S ADDRESS: PHONE: 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. 08/01/10 4 CIiY OF '- *' ,QP E R M IT F CO ME PL DE EN FP - ,Federal Way° COMMUNITY DEVEL 2 CES APPLICATION a g�4 253-835-2607•F 253-835-2609 ,1 ;, RAS-WAY SITE ADDRESS - / �D� SUITE/UNIT# ,-;-6/r/vefri- hiy • PROJECT VALVA 0 ZONING ASSESSOR'S TAX/PARCEL# $ a I I (D 5 0 - 0 0 0 _ 6 UILDING ❑ PLUMBING ❑ MECHANICAL TYPE OF PERMIT � ❑ DEMOLITION ❑ ENGINEERING ['IRE PREVENTION NAME OF PROJECT .. -� //JJ (Tenant Name/Homeowner Last Name) �fliFl�� /Ad (_ t, - �Z/1(/�G — PROJECT DESCRIPTION � 4-4vec // i j�frF��& / /�� L i ^ � Detailed description of work to /rf= ..94 �l '1~D rni�/sT 7,, ,,,,,,,,„:/be included on this permit only /�(tf u, , _ m 1417 I= ;r/ „ ealiv/� �4/7 2E -9 .^1-•''''' PROPERTY OWNER NAME Q/�i. 1(,( �/ e- (,/A/t:/1 �J 3 PHONE ' -Y1/5 2 17;Z77))/ 3/3 7?a / E-MAIL hov 4(91 CITY STATE ZIP fif bfi,IAV )9/7 rroa3 NAME PHONE MAILING ADDRESS E-MAIL CONTRACTOR CITY STATE ZIP FAX WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# / / "y 449 �{/ �NAME/`/Y// ziA&•.. ✓ V//'/j MAILING ADDRESS E-MAIL APPLICANT �9; eV 3/3JSn>(E: c EFAX 07/ ); / / V `3 Uy/ 0e PROJECT CONTACT NAME PHONE (The individual to receive and respond to all correspondence MAILING ADDRESS E-MAIL concerning this application) CITY STATE ZIP FAX ALTERNATE CONTACT NAME: PHONE E-MAIL PROJECT FINANCING NAME El OWNER-FINANCED Required value of$5,000 or more (RCW 19.27.095) MAILING ADDRESS.CITY,STATE,ZIP PHONE 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. -,-444 \ F///%0.// - SIGNATURE: DATE PRINT NAME:- , / /(,t. , • _ u b' ">/a6 Bulletin#100—April 14,2010 Page 1 of 3 k:\ IandoutsWermit Application