19-102238 J f Y
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Building - Single Family
CommCityunity � Permit #:19-102238-00-SF
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: A BEST CHOICE CARE LLC
Project Address: 30621 4TH PL S Parcel Number:241330 0800
Project Description: ALT-Verification of Occupancy for Adult Family Home.***No construction work allowed
under this permit.***
Owner Applicant Contractor Lender
SULTANU CHECKOLE SULTANU CHECKOLE
30621 4TH PLS 30621 4TH PL 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
Mechanical to be Included? No Is this an Online or O.T.C.application9 Yes
Plumbing to be Included9 No
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PERMIT EXPIRES Monday,4 November,2019
Permit Issued on Wednesday.,May 8,2019
I hereby certify that the above information is correct and that the construction on the above described property
and the occupanc the use will be in accordance ith the laws, rules and regulations of the State of
for shington and the ' of Federal Way.
Owner or agent: t� C' Date: 0.5--
tfl*'
• Adult Family Home (AFH) LOCAL BUILDING INSPECTION CHECKLIST ,
• . Code References:2015 IRC Section R325(WAC 51-51) -7
APPLICATION NUMBER: 19- 10`2 s S
SECTIONS 1. 2. 3. AND 4 MUST BE COMPLETED BY APPLICANT BEFORE INSPECTION WILL BE PROCESSED
SECTION 1 - PROPERTY INFORMATION
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SITE ADDRESS: 3O Cc 1I p4S Kc / ASSESSO X/PARCEL# Ni/ 3_0_T_gpc,03
SECTION 2-APPLICANT INFORMATION
PROPERTY OWNER NAME: A`PGY ick ,t5te5) iUAftU G G,2 DAYTIME PHONE: 9199
AFH LICENSEE NAME(IF DIFFERENT): DAYTIME PHONE:, •.0 r:11
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 accuracy of the information suppliecr to the jurisdiction as a part of this application.
NAME/TITLE• iec._CL_ - -SI DATE: 6
,PROPERTY OWNER ['APPLICANT ['LICENSEE
(Effective July 1, 2013.)
Effective:2013 July 01
Updated:2017 February
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NAME OF AFH: _
SECTIONS MUSTBE COMPLETED BYTHE BUILDING DEPARTMENT INTHEJURISDICTIONTHE 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
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 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 compliantywwth R325.9 are provided to evacuate residents to public area.
SLEEPING ROOM A D Type S &Type NS1 0 Type NS2 YES NO
Closetdoor/s are readily openable from the inside JYes DNo Smoke alarm is installed in the bedroom 451 0
Bedroom door opens easily and quickly from the outside when locked Al0
Sleeping room window has a net opening of 5.7 SF(minimum dimensions at least 24"high;atl east 20"wide) A
EXCEPT per R310.2.1:at-grade escape windows—may have net clearance opening 5 SF
Sleeping room window has a maximum sill height of 44"a bove fl oor to clear openi g;no steps under window allowec •I 0
SLEEPING ROOM B 0 Type S Type NS1 0 Type NS2 YES NO
Closetdoor/s are readily openable from the inside I'Yes bNo Smoke alarm is installed in the bedroom „Er 0
Bedroom door opens easily and quickly from the outside when locked ••r 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 R310.2.1:at-grade escape windows—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 allowecAl. 0
SLEEPING ROOM C 0 Type S -Type NS1 0 Type NS2 YES NO
Closetdoor/s are readily openable from the inside jYes ti No Smoke al arm is installed in the bedroom rf, 0
Bedroom door opens easily and quickly from the outside when locked Al-
Sleeping 0
room window has a net opening of 5.7 SF(minimum dimensions atleast 24"high;at least 20"wide) 0
EXCEPT per R310.2.1:at-grade escape windows—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 allowec ' 0
SLEEPING ROOM D 0 Type S 1121Type NS1 0 Type NS2 YES NO
Closetdoor/s are readily openable from the inside Yes 0No Smoke alarm is installed in the bedroom -0 0
Bedroom door opens easily and quickly from the outside when locked 49 0
Sleeping room window has a net opening of 5.7 SF(minimum dimensions at least 24"high;at least 20"wide) .1.
EXCEPT per R310.2.1:at-grade escape windows—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.) 0
SLEEPING ROOM E 0 Type S 0 Type NS1 0 Type NS2 YES NO
Closetdoor/sarereadil openablefromtheinside 10 Yes • • Smoke alarm' '• . , in the bedroom 0 0
Bedroom door opens ea ily and • yfrom heoutsi•= en locked 0 0
Sleeping room window as. - opening of•.7S inimum dimensions at least 24"high;at least 20"wide) 0 0
EXCEPT per R310.2.1:at-grade escape windows—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 allowec 0 0
SLEEPING ROOM F �0 Type S 0 Type NS1 0 Type NS2 YES NO
Closetdoor/s are readilyo'enabl- omthein 'se I II Yes No Smoke alarm is installed in the bedroom 0 0
Bedroom door opens eas' a•• qui klyfr• theou •idewhenlock-• 0 0
Sleeping room window anet oses' gof5.7SF( i I • •lmensionsatleast 24"high;atleast 20"wide) 0 0
EXCEPT per R310.2.1:at-grade escape windows—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 0 0
Effective:2013 July 01
Updated:2017 February
" GENERAL, YES NO
Bathroom doors are easily and quickly openable from the outs ide when locked 0
Carbon Monoxide alarms a reinstalled as required i n R315 on each level of the home. 0
s
Smoke alarms a re i nstalled on all levels of the dwelling,in each resident sleeping room,outside each separate
sleepingareaintheimmediatevicinityofsleepingrooms(R314). 0
Smoke and Carbon Monoxide alarms are installed i nsuch a manner sothat the a udiblewa rning may be heard in all 0
parts of the dwelling upon activation of a single device. iM
Access road a nd water supply meet I ocal fi re jurisdictional requirements. A-- 0
R325.4 Operable parts of door handles,pulls,latches,locks and other devices installed in AFH shall be operable with one hand yy��,��
and shall not require tight grasping,pinching or twisting ofthe wrist(lever-type). CI. 0
Pocket doors shall have graspable hardware available when in the closed or open position. LL 0 0
8311.8 RampsYES NO
Inside Ramp NIA Agg 0 0
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 attop/bottom,where doors open onto ramps,and where ramp changes
directions. 0 0
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 D I 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
R311.8.2 Landing Requirements:min.3X3 foot landing attop/bottom,where doors open onto ramps,and where rampchanges j3 0
directions.
R325.9.1 Handrails required on both sides of ramp in accordance with R311.8.3.1—R311.8.3.3. .,12 0
Guards below are depicted vertically as an example only.All Ramps must have Guards ,® 0
Handrail both sides
—I I-- Less than 4" 34"-38"
Guard
36"min 1 i
1 i 11 1 1 I
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3 3'min
1.1
_ landing
1 u 1 --
3'x3'miny,:
landing ♦ ,
3' -- One unit vertical in twelve units horizontal 3' _
minimum is an 8.3%slope all along surface of the ramp. minimum
R311.2 Means of Egress 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. tt 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). 21 0
R325.4 Required exit door hardware shall unlock inside and outside mechanisms whenexitingthebuildingallowingre-entry a 0
without use of key,tool or special knowledge.
R311.7 Stairways N/AJiU YES NO
R311.7.5.1 Riser Height:Max riser height shall be 7 Y.inches(8 inches in structures built prior to July 1,2004) �] e
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 oftreadsand risers numbering from one riser to multiple a 0
risers.Handrails shall be installed in accordance with R311.7.8.1—R311.7.8.4
Effective:2013 July 01
Updated:2017 February
1
• R315.8 Grab Bars In Bathrooms NIA 0 YES ,. N O
Grab bars shall be installed for all water closets(toilets),bathtubs and showers according to R325.8. 0
Water Closets(toilet)shall have grab bars installed on both sides according to R325.8—R325.8.3.1 or R325.8.3.2. Q
Bathtubs shall have two vertical and three horizontal grab bars installed according to R325.8-R325.8.4—R325.8.4.2 0
Shower stalls have two vertica I and horizontal grab bars mounted on all sides of shower according to R325.8—R325.8.5— 1:1
R325.8.5.2.
Shower stalls must be minimum size of30 inches deep by 48 inches Ion (R325.11) et 0
AG103—AG105Swimming Pool,Spa, Hot Tub4 YES NO
AF10S.2 Must be surrounded by a barrier that is 48 inches high,m y a4e,Hoors and or gates that must have audible alarms when
opened.
AG105.5 EXCEPTION: Pools,Spas or Hot Tubs with a safety cover which complies with ASTM F 1346 0 0
PASSED ['CORRECTIONS REQUIRED 0 PERMIT REQUIRED
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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. 07/01/2013
Effective:2013 July 01
Updated:2017 February
It. RECEIVED
CITY OF �/. MAY 0 8 2019
PERMIT APPLICATION
Federal Way CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT
PERMIT NUMBER I 9 V_ I 2 — 3 7S _ I`
S
— — TARGET DATE
SITE ADDRESS SUITE/UNIT#
l
3 O 6.Q l z,_ �t, 5 c— r-e r c.( Cc_t c ccs ).4- 9-8a23
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 2— g t 5 3 a _ 0 g 0 0
TYPE OF PERMIT L7 BUILDING ❑ PLUMBING 0 MECHANICAL 0 DEMOLITION ❑ ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT S G lies/r e_ 64 1-e.. u.C
PROJECT DESCRIPTION r
Detailed description of work to i) ti �1- Ln..., (1 SY2._J)Z_,
be included on this permit only
"
NAME .4PRIMARY PHONE
PROPERTY OWNER 0 killQ.ch,_s?-e ) f- �2,1 Alli 11,‘ C,`tQG fee G2 90 Og/ 3 6c{O
MAILING ADDRESS E-MAIL
30 6a ( 411LPA .5 Cu►ec I� c , ;5
CITY STATE ZIP
f C4/ k---e(
k---e(1 (t c / jai} 4::, 06 3
NAME PHONE
MAILING ADDRESS E-MAIL
CONTRACTOR
CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
_ _ / _ _�
—
NAME a PRIMARY PHONE -- - --
/.-e,t G r h P-e-S/
APPLICANT MAILI G ADDRESS E-MAIL
CITY STATE ZIP FAX
AME 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 0 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 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: z/'i''z DATE 0 L)I/ /l//
PRINT NAME: "i-,/ /f/2,1,-- 4 r
Bulletin#100—February 22,2016 Page 1 of 2 k:\liandouts\Permit Application