Loading...
13-101899 • Silding - Single Family City FederalWay Permit #: 13-101899-00-SF Community&Econ.Dev.Services 33325 8th Ave S Federal Way,WA 98003 Inspection Request Line: (253) 835-3050 Ph:(253)835-2607 Fax (253)835-2609 p q 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 ROBERT J BUDNICK 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 Additional Permit Information New I Additional Sq.Feet-3rd Floor 0 New/Additional Sq.Feet-Basement 0 Occupancy#1 -Construction Type Type V-B Mechanical to be Included9 No Occupancy#1 -Class R-3 Plumbing to be Included No Occupancy#1 -Use Adult Care Facility No Fixtures Associated With This Permit !! PERMIT EXPIRES Sunday, October 27, 2013 Permit Issued on Tuesday, April 30, 2013 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 the City of Federal Way. Owner or agent: iiiiv, ind Z Date: /s0/zo/3 • • Adult Family Home (AFH) LOCAL BUILDING INSPECTION CHECKLIST Code References: 2009 IRC Section R325(WAC 51-51) APPLICATION NUMBER: j 3 — /O` '?y SECTI"NsE, 1,2,3,AND 4 MUST BE COMPLETED BY APPLICANT BEFORE INSPECTION WILL BE PROCESSED f SECTION 1 - PROPERTY INFORMATION SITE ADDRESS: 9 � ', ) —5 LLQ 3 I - 'e.,vC ASSESSOR'S TAX/PARCEL#: Z l i Jam✓--Q©3 U SECTION 2-APPLICANT INFORMATION PROPERTY OWNER NAi)1(: I V I3 1,L6 fl 'L L I`\ DAYTIME PHONE: ('3 • • l I g AFH LICENSEE NAME(IF DIFFERENT): l P i i1P, cant .c -{-\1!' c,f? DAYTIME PHONE: 1{'7 1 _ 4-,(./- -16 SECTION 3— FLOOR PLAN APPLICANT MUST DRAW COMPLETE FLOOR PLAN/s ON THIS FORM(ALL FLOORS). PLEASE INCLUDE ALL SLEEPING ROOMS(BEDROOMS). 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&ELEVATORS. f' 1 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 accuracy of the information supplied to the jurisdiction as a part of this applicatio / 7 NAME/TITLE: � 1 ° DATE: / Q/20 ) ❑ PROPERTY OWNER APPLICANT 0 LICENSEE 08101110 • • • (Effective July 1,2010) WAC 51-51-0325 Section R325-Adult family homes. SECTION R325 ADULT FAMILY HOMES R325.1 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. R325.2 Submittal Standards.In addition to those requirements in Section 106.1,the submittal shall identify the project as a Group R-3 Adult Family Home Occupancy.A floor plan shall be submitted identifying the means of egress and the components in the means of egress such as stairs,ramps,platform lifts and elevators.The plans shall indicate the rooms used for clients and the sleeping room classification of each room. 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.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. The force required to activate operable parts shall be 5.0 pounds(22.2 N)maximum.Exit doors shall have no additional locking devices. R325.5 Smoke Alarm Requirements. All adult family homes shall be equipped with smoke alarms installed as required in Section R314.Alarms shall be installed in such a manner so that the fire warning may be audible in all parts of the dwelling upon activation of a single device. 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 platforms or other devices placed by the openings will be approved as meeting this requirement. R325.7 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. R325.8 Grab Bars.Grab bars shall be installed for all water closets and bathtubs and showers. The grab bars effective WAC 51-51- 0325:Section R325-Adult family homes.date 7/1/10 shall comply with ICC/ANSI A117.1 Sections 604.5 and 607.4 and 608.3. EXCEPTION: Grab bars are not required for water closets and bathtubs and showers used exclusively by staff of the adult family home. R325.9 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 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 R311.6.3.1 through R311.6.3.3. R325.10 Stair Treads and Risers. Stair treads and risers shall be constructed in accordance with R311.7.4. 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 R311.7.7 through R311.7.7.4 [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 7/1/04.1 08101/10 • /✓ .-�0 / /! / NAME OF AFH: (/ �r'�(/U`- / ��C. T. Y 1C� 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 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 a 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 stars),or ramps constructed compliant with R325.9 are provided to evacuate residents to public area SLEEPING ROOMS . .. ....... Sleeping Room A [- 0._._Type_S_._...._I.-__0-_Type NSI-_..__ _.._._D.....Ty.pe NS2 _YES NO. .._.. Closet door/s are readily openable from the inside YES 0 {NO ❑ Smoke alarm is installed in the bedroom ❑ 1 0 Bedroom door is easily and quickly openable 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 R310.1.1: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 B I 0 Type S I 0 Type NS1 1 0 Type NS2 I YES I NO Closet door/s are readily openable from the inside YES 0 NO 0 Smoke alarm is installed in the bedroom 0 0 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 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 f ❑ ❑ Sleeping Room C 1 0 Type S 0 Type NS1 0 Type NS2 J YES NO Closet door/s are readily openable from the inside YES ❑ NO ❑ Smoke alarm is installed in the bedroom , 0 0 Bedroom door is easily and quickly openable 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 R310.1.1: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 1 0 1 0 Sleeping Room D 1 0 Type S 0 Type NS1 0 Type NS2 YES NO Closet door/s are readily openable from the inside 1 YES❑ NO ❑ Smoke alarm is installed in the bedroom 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-GRADE ESCAPE WINDOWS—MAY HAVE NET CLEAR OPENING 5 SF J Sleeping room window has a maximum sill height of 44"above floor; no steps under window permitted ( 0 { 0 Sleeping Room E 1_._0Type S___._..1_.._❑ Type NS1 j ❑ Type NS2__ YES NO _ Closet door/s are readily openable from the inside I YES❑ I NO ❑ I Smoke alarm is installed in the bedroom 1 0 I 0 Bedroom door is easily and quickly openable 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) 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 ❑ ❑ SleepingRoomF __-- __ J. ❑ .Type S L_❑ Type NS1 I ❑ 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 I ❑ I ❑ Sleeping room window has a net opening of 5.7 SF* (minimum dimensions at least 24" high; at least 20"wide) 0 1 ❑ *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 1 0 j 0 GENERAL YES NO Bathroom doors are easily and quickly openable from the outside when locked 0 0 Smoke alarms are installed on all levels of the dwelling, in each resident sleeping room, outside each separate sleeping 0 0 area in the immediate vicinity of sleeping rooms(R3141_ Smoke alarms are installed in such a manner so that the fire warning may be audible in all parts of the dwelling upon 0 ❑ activation of a single device. Access road and water supply meet local fire jurisdictional requirements j 0 , 0 08/01/10 • • R311.8 Ramps Inside Ramp I NIA 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) ' 0 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 R311.8.3.1 —R311.8.3.3. 0 0 Outside Ramp N/A'' YES I NO R311.8.1 Maximum Slope one unit vertical in twelve units horizontal(8.3%slope).(Exception R311.8.1 Not allowed in AFH) I ❑ I 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 R311.8.3.1 —R311.8.3.3. ❑ 0 *Guards below are depicted vertically as an example only. All Ramps must have Guards Less than 4" �� Handrail both sides 34"-38" I ! I Guard I I i I f : < 36"min 1 i i i i 11IiI I j 3'x asrwrirrrwr��iw�l irr��r ;pwrr �rrar R i € 3 x 3'main 3'min ng o landing 1:12 max + IIIIIMINMMioI 3' 8.3% min '< min > ADULT FAMLY HOME RAMP per 2009 IRO with WA. ST. AMENDMENTS *ALL RAMPS REQUIRE A BUILDING PERMIT* R311.2 Means of Egress 1 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. I ❑ ❑ R325.4 Operable parts of door handles,pulls,latches,locks and other devices installed in AFH shall be operable with one handl and shall not require tight grasping,pinching or twisting of the wrist(lever-type,emergency egress hardware). The Exit doors E ❑ ❑ shall have no additional locking devices. R311.7 Stairways NSA YES NO R311.7.4.1 Riser Height Max riser height shall be 73/,inches (8 inches in structures built prior to July 1,2004) j 0 0 R311.7.4.2 Tread Depth: Min.tread depth shall be 10 inches. (9 inches in structures built prior to July 1,2004) 0 0 8325.10.1 Handrails for Treads and Risers shaii be installed on both sides of treads and risers numbering from one riser to ❑ ❑ multiple risers.Handrails shall be installed in accordance with R311.7.7.1—R311.7.7.4 R 325.8 Grab Bars in Bathrooms(May require"alternate"approval in accordance with IRC Sec.R104.10 and.11) YES NO R325.8 Grab bars shall be installed for all water closets(toilets),bathtubs and showers. Bathing facilities such as tubs and showers; and I 0 0 On both sides of the toilet. (shall comply with ICC/ANSI A117.1 Sections 604.5,607.4&608.3) 0 0 AG103—AG 105 Swimming Pool,Spa,Hot Tub NIA YES NO AG105.2 Must be surrounded by a barrier that is 48 inches high, may have doors and or gates that must have audible 0 0 alarms when opened. AG105.5 EXCEPTION:Pools,Spas or hot tubs with a safety cover which complies with ASTM F 1346 . 0 0 ❑ PASSED 0 CORRECTIONS REQUIRED 0 PERMIT REQUIRED INSPECTOR'S SIGNATURE: DATE: INSPECTOR'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 /-11tZ 1. 2m, 2ii— f2 rt: 4 oftwe Rin - cirsie fir. oldisvbx. 3 $q,''� - 1's tke: -7/1 .--fQ 9 A metil9v-1/1 fir LTJF y !""4".7(57`;#;---F J ,S'TAfr r ilassifi7 fil acc ,qa 171— .r.- L4 . JP a �,-- a a Q 4 ' - . ,,/./i,c,;(/, A/P1 ,c'D&IDA',A # 2412,400.4r2 ...„..z. ,..._. 0 iera A 1 fir i i`,1. ds! r 7/ D , '1E1 I/ 133 C.) C-Alig ci a llilq li‘14 f0SMOKE ALARM Es FIRE EXTINGUISHER Imil LOCATtOM SYI�OL OMI.Y . TSP ACM1414-YOCCUPOSO -Y fir; EXTERIOR - - ENTRANCE-EXIT` INTERIOR • • A Rams Okla= -NIA(X!YES NO ,11.8.1 Maximum Slope one wit vertical in twelve units horizontal(8.3%slope).(Excel an R311.8.1 Nd alvwed in AFH) 1 2r 0 311.8.2 Landing Requbemea min.3X3 foot leading at taplboiorn,wtiem doors open ordo ramps,and where ramp t o flanges cions. � 325.9.1 Handrai required on both of ramp ii accordance with 8311.83.1—8311.8.3.3. dewairkor MI - NO . irR 311.8.1 Maourat>wi Slope one unit vertical in twelve ands hoiismdel(8.3%dope). 8311.8.1 Nat mowed los AFH) .r 0 311.8.2 Landing Requirements:min.3X3 foot tending at tophollom,lettere doors open onto tamps,and where rowan 1 gr 0 lenges dreams. 325.8.1 Handrails required an both sides of ramp in accordance will R311.&3.1—R311.&33 6 - it- *Guards below are depicted verbosity as an astern*oink. _ aealet z 45 Less than P litandraff both sides A.111.113t®-38' -.111111.2111 t i t t a!�if tii t( ap jiiiiitnhi!iiii i j 1 1 will - o I n 1 f. . - i - 3 3'x3`ela&f yy IIIIIIIIIIIIIIIIIIIMMIS�1f.r.r,f.•f 4 3 x 3� yi' a mfr lancruc 83% "tel ADULT FAMLY HOME RAMP per 2009 IRC with WA. ST. AMENDMENTS *ALL RAMPS REQUIRE A BUILDING PERMIT* 83112 Mearns of tones YES NO MU 8311.2 Door mud be sidetinged wih min.width of 32 inches bdwaen face of dowsed stop.Height not lees than 78 inches. > , 0 X25.4 Operable parts of door bwuies,pais,Itches,kodcs and other devices installed in AFH ahad ba operable alb one hand and shall actreguire fight grog,pinching arinsfing attire waist fever-type,emergency egress hardware). The Exit doors 521f g' 1141-fi4 did harem adtiiond locking devices, 276;1 Maliglaman Wfkl, YES NO 1311.7.4.1 Wiser Height Meat riser height Owl be - ' .- -- (8 inches in atnawues bu&pdorf°Jaiy 1,2004) 0 , 0 1311.7.4.2 Treed Dank lln.teed depth shell be 10 inches. (9 indictsin aiueiaaes bIRpior to Atter 1,2004) 0 0 132510.1 Handrails for Treads and Riess shall be installed an both sidesafiea is and deers auib ningions one userio 1 anopia deem.Handreis alai be Welled in accordance with 8311.7.7.1-83117.7.4 r.. C . . - ' r - �., �• _:._?11L'_:L- t.. 'J lot_-L- .__.dL'-- _'.!L,-i _•_MU.'_-:��' ..,_ � R11 10 _12 YES NO t1125.1 Gab bars shall be instated kr at water closets(tctets),bathtubs and shams. Weiiag facifes such as tubs and showier,",and . RC siEr in both sides of the toast(shall comply with ICC/ANSI Al 17.1 Sedans 604.5,607.4&608.31 4 Ex Z I5 1103—AG 105 S1ai rw Plod.9 a..h otTab MWA NO 6105.2 laud be surrounded by a barrier that is 48 inches Mali.may have doors and or gapes that mud have amide ❑ Q hong when opened. iG 05.5 IDCCEPT1Oft Pools,Spas or hot turas*Oh a eddy cover which , . . with ASTM F 1346 0 0 PASA ■ OORREG't"IONS ' .` 0 PERMIT REQUIRED / - / Z.Z.`I? /'�-- I . •' -. i , DATE �J 1• df` is 1 L5s/- � �3 r i .IS ADDRESS: `� MOM Application and Inspection Checklist developed by Washington Association of Building Officials(WABO), in cooperation with Department of Social and Health Services(DS )for use by both departments and 'censor REVIVED e�r~oF ��► PERMIT APPLICATION Federal Way APR 3 0 2013 CITY OF FEDERAL WAY CDS PERMIT NUMBER _ / _ TARGET DATE SITE ADDRESS --� _ SUITE/UNIT# PROJECT VALUATIONL ZONING ASSESSOR'S TAX/PARCEL# sow �_ E ( s� - 0 TYPE OF PERMIT Lb.$UILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT ( re PIy PROJECT DESCRIPTION Q� Detailed description of work to �� L �-moi / C be included on this permit only NAME PRIMARY PHONE (J y PROPERTY OWNER J ��G X 6 V1. Jf ( c,/�l(� ZOl<J3t'}� 1 ! MAILING ADDRESS �JJ th1 E-MAIL 1+ -6 ( S W. 3i3 s-� CITY ecia&Ln / STATE ZIP NAME N•. �VAV//,'11 PHONE MAILING ADDRESS E-MAIL CONTRACTOR CITY ! STATE ZIP FAX WA STAT NTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# NAME PRIMARY PHONE S kart N l-rzs 1s34'fr E APPLICANT MAILING ADDRESS E-MAIL 144 G I s W I s-� sh&v.`I8z3J3 11wt I ,C©m, CITY �[����, `�V STATE S" ZIP I U o�^-. FAX NAME PRIMARY PHONE ��/PROJECT CONTACT r�(�l;Y� I-{"Z-J T S',341111 ''(I'j MAILING ADDRESS E-MAIL (The individual to receive and respond to all correspondence concerning this application) CITY STATE /zIP FAX NAME PROJECT FINANCING El OWNER-FINANCED Required value of$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 Iaws regulating construction or environmental Iaws. 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: 4 / (( / DATE �/30/2C 3o/2C/3 PRINT NAME: S k tit/i. H •Bulletin#100—January 1,2013 Page 1 of 3 k:AHandouts\Permit Application • • VALUE OF MECHANICAL WORK MECHANICAL PERMIT Indicate how many 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(Gas) COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES VALUE OF PLUMBING WORK PLUMBING PERMIT Indicate how many of each type 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 BR AKERS DRINKING FOUNTAINS SINKS(Kitchen/utility) WATER H TERS(EIectric) HOSE BIBBS SUMPS WASHIN 'MACHINES TOTAL FIXTURES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEY.' SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS EXISTING/PREVIOUS USE LOT SIZE(In Square F- t) EXISTING F SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? es❑ No ❑Yes ❑ No RESIDENTIAL — NEW OR ADDITION AREA DESCRIPTION(in square feet) EXISTING P' s POSED TOTAL FOR OFFICE USE ASEMEN1' FIRST FLOOR(or Mobile Home) SSC©ItiI1FLOflR tea: COVERED ENTRY �--_ — -- — — — r � GARAGE ❑ CARPORT ❑ OILIER(describe) 14)„ EXISTING PROPOSED • AL Area Totals ESTIMATED SELLING PRICE$ #OF BEDROOMS COMMERCIAL—NEW/e )DITION AREA DESCRIPTION Area Occupancy Group(s) Construct •n #of Square Feet P y Type Stories Additional Information �.. ... ADDITION COMMERCIAL—REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area Occupancy Group(s) Construction #of in Square Feet P y � ) Type Stories Additional Information TOTA BUILDIL�iG TENANT AREA ONLY `PROJECT AREA ONLY Bulletin#100—January 1,2013 Page 2 of 3 k:\Handouts\Permit Application