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18-101679City of Federal Way Community Development Dept. 33325 8th Ave S Federal Way, WA 98003 Ph: (253) 835-2607 Fax: (253) 835-2609 Project Name: ST BAKHITA ADULT FAMILY HOME Project Address: 30654 11TH AVE S Building - Single Family Permit #:18 -101679 -00 -SF Inspection Request Line: (253) 835-3050 Parcel Number: 091900 0160 Project Description: ALT - Verification of Occupancy for Adult Family Home. ***No construction work allowed under this permit.*** Owner Applicant Contractor Lender ST BAKHITA ADULT FAMILY ST BAKHITA ADULT FAMILY HOME LLC HOME LLC 30654 11TH AVE S 30654 11TH 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 New / Additional Sq. Feet - 3rd Floor ..................... 0 New / Additional Sq. Feet - Basement ................... 0 Mechanical to be Included? ..................................... No Is this an Online or O.T.C. application?.................. Yes Plumbing to be Included? ........................................ No PERMIT EXPIRES Tuesday, 16 October, 2018 Permit Issued on Thursday, April 19, 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 ill be in accordance with the laws, rules and regulations of the State of shington and the City of Federal Way. Owner or agent: Date: a 3J'0%V r-,(, �-J uw wW Adult Family Home (AFH) LOCAL B ' DAG INSPECTION CHECKLIST Code References: 2015 IRC Section R325 (WAC 51-51) APPLICA110N NUMBER: ©I V7 RECEIVED 0411,700 0/6,0 SITEADDRESS: SD6a— - I I'D'{ PUCE- 3 fi�L VJA—A SSESSOR'STAR/PARCEL#:_______-___ PROPERTY OWNER NAME: � - U1 I`I 'RANT) kJVESIiMENA LL -C- DAYTIMEPHONE: AFH LICENSEE NAME (iFotFFERErrr): n NwA ` 1"C n(W DAYTIME PHONE: SECTION 3 — FLOOR PLAN On a separate sheet of paper (8 1/2x 11) draw a floor plan (including all floors) of your prospective AFH. Include all sleeping rooms (bedrooms) indicating which Bedroom is: A, BFC 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 accu//r��acy�� s�of the information supplied to the jurisdiction as a partofthis application. i NAME/TITLE:��C [li �� IG �f `-�VIC�1� DATE: 1 W LlQ� Q PROPERTY OWNER (Effective July 1, 2013.) ,APPLICANT LICENSEE Effective: 2013 July 01 Updated: 2017 February NAME OF AFH: _ SECT] ON5Mi&BE COMPLERDBYTHEBUILDING DEPARTMENT IN THE JURI SDI CTI ON 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 CD E AND F AND CLASSIFICATION CODE S, NS1 OR NS2. SECTION 5 — BUILDING INSPECTOR'S INSPECTION CHECKLIST R32S.3 Sleeping Room Classification: 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. pe NS2 — where 2 means of egress at grade level (both have no stairs) or ramps constructed compliant with Kjz!).`v are proviaea to evacuate resiaenis to ii.IEIING i�M A' '....',< . :', Type S pe NS1 0 Type NS2 Yl ruxw Closetdoor/s are readily openablefromthe inside s -Yes JE3No I Smoke alarm is installed in the bedroom ❑ Bedroom door opens easily and quicklyfrom the outside when locked 13 Sleeping roomwi ndow has a net opening of 5.7SF (minimum dimensions at least 24"high; at least 20" wide) 0 EXCEPT per R310.2.1: at -grade escape wi ndows —may have net clearance opening 5 SF Sl eepi ng room window has a maximums ill height of 44"abovefl oor to clear opening; no steps under window a llowec 13 SLC -GING Rt M . . ,... TYpe S Type NS1 Type NS2 YES NO Closetdoor/s are readily openablefromthe inside LW.Yes, JE314,ol Smokealarm is installed in the bedroom E Bedroom door opens easily and quickly from the outside when I ocked Q Sleeping room window has a net opening of 5.7SF (minimum dimensions at least 24"high; at least 20" wi de) 13 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!'a bove fl oor to clear opening; no steps under window a llowe 5*G I -: Type S Type NS1 Type NS2 YES • -NQ ` ,. . . Closetdoor/s are readily openablefromthe inside IRYes ❑No Smoke alarm is installed in the bedroom Bedroom door opens easily and quickly from the outside when locked 0 Sleeping roomwindowhas a net opening of 5.7SF (minimum dimensions at least 24"high; atleast20"wide) EXCEPT per R310.2.1: at -grade escape wi ndows —may have net clearance opening 5 SF sleeping roomwi ndow has a maximum sill height of 44" a bove fl oor to clear opening; no steps under window allowec 13 C CP R©'I Type S Type NS1 Type NS2 Y NO ., Closetdoor/s are readily openablefromthe inside 1MVes JE3 No'' Smokealarm is installed in the bedroom Z 13 Bedroom door opens easily and quicklyfrom the outside when locked 13 0 SI eepi ng room window has a net opening of 5.7 SF (minimum dimensions at I east 24"high; at least 20" wide) 13 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"a bove fl oor to clear opening; no steps under window a Ilowe LEiNFid " rr s� Type S Type NS1 Type NS2 ........... YES, _ _............. NO Closetdoor/s are readily openablefromthe inside 1W.Yes:,1-1E3No Smokealarm is installed in the bedroom Bedroom door opens easily and quickly from the outside when I ocked 10 Q Sleeping roomwi ndow has a net opening of 5.7SF (minimum dimensions at least 24"high; at least 20"wide) Q EXCEPT per R310.2.1: at -grade escape wi ndows —may have net clearance opening 5 SF Sleeping roomwindow has a maximum sill height of 44"abovefloor to clear opening; no steps under window allowed.AP SLEEPING R F _ Type S Type NS1 Type NS2 YES NO Closetdoor/s are readily openablefromthe inside A Yes 10 No I Smoke alarm is installed in the bedroom Bedroom door opens easily and quicklyfrom the outside when locked 13 Sleeping room window has enet opening of 5.7 SF (minimum dimensions at least 24"high; at least 20" wide) 13 EXCEPT per R310.2.1: at -grade escape wi ndows—may have net clearance opening 5 SF Sl eepi ng room window has a maximums ill height of 44" a bovefl oor to clear opening; no steps under window a llowegQ Effective: 2013 July 01 Updated: 2017 February Bath roorndoorsa,reeasily and quicklyopenablefromtheoutside when locked LJ Carbon Monoxide alarms a re i nstalled as required i n R315 on each level of the home. E3Smoke alarms are i nstalled on a II levels of the dwell ing, in each resident sleeping room, outside each separate 13 sleeping area in the immediate vicinity of sleeping rooms (11314). Smoke and Ca rbon Monoxide a larms are installed in such a manner sothatthe audiblewarning may be hea rd ina 11 J parts of the dwelling upon activation of single device. Access road a nd water supply meet I ocalfi rej urisdictional requirements. 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 of the wrist (lever -type). E3 Pocket doors shall have graspable hardware available when in the closed or open position. R311.8.1 Maximum Slope one unit vertical in twelve units horizontal (8.3%slope). (Exception R311.8.1 Not allowed in AFH) R311.8.2 Landing Requirements: min. 3X3 foot landing attop/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. Q Q R311.8.1 Maximum Slope one unit vertical in twelve units horizonta I (8.3%slope). (Exception R311.8.1 Not allowed in AFH) 91 1 ❑ R311.8.2 Landing Requirements: min. 3X3 foot landing attop/bottom, where doorsopen onto ramps, and where rampchanges directions. R325.9.1 Handrails required on both sides of ramp in accordancewith R311.8.3.1—R311.8.3.3. V Guards below are depicted vertically as an example only. All Ramps must have Guards 11 113 Gi 36' minimum is an 8.3% slope all along surface of the ramp. minimum 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 Q 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, pinchingor twistingof the wrist (lever -type). JO E3 R325.4 Required exit door hardware shall unlock inside and outside mechanisms when exiting the building allowing re-entry Q without use of key, tool or special knowledge. R311.7.5.1 Riser Height: Max riser height shall be 7 % inches (8 inches in structures builtprior to July 1, 2004) R311.7.5.2 Tread Depth: Min. tread depth shall be in 10 inches (9 inches in structures builtpriorto July 1, 2004) ❑ R325.10.1 Handrails for Treads and Risers shall be installed on both sides of treads and risers numberingfrom one riser to m ultiple 1:1 0 risers. Handrailsshall be installed in accordance with R311.7.8.1—R311.7.8.4 Effective: 2013 July 01 Updated: 2017 February Effective: 2013 July 01 Updated: 2017 February RECEIVED 4 APR 19 AERMIT APPLICATION CITY OF Federal WayCOM UNTY mrDEV o MENT PERMIT NUMBER C_ / O (o 7 5 -5 F _ TARGET DATE SITE ADDRESS SUITE/UNIT # ?50 � r _ PROJECT VALUATION $ ZONING ASSESSOR'S TAX/PARCEL # (® 1 TYPE OF PERMIT,UILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ElFIRE PREVENTION NAME OF PROJECT PROJECT DESCRIPTION Detailed description of work to be included�on this permit only ; 1 I, �` 1 �� \ I-k>I !-Iv NAME NVA ► �-� ►� Nv s ^ c�C PRIMARY PHONE aoG PROPERTY OWNER MAILING ADDRESS E-MAIL CI�s I I v I `� IL-- STATE WA ZIP 018n8 NAME PHONE MAILING ADDRESS E-MAIL CONTRACTOR CITY STATE ZIP FAX WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE #' NAME,I PHONE � (c) 6) 44G9 C) 1 MAILING ADDRESS 3b 5 ITIf L- At WAJ E-MAIL gnGk-WaA 1 jooAV-jgl4M APPLICANT CITY� ^ /-T 8W ZIP FAX NAME PRIMARY PHONE PROJECT CONTACT MAILING ADDRESS / L j Loi A t3 Nn `r `� N "I E-MAIL (The individual to receive and respond to all correspondence cl� sEA ZIP� � FAx concerning this application) PROJECT FINANCING NAME ❑ OWNER -FINANCED When value is $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 cert(& that to the best of my knowledge, the information submitted in support of this permit application is true and correct. I cert(& 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 NA z: A- rJ A-�r"s ► ► W ' Li /J C� Bulletin # 100 - February 22, 2016 Page I of 2 k:\Handouts\Permit Application