20903 70TH AVE W (2)7 0 ih LJ
FIRE PREVENT16N
SNOHOMISH CO Serving Brier, Edmonds, and 12425 Meridian Ave S INSPECTION REPORT
Mountlake Terrace 0 EDMONDS
Everett, WA 98208 0 BRIER
DISTRFIRE Phone (425) 551-1200 0 MOUNTLAKE TERRACE
T www. FireDistrict.l. org Fax (425) 551-1272 0 UNINCORPORATED
FREQUENCY STATION & SHIFT
LOCATION:
.20903 70 th Avenue W 9802T All. -i 116 P
BUSINESS NAME: SCHEDULED
PHONE: DATE DUE 1'
Aurora House/Compass Health 4256723333 -1.01
MAILING LIFIR 0
ADDRESS: 452207
20903 70th Avenue W, Edmonds,
BUSINESS OWNER: HOME PHONE:
EMERGENCY-1: '11xx4hVw' & HOME PHONE: CURRENT __S
KEY ACCESS-2: A79 YEY' NO
;.:I CITY
HOME PHONE:
EMAIL:, BUSINESS
LICENSE
PERSON CONTACTED: I L L INITI DATE
NAME OF INSPECTOR:
AJ
-7' -,z P_;�wl
FIRESYSTEMS: AS2/j6FA2/14RE,iQ/13 UL30012/15
0bMqD§§P8W?W&d3CATION OMMUNIC��S
2
2
3
3
4
4
5
-5
6
6
7
7
I AGREE TO CO RRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE-INSPECTIOK
2nd RE -INSPECTION
EXTENSION
FINAL RE-IN§PECTION
VIOLATIONS
DATE DUE:
DATE DUE:
GRANTEDTO:
DATE DUE:
CITED:
PERSON
PERSON
CONTACTED:
CON TED:
PERSON
CONTACTED:
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
VIOLATIONS,;-,
PRE -CITATION
CITATION ISSUED
1 5
1 5
LETTER SENT
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION,
5
RETURN RECEIPT
3
17
3
7
RECEIVED
6
DI SPOSITION:
.4
L8
4
8
7
LETTER NEEDED C] YES NO
LETTER NEEDED [] YES NO
8
Emerald Pire
fire Spfinkler Specialists
11021 Cramer Rd. KPN - Gig Harbor, WA 98329
Office (253) 857-2056 - Fax (253) 857-2312 - Local 699 Contractor
AUTOMATIC SPRINKLER SYSTEMS
(One System per Report) C 0;1 55
2,0
kA" Y—G,
a ss: A,�K4cupanpy� Err�ie-'\7'
occup9r4 Ad6 e AV?— W, ;t 40
Responsible Person: 'Ga'- )9,9
Phone Nbn)ber:-/3
Building Owner: Phone Number:
Date of Inspection: 4 Type of Inspection: Quarterly F-1 Annual Other
Testers Name (Please Print): �e_
(A K_t� WA State FSCC#
DRY SYSTEM/PRE-ACTION SYSTEM:
1 Tripjt�!t (dry trip or full flow) conducted: .................................................. Yes El No El
System i ed in. seconds.
2. All flow switches, ervisory switches and alarm bells tested: ..................... Yes No El N/A EJ
3. Alarm bell operates: .......... ............................ .... ... .. ....................... Yes No E] N/A
4. Flow tests conducted: .................... .................. ..... .... ....................... Yes No E]
Flow pressure: psi 2-in drain? ...... V ..... //. ........................... Yes No E]
5. Systems inspected and lubricated: .................. ...................................... Yes F-I No N/A
6. Air compressor refills system in 30 minutes: ................. ........................... Yes F] No
7. System drained and restored to normal operation: ..................................... Yes n Non
8. Were the heat actuation devices tested on pre -action and deluge system? ..... YesF1 NoEl N/A[]
CW:E::T�S�YSTE �ANTI�-FREEZ�ESYS�TEM: Tested at
1. Trip test conducted: ..................................... ................................ Yerf�N o
Static pressure: psi Flow pressure: 2 inch drain? ....... Yes E] NOE�—A/A R
2. Flow switches, supervisory switches and alarm bells tested: ..................... YesE_7— No 0 N/A F-1
3. Alarm bell operates: ............. I ............................................................... Yes4��No 0 N/A F-1
4. Systems inspected and lubricated: .......................................................... Yesl-[No f-I
5. Pressure regulating valves tested: ............................................................ Yes E] No Ej N/AN
..AUTOMATIC SPRINKLFR SYSTEM S'(contin ued)
General:
Central Station Monitoring? ...................... .................................................. Yeg�f-'No El
Monitoring company name
2. Location of Sprinklers
100% .......... Pa r k i n g ......... 0 Basement ......... El Hallways ......... 0 Other ........
3. Pumper connections and clapper valves unobstructed ....................................... Yes��No
4. Sprinkler heads less than 50 years old ............................................................. Yes��No
5. Sprinkler coverage is acceptable .................................................................... YeH!:rNo
6. Spare sprinkler heads are available ................................................................. Yes-EJ'No
7. Systems left in service .................................................................................. Ye5�.�— No
8. Valves are sealed or supervised ...................................................................... Yes�ff� No
9. Signs are provided on valves ......................................................................... YeseE�O D
10. City static water pressure —YL—psi.
Problems Found:
Corrections Made: Date Corrected:
Corrected By:
SIGNATURE OF TESTER:
AGENCY: Emerald Fire
PHONE: 253-857-20-56
MAILING ADDRESS: 11021 Cramer Road KPN, Gig Harbor WA 98329
TI
cimrAs.
HOME OF THE VALUE INSPECTION PROGRAM
WA Contractor CINTAFP904DJ/Electrical CINTAFP9=K
INDUSTRIAL * COMMERCIAL * BONDED * INSURED
. ph: 253.852.1962 fax 253.852.1962
3320 West Valley Hwy N, D1 11 * Auburn WA 98001
CUSTOMER
Name 14 U lezt-i dez--f T--
Address ao7e)3 76�t�-i F,
City d-5�
�., -74 3-V$
Telephone- Store
Owner or Manager
Alarmed: 21es C3 No Monitoring Co.
Signal Rec'd: IkYes C3 No Phone III
Restoral Rec'd: CPYes C3 No Time
Operator cct #_
Cookinq ADDliance Locations: Left to Ric3ht
Ivip]
IgMEM
Ask abC
ThiS has
made =e the perfect service to our custorners.
RANGE HOOD FIRE SYSTEM
INSPECTION & SERVICE,
REPORT
DATE/F SE
P/ 9 71P 1
TIME
cf� _V
AM
I k_%_1
PM
ANNUAL
I SEMI-ANN�Vl_
IRECHARGE
I INSTALLATION
RENOVATION
LOCATION OF SYSTEM CYLINDERS
MJUFACTURER
IMODELNUMBER.
WETCHEM
UL 300
DRY CHEM
CYLINDER SIZE MASTER
CYLINDER SIZE SLAVE
CYLINDER SIZE SLAVE
y (,- r, t
I
I
FUSE LINKS 360
FUSE LINKS 450 F
:3
FUSE LINKS 500 F
OTHER
FUEL SHUT-OFF
ELECTRIC
GAS
SIZE
SERIAL NUMBER
LAST HYDRO TEST DATE
LAST RECHARGE DATE
Grease Accumulation
Clean Moderate Heavy Excessive
Plenum V
Duct Z
Filters V
Date Last Cleaned :5./ /h
Cleaning Cycle Recommended
,Cleaning ompany /f?_VX Phone #_
Conditions Found on Arrival
Yes No N/A
.1
I . Date Last Servic
2. Tamper Seals Intact .................................................
3. Any Filters Missing or Broken? .................................
4. Filters Conform to NFPA 96 or Hood Type ................
5. Remote/Manual Pull Obstructed ...............................
6. System Discharged ..................................................
7. Pressure Gauge in Proper Range ........... ' ............
8. New Appl/Appl Moved Since Last Service ................ .
9. All Appl Properly Covered w/Correct Nozzle ............. -V-
10. Hood & Duct Penetrations Properly Sealed .............. --;,7-
11. Distribution Piping Secured & Unobstructed ............. .
12. Detectors & Conduit/Cable Secured & nobstructed
13. Cylinder Hydrostatic Test Due Dntp �10 I V Y
14. Cylinder Six Year Maintenance IVIZ hr
15. Nozzle Seals Missing or Plugged? ...........................
16. Fryer/Salamander Flue to Filter 18" Min? NFPA 96 ...
17. Charbroiler Clearance Flame to Filter (3.5' IMC) .......
18 Links Covered With Grease ......................................
CO MMENTS -.- W1 f Z
Service Perforrne�dz
19. Manual Pull Operation ............ ..................................
20. Operate System From Terminal Link ...........................
21. Check Operation of Micro-Switch(s) ...........................
22. Exhaust Fan in Operating Order/Continues to Operate.
23. Make Up Air Shuts Down .....................................
24. Check Oper. of Gas Value Mech-Elect I,/
25. All Appliances Shut Down - Gas & Elect .....................
26. Agent Checked, Powder or Liquid ..............................
27. Cartridge Weight Within 1/2 oz (if Appl) ......................
28. Clean Nozzles & Cover Seals in Place .......................
29. Gas Valve Reset -Relight Pilot Light(s) ........................
30.- Replace Fuse Links Mfg. Date "L'o 1G,
31. All Filters Replaced ....................................................
32. Reset System/Remove All Safety Devices ..................
33. System Ope rationa [/Cover & Seals in Place ...............
34. Exhaust Fan Warning Sign on Hood ...........................
35. Kitchen FEX Svc'd per NFPA 10. Type
36. Staff Instructed in Manual Oper. of System .................
37. Kitchen FEX Mounted Within 30 . ................................
38. System Installed According to Mfg. Spec ....................
39. Hood & All Appliances Protected ................................
40. Service Tag on System ...............................................
No N/A
The Service Technician on this Date Operated, Tested & Inspected this System in Accordance with Procedure of NFPA 17, 17A. 96 & the Manufacturers Manual.
Results/Conditions Listed Above.
SERVICE TECHNICIAN DATE TIME AM PM I CUSTOMER'S AUTHORIZED AGENT
i�/Jqd 10 1 1. ) I y - � I m i a 2016
Note: Fire Code requires a copy of this report to be mailed to Authority having Jurisdiction.
White Copy - Customer - Yellow Copy - Distributor - Pink Copy - Authority having Jurisdiction
CINM- a Seml-Annual
LW SYStem, Service Repor,
3320 West Valley Hvvy N, Suite D111, Auburn, WA 98001
Phone: 253-852-1962 Fax: 253-852-2049
9 Restaurant 12 Industrial
CUSTOMER
INSPECTION DATE
ADDRESS
CITY STATE ZJP
7022h 9) iA� 0 ANNUAL
CONTACT 0 SEMI-ANii(AL
TITLE PHONE N 1.
MONITORED __F_YES No MONITORED BY PHONE NO. ACC7. NO.
-BLDG. AUDIBLE Q( Y ES 0 NO I I
MANUFACTURER: MODEL COVERAGE HOOD ROILER WOK BURNER HOT
P I yp, TOP GRILL
C, C QUAnTY
FUSIBLE LINKS 165* 212, 290- 1 360- 1 450- 501, FIRE EXTINGUISHER ABC 8C FU EL 0 GAS
QUANTITY 1 3 GuAunTy SOURCE
YES— -No— NIA YES No N/A
1. Cylinder Pressure Gauge or 9. Automatic shutdown of Fuelt
weight is at acceptable Level Power operated properly
2. System is free of any p do r 10. Exhaust Fan operated properly
Discharge/Damage or Tampering
3. All piping and conduit is immobilized 11. All cooking surfaces properly
with proper hangers and brackets protected
12. Grease accumulation in hood and
4. All Nozzles are in proper position duct A110% X
5. All Nozzles are covered by 13. Hood has full bank of filters
blGWOff caps (J
6. Date Fusible Links last changed 14. Last date Pressurized Dry
Systems had Chemical Checked
7. System operated properly from 15. Date of last Hydrostdc, Test of
Terminal Link Cylinder
8. System operated properly from 16. Inspection Tag on System
Manual Actuators Cylinder and remote pull
INFORMED ABOUT ANY DISCREPANCIES OR NEEDED REPAIRS NONE YES
TECHNICLAN NOTES:
APPT. TIME
AM
PU
NT71HOORPOIZOED
TECHNICIAN LIC #
CUSTOMER'S AU AGrNT
----------
FIRE SUPPRESSION SYSTEM INSPECTION REPdR_T
FIRE DEPARTMENT COPY - WHITE FILE COPY - YELLOW CUSTOMER COPY - PINK
Emerald Tire
Fire SpfinkJer Specialists
11021 Cram ' er Rd. KPN - Gig HarborWA 98329
Office (253) 857-2056 - Fax (253) 857-2312 - Local 699 Contractor
AUTOMATIC SPRINKLER SYSTEMS
(One System per Report) co),hpo'.5's 4ect
20-Pc ju aq � A d 7r W - "ANP�- \1/; F�)"'n 0111 WA-ccupaAy11ajm.)CCA,
: 33 1-36 38
Responsible Person: C\ Phone NL%�)_
Building Owner: A7 Phone Number:
Date of Inspection: J )_5 Type of Inspection: Quarterly E] AnnuakTo' Other Fj
Testers Name (Please Print): WA State FSCC#
1. _1hptest (dry trip or full flow) conducted: .................................................. Yes Ej No 0
System 11,a ed in -seconds.
swit�2. All flow ches, ervisory switches and alarm bells tested: ..................... Yes E] No [] N/A E]
3. Alarm bell operates: ............ .................................... ja ...... r ...... ... I ........ Yes F1 Non N/A E]
4. Flow tests conducted: .................... ........................... . ..... .... . ........ Yes E] No E]
-in rain? ............ .. ... .... ... .. .... Yes E] No
Flow pressure: ps! 2� ..... V / —
5. Systems inspected and lubricated: .................... .................................... Yes F-1 No E] N/A El
6. Air compressor refills system in 30 minutes: ........... ....... ........................ Yes F No
7. System drained and restored to normal operation: ................... ........... Yes E] No []
8. Were the heat actuation devices tested on pre -action and deluge syste M No E) N/A Ej
(gWET SYST lVlh*NT+4RfiEZf-_W9f EM-Tested at
0
1 rip test conducted: ... ....................................................... YeW-
Static pressure: psi Flow pressure:. .................. rNo E�
6a-psi 2 inch drain? ....... YesE] NWj�/AR
2. Flow switches, supervisory switches and alarm bells tested: ..................... YejJ�_-- o[] N/AFj
3. Alarm bell operates: .............................................................................. Yeke!rNo [] N/A E]
4. Systems inspected and lubricated: ........................................................... YesE -No El
5. Pressure regulating valves tested: ........................................................... Yes[] No E] N/kl�_
y
Corrected By: Vkl- - f'o-cs
MEWIN
AUTOMATIC SPRINKLER SYSTEMS (continued)
General:
1 Central Station Monitoring? ........................................... .......... I.... Ye sO-'OON 0 El
Monitoring company name
2. Location olSprin lers
100%.... Parking ......... F Basement ......... E] Hallways ......... Other ........ r
3. Pumper connections and clapper valves unobstructed ....................................... YesA Non
4. Sprinkler heads less than 50 years old ............................................................. Yes RT No f-1
5. Sprinkler coverage is acceptable ................................................. I .................. Ye s/ Non
6. Spare sprinkler heads are available ................................................................. YesZ No F1
7. Systems left in service .................................................................................. Yes 7T No El
8. Valves are sealed or supervised ...................................................................... Yes X No f-1
9. Signs are provided on valves ......................................................................... Yeo No E]
10. City static water pressure psi.
Problems Found: 0 One, 9 ono�r o\� .5 v*-Av--C
10
Corrections Made: Date Corrected:,
vk'-�q— �� Y-Oeb
SIGNATURE OF TESTER:
AGENCY: Emerald Fire PHONE: 253-857-2056
MAILING ADDRESS: 11021 Cramer Road KPN, Gig Harbor, WA 98329
EA/E�RALDFiRE, LLc -
Fire SPrbWer Spedafts . ,
11021 Cranler Road KPN, Gig Harbor, Washington 98329
Ph (253) 857-2056 - Fax (253) 857-2312
SYSTEM CORRECTION REPORT
D ate )22L/1,5
System Type:
FPB File #
Alarm 4.-Sprinkler _jtan*ood _.Standpipe _FireEscape -_Other
awe of Facility: Contact Person:
1-0103 704b Phone: 33
Address: 31f
iA , i.
Have your service provider complete section below and return to this office wi&in 7 days of
CGUIDletion:
Date Corrections Made:
0/) 5
COMPanY Malcing Corrections: A- FM CU
COmPanY Contact Person:
Correcdons Made: P e
?-1Ctq—T6r M� -5
Phonefzs�s—x
—Zo 4v--
-eck,,v-- FTL �Uuowjk
T
-s
etying Briet; Edmonds, and 72425 Meridian Ave S.
sNoH6mlSH CO.
4�
W�Antlake Terrqce Everett, WA 98208
FIR
. __Z t Phone (425) 5j]-.1200-'
DISTh -T wwwFireDistri4.prg Fax (425) 551-1272
LOCATION:
21MB3 70 th A%enua %jV QSTM,
FIRE PREVENTION
INSPECTION REPORT
0 EDMONDS
0 BRIER
0 MOUNTLAKE TERRACE
[I UNINCORP6RATED
STATION & SHIFT
SCHEDULED
BUSINESS NAME: PHONE�
Aurara I lcluscJCampiass I Icall1l 425E7233;32 DATE DUE I Jun 2014
MAILING
LIFIR " 4-b2 207
ADDRESS:
Edmondti,
BUSINESS OWNER:
HOME PHONE:
"CURRENT
EMERGENCY-1:
HOME PHONE:
KEY ACCESS-2:
z
HOME PHONE:
YES NO
CITY rl?i
BUS,INESS Pki o
EMAIL:
LICENSE /Lie
PERSON CONTACTED:
INSPECTOR
INITIAL INSPECTION DATE
NAME OF
FIRE: SYS ILMS:
FE
1 UL
iv 711 I r
HAZARDS.FOUND AND LOCATIONS / COMMUNICATIONS, V
54-A_
PJD V
3
3
4
4
5
6 911., 4 4)
V
j,
6
77 ww
7
—7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1 st RE -INSPECTION
2nd RE -INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
DATE DUE:
DATE DUE:
GRANTEDTO:
DATE DUE:
CITED:
PERSON
PERSON
PERSON
CONTACTED:
CONTACTED:
CONTACTED:
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
D E:
DATE:
3
VIOLATIONS
VIOLATIONS,:
PRE -CITATION
CITATION ISSUED
1 5
5
LETTER SENT
NUMBER:
-4
CODE
5
2
6
2
6
DATE:
SECTION:
RETURN RECEIPT
6
3
7
3
7_7
RECEIVED
1
0,
, ,
DISPOSITION: f
4
18
4
18
DATE:
7
LETTER NEEDED [] YES NO
LETTER NEEDED [-] YES NO
FIRE DEPARTMItNt tOPY
Emerald Pire
Fire Sprinkler Specialists
11021 Cramer Rd. KPN - Gig HarborWA 98329
Office (253) 857-2056 - Fax (253) 857-2312 - Local 699 Contractor
AUTOMATIC SPRINKLER SYSTEMS
(Onp 5;vstem ner Renort)
I Ar-'�- 9,9L?f-5
occupancy Address: t4 Z.': q rn 2. z Q Occupancy Name:
Responsible Person:
Phone Number:
Building Owner: Phone Number:
Date of Inspection: Type of Inspection: Quarterly E] Annual S2r Other F�
Testers Name (Please Print): 50L ?_QC0!z'4 WA State FSCC# 0633-IT-0518(
1 0 1
DRY SYSTEM/PRE-ACTION SYSTEM:
1 Trip test (dry trip or full flow) conducted: .................................................. YesE] NoE]
System tripped in seconds.
2. All flow switches, supervisory switches nd alarm be tested: ...................... YesE] NoE] N/AF�
3.* Alarm bell operates: .............. .. ...... ............ .......................................... Yes [7 No r7 N/A 0
4. Flow tests conducted: .......... ...... . ......... ........................ .......... Yes R No E]
Flow pressure: psi 2-inch rai . ......... YesE, No E,
5. Systems inspected and lubricated: ..... ....... ........ ..................... Yes E] No [] N/A r-1
6. Air compressor refills system in 30 inutes: .............................................. Yes [] No F�
7. System drained and restored t ormal operation: ...................................... Yes E] No E]
8. Were the heat actuation d ices tested on pre -action and deluge system? ..... Yes E] No F-� N/A E]
WET SYSTEM/ANTI-FREEZE -SYSTEM: Tested at
I Trip test conducted: ..............................................................................
YesG�
Noo
Static pressure: '70 psi Flow pressure: , psi I inch drain? .......
YesV
NoF�
N/A E]
2. Flow switches, supervisory switches and alarm bells tested: .....................
Yes EZ
No[-]
N/A
3. Alarm bell operates: ..............................................................................
Yes
Noo
N/A 0
4. Systems inspected and lubricated: ..........................................................
Yes
Non
5. Pressure regulating valves tested: .................. * .........................................
Yes E]
No Ej
N/A E�
A_UTOMATIC SPRINKLER SYSTEMS (continued)
General:
I
Central Station Monitoring? ..........................................................................
Yes V
No[]
Monitoring company name
2.
Location of Sprinklers
100% ......... V Parking ......... Basement ......... Hallways ......... Other ........
E]
3.
Pumper connections and clapper valves unobstructed .......................................
yes1d
NoR
4.
Sprinkler heads less than 50 years old .............................................................
Yes [j�
No n
5.
Sprinkler coverage is acceptable ....................................................................
Yes [�f
NoR
6.
Spare sprinkler heads are available .................................................................
Yes [V
NoR
7.
Systems left in service ..................................................................................
Yes [�(
NoR
8.
Valves are sealed or supervised ......................................................................
Yes T(
NoR
9.
Signs are provided on valves .........................................................................
Yes IV
No E]
10.
City static water pressure '70 psi.
Problems Found:
Corrections Made: Date Corrected: Corrected By:
SIGNATURE OF TESTER:
AGENCY: Emerald Fire PHONE: 253-857-2056
MAILINGADDRESS: 11021 Cramer Road KPN, Gig Harbor, WA 98329
Range Hood Systems Report
Z =,Vj
A 1P I
LO
FIRE CONTROL
877-866-3473 Phone 1 877-841-9293 Fax
PO Box 11369
Olympia, WA 98508
CUSTOMER
Name
Address,�via,� --)O�-k Ay�:- w
4A
city C-1 mnjj.�-3 State Z I P
Telephone I-V9-5 - 6 -2'?�-W3�lStore No. 0
Owner or Manager
COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT
1. All appliances property covered w/correct nozzles X
2. Duct and plenum covered w/correct nozzles
3. Check positioning of all nozzles
4. System installed in accordance w/MFG LIL listing
5. HooWduct penetrations sealed w/weld or UL device
6. QhIeRkrii seals int4ct, evidence of tampering
7. lxj�s beepdipcharged, repprt'pame,
Yk
8.11 Preso6rdouge"In'pro eir range (if'6auge.d
9j Ch 'k dqrtirdpe weigN
QP 1(if.appligable)
10. Hydrostatic test date
11,;, 6 year maintenace date
12. Ihap-ect cylinder and mount
13. Operate. system from terminal liqk,.
14. Test for pr6per doerati61n' frdl� re�nbte-
15. Check operation of micro switch
16- Check operation of gas valve
X
17. Clean nozzles
18. Proper nozzle covers in place
19. Check fuse links and clean
COMMENTS:
DATE OF �ERVIC T 7
TIME
A.M.
P.M.
ANNUAL
am-ANNLAAL
REcHARrE
INSTALLATION
RENOVATION
LOCATION OF SYSTEM CYLINDERS
UL 300
qYES []NO
N!!!;�
MODFLNUMBER
WET
ORYCHEMICAL
jRER
�F�C
CYLINDER SIZETSTER
CYLINDER SIZE SLAVE
CYLINDER SIZE SLAVE
FUSE LINKS 360- F.
FUSE LINKS.450o F.
FVSEUNKS500�
OTHER
FUEL SKUTOFF
ELECTRIC
GAS
SIZE
K
X
',�( I
SERIALNUMBER
LAST HYDRO TEST DATE
LAST RECHARGE DATE
MANUFACTURER'S MANUAL PREFERENCE
PAGE NUMBER: DRAWING NUMBER: DATE
20. Replaced fuse links
21. Check travel of cable nuts/G-hooks
22. Piping & conduit securely bracketed
K
23. Proper separation between fryers & flame
24. Proper clearance - flame to filters
25. Exhaust fan in operating order
26. All filters in place
27. Fuel shut-off in on P' ition
'os
28. Manual & remote-ieVseals in place
29. Replace' systems covers
30. Sys�6d-76perational & seals in place
31.,SW-
6 system operational
A�I-A
-.1
392�,,,�(,-;Iean cylinder& mount
/33". Fan warning sign on hood
34. Personnel instructed in manual operation of system
35. Proper hand portable extinguishers
36. Portable extinguishers properly serviced
37. Service & Certification tag on system
X
NOTE DISCREPANICES OR DEFICIENCIES BELOW
On this date, this range hood fire suppression system was inspected and operatic' nafly test�*d-i'A'-�g-c-c-'o-'r'aa'nce with the fire
suppression systerq�requirements of NFPA1 7 or 17A, 96 and the manufacturer's manual, with the ated above.
jesu�s4hdic
X 4 Z.,(
"SERVICE 1ECHNicrAN PERMIT NO. DATE: TIME: AM PM Z_OUSTOMER'S AUTHORIZED AGENT
The above service technician certifies that the system was personally inspected and found conditions to be as indicated on this report.
I WHITE: CUSTOMER COPY - CANARY: DISTRIBUTOR /AUTHORITY HAVING JURISDICTION I I
.:....Range Hood Systems Report
F FiRr Irn
IRE CONTROL
877-866-3473 Phone / 877-841-9293 Fax
PO Box 11369
Olympia, WA 98508
CUSTOMER
NameAlmev'o-,
Address Q09
.City wenor[S_ State ZIP
Telephoneq2S-M-3333&ore No.61
or Manager
APPLIANCE LOCATIONS: LEFT TO RIGHT
I . Ali appliances property covered w/correct nozzles
2. Duct and plenum covered w/correct nozzles
3. Check positioning of all nozzles
4. System installed in accordance w/MFG UL listing
5. Hood/duct penetrations sealed w1weld or UL device
6. Check if seals intact, evidence of tampering
7. If system has been discharged, report same
8. Pressure gauge in proper range (if gauged)
9. Check cartirdge weight (if applicable)
10. Hydrostatic test d ' ate
11. 6 year maintenace.date
12. Inspect cylinder and�,mount
13. Operate system frorry terminal link
,14. Test for proper operation from remote
15. Check operation of micro switch
�'16. Check operation of gas valve
�A 7. Clean nozzles
18. Proper nozzle covers in place
19. Check fuse links and clean
COMMENTS: 5V5�ern rvorco �Oflcx,
DATE OF
//-3
1 � o 0
A.M.
P.
ANNUAL
SEMI-ANIUAL
I
I RECHARGE
INSTA�LLATION
RENOVATION
LOCATION OF SYSTEM CYLINDERS
UL300
EYES []NO
MANUFACTURER
MODELNUMBER
WET
DRY CHEMICAL
CYLINDER SIZE MASTER
CYLINDER SIZE SLAVE
CYLINDER SIZE SIAVE'
S�r, III,
o--. I
---
FUSE Lq�100- F.
FUSE LINKS 4W F,
FUSE LINKS 5ODD F.
OTHER
-z
FUELSHUTOFP
X
ELECTRIC
X -
13AS
SrLE
SERIAL NUMBER
LAST HYD RO TEST DATE
LAST RECHARGE DATE
MANUFACTUREWS MANUAL PREFERENCE
PAGE NUMBER: DRAWING NUMBER. DATE
20. Replaced fuse links
21. Check travel of cable nuts/G-hooks
Y
22. Piping & conduit securely bracketed
23. Proper separation between fryers & flame
24. Proper clearance - flame to filters
1�1
25. Exhaust fan in operating order
X
26. All filters in place
'A
27. Fuel shut-off in on position
_X
IL
28. Manual & remote set/seals in place
29. Replace systems covers
30. System operational & seals In place
31. Slave system operational
32, Clean cylinder& mount
33. Fan warning sign on hood
34. Personnel instructed in manual operation of system
35. Proper hand portable extinguishers
36. Portable extinguishers properly serviced
Awl
37. Service & Certification tag on system
NOTE DISCREPANICES OR DEFICIENCIES BELOW
On this date, this range hood fire suppression system was inspected and operationally tested in ac9gr4ance, with the fire
suppression system requirements of NFPA17 or 17A, 96 and the manufacturer's manu 1,-with he�suqs !Qtlicated above.
P . -t
x A
S�RVICE fEaf-INICIAN 'PERMIT NO. DATE: TIME: AM PM CUSTOMER'S AUTHORIZED AGENT
The above service technician certifies that the system was personally inspected and found conditions to be as indicated on this report.
WHITE: CUSTOMER COPY CANARY. DISTRIBUTOR /AUTHORITY HAVING JURISDICTION
7;
Range Hood Systems Report
A
FIRE CONTROL
877-866-3473 Phone 1 877-841-9293 Fax
PO Box 11369
Olympia, WA 98508
CUSTOMER
... NamekIA(d r
Address -70i6
city /A.Vylonctt State Wk ZIP 5�otl
Telephone
Owner or Manager
Store No.
COOKING APPLIANCE LOCATIONS. LEFTTORIGHT
DATEOFSERVICE
TIME
A.M.
KM.
"I
A
10
I
fINNUAL SEW NU&
-AN
I RECHARGE
INSTALLATION
RE1,10VATION
LOCATION OF SYSIEM CYLINDERS
UL 3W
1J, � S �,, " )�,
QYES []NO
MANUFAMRER
MODrLNUMnFR
WET
ORYCHEMICAL
wo 1
-30 01
>�
I
MNDrn sar MASTER
_�
CYLINDER SIZE SLAVE
CYLINDER SIZE SLAVE
C1 V. I
I
7USE Loj 360- F.
FUSE UNKS 01P F.
FUSE L64KS 500- r.
OTHER
FUELSHUTOFF
IIECTRIC
GAS
SIZE
- ;K
X
8FRI'AL NLRA13ER
LAST HYDRO Trw-T DA711
LAST RECHARGE 12ATE
I '� 0 10
T
MANUFACTU11EITS MANUAL PREFFJIENLF
PAGCNUMSCR: DRAVWNG NUMBER;
WE
il. All appliances property covered w/correct nozzles
%A
20. Replaced fuse links
Duct and plenum covered w/correct nozzles
%
21. Check travel of cable nuts7G-�hoqk!�
!3. Check positioning of all nozzles
'A
22. Piping & conduit securely bgicKpted
X
4. System installed in accordance w/MFG UL listing
23. Proper:sep�ak�tjon betw In fr��rs & flame
X
Hood/duct penetrations sealed w/weld or UL device
24. Proper cleiafaiihcd - flame to filters
Check if seals intact evidence of tampering
X
25. Exhaust fan in operating order
If system has been discharged, report same
26. All filters in place
8. Pressure gauge in proper range (if gauged)
27. Fuel shut-off in on position
9. Check cartirdge weight (if applicable)
28. Manual & remote set/seals in place
10. Hydrostatic test date
11. 6 date
29, Replace systems covers
X
year maintenace
30. System operational & seals in place
12. Inspect cylinder and mount
31. Slave systerin operatfonal
13. Operate system from terminal link
32. Clean cylinder & mount
14. Test for proper operation from remote
33. Fan warning sign on hood
15. Check operation of micro switch
24
34. Personnel instructed in manual operation of system
16. Check operation of gas valve
11(
36. Proper hand portable extinguishers
7. Clean nozzles
36. Portable extinguishers properly serviced
18. Proper nozzle covers in place
37. Service & Certification tag on system
il 9. Check fuse links and clean
NOTE DISCREPANICES OR DEFICIENCIES BELOW
iDOMMENTS:
On this date, this range hood fire suppression system was inspected and operationally tested in accordance with the fire
suppression systeM requirements of NFPA17 or 17A, 96 and the manufacturer's manual, pwth theiresults Wicated aWve.
X
W-30 X
SERVICE TECHNYLAN PERMIT NO. DATE: TIME: AM PM CU,9,T0M5K4.AUTHORIZj,4rAVNT
The above service tdchniGian certifies that the system was personally inspected and found conditions to -be as indicated nthisreport.
I WHITE -CUSTOMER COPY I CANARY- DISTRIBUTOR I PINK -AUTHORITY HAVING JURISDICTION
Range Hood Systems Report
A
FIRE CONTROL
877-866-3473 Phone / 877-841-9293 Fax
PO Box 11369
Olympia, WA 98508
CUSTOMER
Name lrnvnv��q6S 6&A'
Address '201199 —7n K ch,je_
city Anc�6 State ZIP 91OLi
f -
Telephone
;L33___,9tore.No.
'Owner or manager
COOKING APPLJANCE LOCATIONS: LEFT TO RIGHT
DATE (IF SER'ACE
TIME
9 /25)
1,;2,
ANNUAL
sEmi-ANNuAL
I RFCHAROE
INSTALLATION
REhMATI[ON
LOCATION OrYSTC.Y. CYLINDERS
UL300
�. Q
r k ,, " (A
I [RYES []NO
MANUFACTURER
MODELNUMBER
WEV
DRY C1 IMCAL
W dm
CYLIAQE mAsTER
R SIZE
CYLINDER SIZE SLAVE
CYLINDER SIZE SLAVE
FUSE LINKS 3600 F.
FUSE LI NK3 4500 r.
FUSE LIN" 5WO F,
OIHER
AL
3
FUFLSI4UTOFF
ELECTRIC
(AS
SIZE
X
X
I
SERIAL NUMBER
LAST HYDRO TEST DATE
LAST RECILARGE DATE
aC2,1D
MANUFACTUkER'S M-AWAL PREFERENCE
PAGUNUMIJER:
DRAWING NUMHM
DATE
Z ""le loveyl
(7
ft. All appliances property covered w/correct nozzles
2. Duct and plenum covered w/correct nozzles
3. Check positioning of all nozzles
System installed in accordance wIMFG UL listing
5. Hood/duct penetrations sealed w/weld or UL device X
t' Check if seals intact, evidence of tampering
7. If system has been discharged, report same
'i Pressure gauge in proper range (if gauged)
9. Check cartirdge weight .(If applicable)
;1'0. Hydrostatic test date
�11 1. 6 year maintenace date
12. Inspect cylinder and mount
13. Operate system from terminal link
14. Test for proper operation from remote
.15. Check operation of micro switch — )XI
16. Check operation of gas valve Wj
,17. Clean nozzles
.18. Proper nozzle covers In place X
119. Check fuse links and clean X
COMMENTS: S-_<4-ew) e-il7el-affelklal
5
20. Replaced fuse links
21. Check travel of cable nuts/G-hooks
ie
22. Piping & conduit securely bracketed
23. Proper separation between fryers & flane
24. Proper clearance - flame to filters
25. Exhaust fan in operating order
A-
26. All filters in place
27. Fuel shut-off in on position
28. Manual & remote set/seals in place
Y
29. Replace systems covers
30. System operational & seals in place
AN
31. Slave system operational
32. Clean cylinder & mount
33. Fan warning sign on hood
34. Personnel instructed In manual operation of system
35. Proper hand portable extinguishers
36. Portable extinguishers properly serviced
37, Service & Certification tag on system
NOTE DISCREPANICES OR DEFICIENCIES BELOW
On this date, this range hood fire suppression system was inspected and operationally tested in accordance with the fire
�,uppression system requirements of NFPAI 7 or 17A, 96 and the manufacturer's manual, yy�th the results,.in, dicated above.
X i�y 0-? 0
SERVICE TECHNIelAN PERMIT NO. DATE: TIME; AM PM CUSTOMER's AUTHORIZED AGENT
The above service technician certifies that the system was personally inspected and found conditions to be as indicated on this report.
I WHITE -CUSTOMER COPY I CANARY- DISTRIBUTOR I PINK -AUTHORITY HAVING JURISDICTION I
HOMISH CO. Serving Brier, Edmonds
IREMountlake Terraceand
the Town of Woodway
IS T RltT www.FireDistrictl.org
LOCATION: 20903 70th Avenue
BUSINESS NAME: Aurora House /Compass Health
MAILING 20903 70Th Ave VV
ADDRESS: Edmonds
BUSINESS OWNER: Compass Heafth
EMERGENCY-1: St&d==M
KEY ACCESS-2: 'P540-t" ma%—C�-v
PERSON CONTACTED: GA �, f� Y AA) T o
NAME OF INSPECTOR: D D A-) C)
FIRE FA 3,111 AS 3/12
SYSTEMS: 1.112- 2/.' Z_
FIRE PREVENTION
12425 Meridian Ave S INSPECTION REPORT
Everett, WA 98208 0 EDMONDS
0 BRIER
Phone (425) 551-1200 0 WOODWAY
0 MOUNTLAKE TERRACE
Fax (425) 551-1272 0 UNINCORPORATED
W
PHONE: 4256723333
98036
FREQUENCY
366
I STATION & SHII`7"�
16 D
SCHEDULED 07/01/12
DATE DUE
UFIR � P29
7207
HOME PHONE: 4253496200
AC19VE
HOME PHONE.
HOM E PHON E3r/,P—t-A.4 1 - 1 (61
CURRENT
CITY YES NO
BUSINESS
LICENSE
IN[ IAL INSPECTION DATE
�-0/2
FE _L1_L2__
ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2 Q LA
-1 1 D A)
2
3
3
4
4
5
5
6
6
7
7
1 AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
-i
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
1 5
VIOLATIONS
5
PRE -CITATION
CETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
3
7
-RETURNRECEIPT
RECEIVED
6
4
18
4
�18.
DATE:
DISPOSITION:
LETTERNEEDED F] YES NO
UETTERN9EDED [3� YES [I NO
8
FIRE DEPARTMENT COPY
Emerald Pire
Fire Spfinkler Specialists
11021 Cramer Rd. KPN - Gig Harbor, WA 98329
Office (253) 857-2056 - Fax (253) 857-2312 - Local 699 Contractor
AUTOMATIC SPRINKLER SYSTEMS
(One System per Report) Af4�
Occupancy Address: AwAeli Occupancy Nan
Responsible Person: Phone Number:
Building Owner:
Phone Number:6��O�Z___Tffe_ff
Date of Inspection: 4447—'010e
Type of Inspection: Quarterly Annual 2r'Other Fj
Testers Name (Please Print): A�__1113�Ikltoe WA State FSCC# le PFI?
DRY SYSTEM/PRE-ACTION SYSTEM:
1. Trip test (dry trip or full flow) conducted: ..................................................
Yes E]
No
System tripped in seconds.
2. All flow switches, supervisory switches and alarm bells tested: .....................
Yes
No E] N/A
3. Alarm bell operates: .............................................................................
Yes E]
No El N/A El
4. Flow tests conducted: ...........................................................................
Yes F1
NoR
Flow pressure: psi 2-inch drain? .......................................
Yes El
No EJ
5. Systems inspected and lubricated: ..........................................................
Yes Ej
NoR N/A Ej
6. Air compressor refills system in 30 minutes: ..............................................
Yes E]
NoR
7. System drained and restored to normal operation: .....................................
Yes E]
NoR
8. Were the heat actuation devices tested on pre -action and deluge system? ..... Yes.0 No [] N/A
��WET SYSTEM . TI-FREEZE SYSTEM: Tested at
1. Trip test conducted: .............................................................................. Yes E4—No R
Static pressure: Ad psi Flow pressure: psi 2 inch drain? / ... Yes E] No 2-"'N/A
2. Flow switches, supervisory switches and alarm bells tested: ..... ................ Yes Er'�o E] N/A E]
3. Alarm bell operates: ............................................................................. Yes 2""No Ej N/A E]
4. Systems inspected and lubricated: .......................................................... Yes 0"No 0
5. Pressure regulating valves tested: ........................................................... Yes E]. No E] N/A
AUTOMATIC SPRINKLER SYSTEMS (continued)
General:
1. . Central Station Monitoring? ........................................................................... Yes 2/"No 0
Monitoring company name
2. Location of Sprinklers
100% ......... E2,-" Parking ......... [] Basement ......... E] Hallways ......... E] Other ........ [:]
3. Pumper connections and clapper valves unobstructed ....................................... Yes D-lTo El
4. Sprinkler heads less than 50 years old .............................................................. Yes [;KNo
5. Sprinkler coverage is acceptable .... ............................................................ I ..... Yes E�' No E]
6. Spare sprinkler heads are available ................................................................. Yes [2---N o R
7. Systems left in service ................................................... ; .............................. Yes 2-"No R
8. Valves are sealed or supervised .................. /7*0&S .... /lOWLIZA-01 ........ Yes eT"*"N 0 F1
9. Signs are provided on valves ......................................................................... Yes E] No La,-
10. City static water pressure ;7z— -psi.
Problems Found:
Corrections Made: Date Corrected: Corrected By:
0. 0
SIGNATURE OF TESTER:
AGENCY. Emerald Fire 14-f PHONE: 253-857-2056
MAILINGADDRESS: 11021 Cramer Road KPN, Gig Harbor, WA 98329
FIRE PREVENTION
;If ITY OF EDMONDS SAFETY SURVEY
121 STH AVENUE N. - EDMONDS, WASHINGTON 98020 (425) 771-0215
FIRE DEPARTMENT
4�'
LOCATION: 20903 70th Avenue w
BUSINESS NAME: Aurora House f Compass Health PHONE: 4256723333
MAILING 2113903 70Th Ave W
ADDRESS: Edmonds 98036
BUSINESS OWNER: Compass Health HOMEPHONE: 4253496200
EMERGENCY-1: Shively, Dave HOMEPHONE: 4253082921
KEY ACCESS-2: HOME PHONE:
FREQUENCY
STATION& SHIFT
366
16 6
SCHEDULED
DATE DUE 11�
07/01/10
UFIR 1� 329
7207
ACT`IVE 18
PERSON CONTACTED: 'Avii INITIAL INSPECTION DATE
NAME OF INSPECTOR7��4a avix
FIRE FA 4/07
SYSTEMS:
FE I
A�NUZ
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
ly
A 4,
ENTER CODE ONLY ONCE I� ,
VIOLATION CODE
2
2
3
3
4
4
5
5
6
6
7
7
8
1st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE,
EXTENSION
GRANTED TO:'
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE.
DATE:
3
VIOLATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
7
4
18
4
8
DATE:
DISPOSITION:
�UETTERNEEDED 0 YES 0 NO
LETTER NEEDED I] YES NO
FIRE DEPARTMENT COPY
"I A i ,
VIL �,CT IRS
Fire Incident Report
Edmonds Fire Department
Incident Number: EF10001533 Exposure: 0 Incident Date: ' 4/27/2010
Narrative
Engine 16 was dispatched tdj�2-0903 70 Av W at 0148 for an automatic fire alarm (The Aurora
House). Upon our arrival, we found a two story wood frame adult board and care home for
mental patients with nothing visible and no alarm sounding. We made contact with the night
staff member named Mr. Friel. He stated the alarm sounded, stopped and the panel remained
in alarm. We found the alarm panel silenced and in trouble upon our arrival. We found no signs
of smoke or fire. Two rate of rise heads in the main hallway and one in the lounge area that
were not showing any blinking power to them. Two zones on the alarm panel remained in
trouble. We were unable to clear the trouble on the panel. We advised Mr. Friel that he would
have to remain awake and on fire watch until the alarm technician arrived due to the
occupancy type. Mr. Friel agreed. Engine 16 returned to service at 0212.
Lt ANDRE YOAKUM
Message
Page I of I
Wesffall, John
From: Westfall, John
Sent: Monday, January 14, 2008 11:40 AM
To: Paul Schroer
Subject: FW: Compass Health - Aurora House
Paul:
Thanks for the callback. The information I was asking for appears to already be provided by
my inspector.
Whomever the DOH contact, it appears they agree fire sprinkler is warranted. Thank you,
John
----- Original Message -----
From: Smith, Mike
Sent: Monday, January 14, 2008 6:15 AM
To: Bullis, Ann; Westfall, John
Subject: FW: Compass Health - Aurora House
Interesting how DOH classified the building. Jean originally told me they were going to have a license for 12. IBC
call this an R-4. The state has not adopted the R-4 classification so it is an R-3.
And I concur that it should be sprinkled.
----- Original Message -----
From: lean. Costa nti-Oeh ler [mailto:Jean.Costanti@compassh.org]
Sent: Friday, January 11, 2008 2:16 PM
To: Smith, Mike
Subject: RE: Compass Health - Aurora House
Hi Mike, I checked back in with our contact at DOH. He now says that we will require a building sprinkler system,
according to the 2006 International Building Code, that Aurora House is classified as 1-1 occupancy and Section
903.2.5 that an automatic sprinkler system shall be provided throughout buildings with a Group 1 fire area.
Is this a system you mentioned - 13-R. Would you give me a call at your convenience as it is my understanding
you'll have to approve any system we install, 425-346-5537. Thanks, Jean
----- Original Message -----
From: Jean. Costa nti-Oeh ler
Sent: Wednesday, January 09, 2008 4:43 PM
To: 'smithm@ci.edmonds.wa.us'
Subject: Compass Health - Aurora House
Hi Mike, Thanks for meeting with me today. You have provided good information for me to begin some
research. We are presently designated from DOH as a Boarding Home and if it all comes together we
would convert to Residential Treatment Facility. Let me know if you need more info. Thanks again, Jean
1/14/2008
Wesffall, John
From: Smith, Mike
Sent: Thursday, January 10, 2008 6:16 AM
To: Westfall, John
Cc: Bullis, Ann
Subject: Aurora House/Compass Health 20903 70th Ave W
Jean Costanti-Oehler from Compass Health contacted me regarding a change of use (kind of) from what Dept of Health
classifies their facility now (Boarding Home) to Residential Treatment Facility. It would appear the facility at this time is an
R-3 and the change will remain an R-3 based on 16 or less residents.
I met with Jean today and did a walk through the facility. Upgrades from DOH require a grease interceptor (or trap) and a
type I hood with fire suppression. DOH requested the FD be contacted for fire alarm upgrades.
The present system has smoke and heat detection in all occupied areas. Smoke detection in the sleeping rooms sounds
a general alarm. Horn strobes are scattered throughout and spacing looks correct. Manual pulls are at the exits. The
system is monitored offsite.
FD requirements will include mini horns in the sleeping areas and strobes in the common bathrooms.
I seem to recall seeing some 13R plans for sprinklering the building. According to Jean DOH is not requiring a sprinkler
upgrade.
Jean was also advised the above work will require permits from the City.
The anticipated work is several months out.
'111 ( (6 r�6 ioiory L- �-uY-co-ce-- 3 C- c (sp -? s- - 2- 1� � C
va
Message
Page 1 of 3
Westfall, John
From: Westfall, John
Sent: Monday, September 29, 2003 9:56 AM
To: 'Cole. Roberts@wsp.wa.gov'
Cc: Tomberg, Thomas; Smith, Mike
Subject: RE: Aurora House 20903 - 70th Ave. W, Edmonds, 98020
Welcome aboard Robert:
The Aurora House is a 5,000 s.f. type V-1 hr structure, R1 /A3 occupancy designed and built in 1986 and currently
operated by Compass Health. The occupancy is an adult treatment center with nine residential beds and fully smoke- and
fire -detected with central station monitoring by WA Alarm. The facility is non-sprinklered and inspected annually by local
inspection companies during the month of July.
1. Our evacuation policy is to have able-bodied residents/tenants of care facilities to remove themselves and fully
evacuate with the assistance (and evacuation) of on -site staff. And the small size of the facility lends itself to full
evacuation.
Only with fully sprinklered elderly care facilities with on -site management do we ask facilities to accomodate a defend in
place strategy.
.2. The last 12 months we have had 14 calls to Aurora House: 86% EMS - 7% False alarm - 7% Excess heating
condition.
3. Of 14 calls, one call was provided by automatic aid. The average response time for the 13 remaining calls is 4:42.
The travel route is primarily arterial, however the facility is near the edge of our station's response area.
4. 1 have no record of structural changes since construction in 1986 in my address file. My records show that the facility
was built as an adult residential treatment center. The alarm maintenance company identifies the facility as a youth home
since 2000. You may have the most recent numbers and exact nature of the residents in your records.
For your information, NW Group Homes at 21110 80th Pl. W. has completed their sprinkler grant project. The sprinkler
grant is a good program that can be made better by opening up to dedicated private care facilities, such as Avalon Inn
22816 Edmonds Wy.
If I can be of further assistance let me know.
John Westfall
425.771.0213
----- Original Message -----
From: Cole. Roberts@wsp.wa.gov [ma ilto: Cole. Roberts@wsp.wa.gov]
Sent: Monday, September 29, 2003 7:50 AM
To: Westfall@ci.edmonds.wa.us
Subject: RE: Aurora House 20903 - 70th Ave. W, Edmonds, 98020
Thank you so much John. I appreciate your intended efforts on this matter. Have a great week!
Regards,
Cole Roberts
Deputy State Fire Marshal
Washington State Patrol
2502 - 112th St. E.
Tacoma, WA 98445-51404
(253) 536-4325 / FAX (253) 536-4385
9/29/2003
Message
Page 2 of 3
Cole. Roberts@WSP.WA.GOV
----- Original Message -----
From: Westfall, John [mailto:Westfall@ci.edmonds.wa.us]
Sent: Friday, September 26, 2003 8:40 AM
To: Roberts, Cole (WSP)
Subject: RE: Aurora House 20903 - 70th Ave. W, Edmonds, 98020
Robert:
I will be happy to assist. Please give me a few days to sort other priorities and research
John
----- Original Message -----
From: Cole. Roberts@wsp.wa.gov [mailto: Cole. Roberts@wsp.wa.gov]
Sent: Thursday, September 25, 2003 9:50 AM
To: Westfall@ci.edmonds.wa.us
Subject: Aurora House 20903 - 70th Ave. W, Edmonds, 98020
Greetings John;
My name is Cole Roberts, and I am a Deputy state Fire Marshal with the
Washington State Patrol, stationed in Tacoma. The purpose of this e-mail is that
our office is currently in the process of re-evaluating a number of our licensed
boarding home facilities throughout the state. I am seeking your assistance
regarding Aurora House located at 20903 - 70th Ave. W, Edmonds, WA,98020.
Our records indicate that this is a 4,894 square foot two story Type V 1 hour built
structure that has some compartmentation, and is fully alarmed and detected,
however is unsprinklered. I am hoping that you may be able to assist me in gaining
answers to the following questions:
What is your evacuation policy for the occupants of this facility in
regard to fire emergencies e.g. full evacuation? ... Defend in
place? ... Other?
2. The number and nature of Edmonds Fire responses to this address
during the last 12 months.
3. Typical response times and response characteristics that Edmonds
Fire provides for this facility.
4. A brief biography of the structure and its intended use. i.e. Yr. built,
any additions, type of use, etc.
Any assistance you could offer on this facility would be greatly appreciated!
Regards,
Cole Roberts
Deputy State Fire Marshal
Washington State Patrol
2502 - 112th St. E.
Tacoma, WA 98445-51404
(253) 536-4325 / FAX (253) 536-4385
9/29/2003
Message
Page I of 2
Westfall, John
From: Westfall, John
Sent: Friday, September 26, 2003 8:40 AM
To: 'Cole. Roberts@wsp.wa.gov'
Subject: RE: Aurora House 20903 - 70th Ave. W, Edmonds, 98020
Robert:
I will be happy to assist. Please give me a few days to sort other priorities and research
John
----- Original Message -----
From: Cole. Roberts@wsp.wa.gov [mailto: Cole. Roberts@wsp.wa.gov]
Sent: Thursday, September 25, 2003 9:50 AM
To: Westfall@ci.edmonds.wa.us
Subject: Aurora House 20903 - 70th Ave. W, Edmonds, 98020
Greetings John;
My name is Cole Roberts, and I am a Deputy state Fire Marshal with the Washington State Patrol,
stationed in Tacoma. The purpose of this e-mail is that our office is currently in the process of re-
evaluating a number of our licensed boarding home facilities throughout the state. I am seeking
your assistance regarding Aurora House located at 20903 - 70th Ave. W, Edmonds, WA,98020.
Our records indicate that this is a 4,894 square foot two story Type V 1 hour built structure that has
some compartmentation, and is fully alarmed and detected, however is unsprinklered. I am hoping
that you may be able to assist me in gaining answers to the following questions:
What is your evacuation policy for the occupants of this facility in regard to fire
emergencies e.g. full evacuation? ... Defend in place? ... Other?
2. The number and nature of Edmonds Fire responses to this address during the last 12
months.
3. Typical response times and response characteristics that Edmonds Fire provides for
this facility.
4. A brief biography of the structure and its intended use. i.e. Yr. built, any additions,
type of use, etc.
Any assistance you could offer on this facility would be greatly appreciated!
Regards,
Cole Roberts
Deputy State Fire Marshal
Washington State Patrol
2502 - 112th St. E.
Tacoma, WA 98445-51404
(253) 536-4325 / FAX (253) 536-4385
9/26/2003
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ROUTING AND ACTION CONTROL FORM
FACILITIES AND SERVICES LICENSING DIVISION
BOARDING HOME
-,/-State —Medicare
Request # 94-002940
ACTIVITY ASSIGNMENT
initial Licensure/Certification
---'—Reticensure/Recertification Survey
v
Survey Follow-up
Bed/Unit Increase + Beds/Units
Complaint # _
Change of Ownership
Change of Environment/Use
Resurvey
___7_Life Safety
Other
AURORA HOUSE
Facility ID:�0612* BEDS/UNITS: 20 SURVEYOR(s):State Fire Marshal
20903 70TH AVE W OCCUPANTS: 0 SURVEYOR(s):
EDMONDS Snohomish 98026 LAST FULL SURVEY:04/19/93 FIRE MARSHAL SURVEY: 02/11/93 ON -SITE SURVEY DUE: 03/31/94
PAULA KAHN (206)672-3333
BH-815 LICENSE/CERT. EXPIRES: 04/30/94 Number of employees: 0
OWNER:COUNTERPOINT COMMUNITY MENTAL HEALTH SERVICES
DATE INITIAL
Request sent to FPS
Request sent to Deputy
Survey date
01/25/94
Due back to SFK Office Local Fire Department contacted? Yes �* No— Person contactedi m C� xv W onj��
Rec'd by DOH Reinspection.required? Yes— No",J Reinspection Date
Occupancy Number of stories Basement/CeLtar Yes NoV
Type Constr uction Local AHJ1Afy%avL,
L Part
Yes No Full Part Automatic Yes No f !n' Manual Yes No Commercial
Automatic Detection Fu Fire Alarm Range Hood
Sprinklers System System System
Surveyor Comments
COMPLIANCE STATEMENT ACTION
Renewal New
The faciLity/agency indentified above is in full
compliance with Licensure/certification
requirements.
The faciLity/agency indentified above is in
compliance with Licensure/certification
requirements subject to implementation of approved
plan of correction. (SFM 470)
The faciLity/agency indentified above has not
submitted -an -approved plan of correction.
The facitity/agency indentified above has failed or
refused to comply with Licensure/certification
requir ts ov ide an approved plan of
correc7on.
Surveyed By Date
(J) —_ \ -
Reviewed By Date
Initial Licensure/certification Recommended
ReLicensure/Recertification Recommended
State Medicare
Progress Report Required Date
Disapproved
LICENSURE/CERTIFICATION DECISION:
SFM Approval
Full Licensure/Certification
Short -Term License/Certificate to expire
Prov. License/Certificate to expire
License/Certificate Den!aL-Revocation
Complaint Investigation Completed
Cgrtification Dates,. Certification Performed BY:
PIA
F i re A L arm Sys em
I
Sprinkler System
Emergency Generator�-77 —h6lit'l-D-16 14WV�ILVA t1k,1-
Fire Extinguishers �,64 t A IF (W/.
FIRE AND LIFE SAFETY INSPECTION: STATEMENT OF DEFICIENCY & CORRECTIVE ACTION
FACIL
NAME AVOWN flasr.
AD!)AEb �t
V\j
—ZA-
IM) M0 2 6
INSPECTt.,,
AGENCY
STATE FIRE MARSHAL
DAT�
JW UA P-�(
ITEM
NO.
STATEMENT OF DEFICIENCY
CODE OR WAC
REFERENCE
CORRECTIVE ACTION REQUIRED
CORRECTION RE
QUIRED BY (DATE)
�cn
VVY
1)6A-MW WAWaW -C-16V
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THE DEFICIENCIES DESCRI13ED ABOVE HAVE BEW EXPLAINED
TO ME, AND I AGREE TO MAKE CORRECTIONS NOT LATER THAN
SIGNt' U E bFFP- 1. 6Y:
GK-Ila
REINSPECTION DATE:
I
THE DATES INDICATED.
SF FORM 470 (Revised 9/89) QX A-259 OFFICE OF STATE FIRE MARHSAL - 1/ STATE FIRE MARSHAL CENTRAL FILE COPY PAGE --(— OF —�— PAGES
RIGHT OF APPEAL
A facility aggrieved by the corrective orders of the State Fire Marshal or his authorized representative may appeal to the State Fire
Marshal within live days of the order. If the State Fire Marshal confirms the order. it shall remain in force.
'�
WASHINGTON STATE FIRE INCIDENT REPORT
NFIRS I
FIRE DEPT.' 1 0 delete
— C_�`n Z 6ioc-'s 12 0 change
FDID INCIDENT NO.
EXP.
Y
YEAR
DAY OF WEEK
5_W Thursday
ALARM TIM11
IN SWCE
Flo
3',) nloij kRJ'0121-?I91QI6
!0
I Sunday 3 0 Tuesday 61-1 Friday
2 0 Monday 4 C1 Wednesday 7 0 Saturday
_D
157
15�2 Q'�
163 6
TYPE OF SITUATION -FOUND
FIRE, EXPL. 3. RESCUE .5. SER. CALL 7. FALSE
2. PRESSURE RUPTURE 4. HAL COND. 6. GOOD INTE T 9. OTHER
Z
MUTUAL AID
0Z
I- he
I El Extinguishment 5 0 San:,.by 80 Fill in. Move up
2 0 Rescue Only 6 C] Sal" 9 0 Not classified
1 6 R c'd
Q<
investigation only
3 7 0 Emerg. Mad. 0 C1 Undetermined I Not reported
Aemove Hazard
2 Given
C1 N/A
FIXED PROPERTY USE (Occupancy)
IGNITION FACTOR
C
merwlno r r,4 6 7y
rQ 10
CORRECT ADDRESS (Up to maximum of 21 characters)
ZIP CODE
CENSUS TRACT
0
o209 0 S 71i�4 Al'6
16 () 12P
1 1 1017-
OCCUPANT NAME I) T
/14kT. IA.
N!
TELEP HONE
ROOM or API.
CIO V/VT6W POM) r
7 Z
OWNER NAME (LAST. FIRST, M.I.)
ADDRESS
TELEPHONE
12
729 .26
METHOD OF ALARM .0759
—
CO. INSPECTION
SHIFT
NO. ALARMS
1 0 Telephone direct 4 0 A dio 8 0 v i signal municipal alarm signal
calassilied
DISTRICT
13
2 Cl Municip alarm system 5 0 V:rb 1 9 0 No
a, a of
3 )( Private . arm sy tam 6 0 N alarm rec'd. 0 0 Undetermined or not reported
3
7 0 Tie -line (911)
1
NO. FIRE SERVICE PERSONNEL
ENGINES
NO. AERIAL APPARATUS
No. OTHER VEHICLES
RESPONDED
RESPONDED
RESPONDED
RESPONDED
101 61�1
1b, 0, 1
k�s 1-vi 1,0
ID Q
NUMBER OF INJURIES Complete Form NFIRS 3 ' COMPLETE FORM NFIRS 2 NUMBER OF FATALITIES
20
— FIRE SERVICE lt)010 OTHER lt� FIRE SERVICE lol 010 OTHER I
III
K
L
M
COMPLEX
MOBILE PROPERTY TYPE
(Complete Llne,S)
AREA OF FIRE ORIGIN
EQUIPMENT INVOLVED IN IGNITION
(Complete Line T)
FORM OF HEAT IGNITION
ATERIAL IGNITED
FORM OF MATERIAL IGNITED V,
METHOD OF
EXTINGUISHMENT
2 0 Make shift aide 5 C1 Pro -connect hose/tank only
8 C3 Master stream device
0 1 Self extinguished
3 C1 Portable extinguisher 6 0 Pro -connect hose/hydrant draft standpipe
9 0 Not classified
4 C1 Automatic ext. system 7 0 Hand -laid hose/hydrant draft standpipe
0 0 Undetermined or not reported
LEVEL OF FIRE ORIGIN
1 11 Grade level to 9 ft. 6 0 Over 70 feet
ESTIMATED DOLLAR LOSS
2 0 10 to 19 feet 7 C1 Objects in flight
3 C3 20 to 29 feet 8 C3 Below ground level
4 C1 30 to 49 feet 9 C3 Not classified above
6 El 50 to 70 feet 0 1:1 Undetermined
NUMBER OF STORIES
1 0 1 story. 4 0 5 to 6 stories. 7 11 26 to 49 stories.
N2 0 2 story. 5 0 7 to 12 stories. 8 0 60 stories or more.
3 0 3 to 4 stories. 6 0 13 to 24 stories. 0 EJ Number of Stories undetermined or not reported.
CONSTRUCTION TYPE
1 0 Fire resistive
6 0 Unprotected ordinary
2 0 Heavy timber
7 1:1 Protected wood frame
3 0 Protected noncombustible
8 1:1 Unprotected wood frame
4 0 Unprotected noncombustible
9 0 Not classilied above
5 ID Protected ordinary
0 El Undetermined or not
Flame
Smoke
0 Det. in room or spacp of fire origin-oper.
1 Confined to the object of origin 1 0
2 Confined to pan of room or area of origin 2 0
1 0
2 0
0 Dot. not in rm. or space of fire ofigin-oper.
1 0 Equipment operated
3 C nfin:d room of origin 3 0
3 0
3 0 Det in rm. or space of origin -not oper.
2 0 Equipment should have operated —did not
to
I Coonhn d FT he tire -rated comp. of origin 4 C1
4 11
P
4 0 Det. not in rm. of space of origin -not oper.
3 0 Equipment present. fire too small to oper.
5 Conlined to floor of origin 5 11
5 0
5 0 Oat. not in mn. or space of fire on . gin
8 11 No.equipment present (N/A)
0
Confined to structure of origin 6 11
16 Extended beyond structure of origin 7 0
6 11
7 0
but fire too small to oper.
9 El Not classified
0 Undetermined/ not reported o 0
0.
8 ID No detectors present
0 11 Undetermined or not reported
�0
9 0 Not classified
F
0 No damage of this type (N/A)
r
1 9 0
0 0 Undetermined or not reported
TYPE OF MATERIAL GENERATING MOST SMOKE
AVENUE OF SMOKE TRAVEL
IF SMOKE SPREAD
1 0 Air handling duct 4 0 Stairwell
7 El Utility opening in floor
8 El No avenue of smoke travel
Q
BEYOND ROOM
2 0 Corridor 6 0 Opening in construction 9 D Not classified
OF ORIGIN
3 El Elevator shaft 6 0 Utility opening in well
0 0 Undetermined or not reported
FORM OF MATERIAL GENERATING MOST SMOKE
_L__1
I R
IF MOBILE PROPERTY
YEAR
MAKE
MODEL
SERIAL NO.
LICENSE NO.
(N . A. IF NOT APPLICABLE)
30
IF EQUIPMENT - (N.A. IF NOT APPLICABLE)
YEAR
MAKE
MODEL
SERIAL NO.
INVOLVED
40
IN IGNITION
0
0
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0
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OFFICER IN CHARGE EMBER MAKING REPORT DATE
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i'- June 30, 1986
MEMO TO: Hal Reeves
Building Official
FROM: Gary L. McComas
Fire Marshal
SUBJECT: SNOHOMISH COUNTY INSTITUTIONAL FACILITY
20903-70TH AVENUE WEST
After review, the fire department has the following comments:
1. One additional extinguisher required in*the kitchen.
Minimum - 40-B:C.
2. All other extinguishers to be a minimum of 2,A-10,B:C,
dry chemical types.
3. Site Plan and General Comments
#4. Access to the north side of the building can be
provided by the existing driveway if proof of
an easement is provided. This requirement was
discussed during a previous conversation with a
representative of the project.
GLMI: be
ayKernan,
aldridge �
April 30, 1986
Mr. Harold Reeves,
City of Edmonds
250 5th Ave N.
Edmonds, WA 98020
Dear Mr. Reeves:
Qden,
quinton
BUILDING
MY 5 - 1986
Building Official
architects p.s.
chorles b. ogden oia
robert g oldridge CIJ 0
gorryv. quinton cio
b. croig thompson cia
I have reviewed your plan check comments and hereby am
responding by way of this letter and enclosed revised drawings.
SITE PLAN AND GENERAL COMMENTS
1. All footings currently bear on undisturbed soil.
2. No comment.
3. Roof drainage is currently collected and tightlined to storm
sewer per existing drawing SD1.2.
4. Per conversation with the Fire Department, we understood
that this building would be served by 2 fire hydrants, (1)
located on the access drive to the northeast of the building
and the other located on 70th Ave. W. approximiately 501
north of the subject property. Acces s �� back (north) side
J
of property is provided by existing drLive on adjacent
property.
5. This is a curb cut and normally does not require handrails.
6. Section 1 & 3/SD1.3 revised to show 2211 extension @ bottom.
landing of stairs.
7. Detail 13/A4.2 added to show H.C. designated parking. There
is only one site entrance drive and as such we feel there is
no need to identify with an H.C. entrance sign.
8. No. A previous agreement exists to provide power from this
I vault to the property to the south.
322-'! !�E- Q,,c32(--'1 20�-) '259-3161
BUILDING
dykernan, ogden, MAY 5 - 1986 .
aldridge & quinton architects p.s.
Mr. Harold Reeves
April 10, 1986
Page 2
OCCUPANCY & EXIT COMMENTS
1. We disagree with I.C.B.O. designation of a mixed occupancy,
R-1/A-3. Sec. 601, Div. 3 defines the maximum occupant
load (300). It would seem obvious to us that there is a
lower limit as such a designation for an occupant load of
10 or some other low number would be ludicrous. We have
always been under the impression that Section 402-"Assembly
Building" states this lower limit (50 occupants). We
cannot technically get more than 40 occupants in the area
in question, using an occupant load factor of 15 sf/occ.
(Table 33A-Assembly Areas less concentrated use).
In our preliminary discussion of 4-3-86, it is my
understanding that we will be allowed to remain a single
occupancy of R-1 designation, but that we will build a
1-hr. F.R. wall separation at the juncture of the south
wing and corridor 15.
2. Not required per discussion in Item 1 above.
3. Door 18A has been revised on the Door Schedule to be a I
hr. rated door assembly. Walls and ceiling are currently 1
hr. F.R. construction and are not required to extend to
roof sheathing.
4.a. Cedar siding is a 3/4" drop channel siding. In addition,
you will note that we are using 5/8" gypsum sheathing
instead of 1/211.
b. No A-3 occupancy involved.
5. No A-3 occupancy involved.
6. No A-3 occupancy involved.
7., Note 4/A2.1 revised to note minimum opening and compliance
required.
8. Per our discussion on 4-3-86, the number of plumbing
fixtures currently shown is acceptable.
9. Smoke detectors are tied in existing electrical system at
circuit 2C-1.
dykernan
aldridge 1
Mr. Harold Reeves
April 10, 1986
Page 3
9den,
quinton
architects p.s.
10.a. Again, we consider this to be a group home residence of 20
beds maximum (per state licensure) and as such are
required to make one bedroom and bathroom unit H.C.
accessible. However, we have endeavored to make the
facility fully H.C. accessible with the exception of baths
19 and 24 and bedrooms 11., 29 and 30. (2 beds in each of
bedrooms 11, 29, and 30 could be made H.C. accessible by
rearrangement of beds and changing the doors at baths 19
and 24 to swing in would make them H.C. accessible).
b. Baths 19 and 24 are not H.C. accessible at this time.
Lever operated faucets are specified throughout.
c. Bathtub areas.are all designated to utilize seat in tub
configuration Sec. 511 (f), 2. Note: 4th grab bar has
been added at end wall opposite drain. See revised sheets
A1.1 and A5.1.
d. Acknowledged. See 10a.
e. Door 15A has been revised to swing outward. See A1.1.
f. Lever hardware has been specified throughout facility,
except where locksets are required.
11. Door 8A is not a required exit.
12. Acknowledged. Revised 25/A4.1.
13. Exit doors 01A, 07A, 15A, and 15B shall have a Schlage
H153PD with a lever handle (Levon) on the inside face.
See enclosed spec. sheet.
14. These are not exit doors and do not fall under Sec. 3304
(c).
15. Will remain Type V-1 hr.
i
16. Doors 16A will open 180
17. Per our discussion 4-3-86, Detail 13/A4.1 is acceptable as
a non -labeled 20 min. frame.
1\ ) 11 )
dykernan, ogden, architects p.s.
aldridge & quinton
Mr. Harold Reeves
April 10, 1986
Page 4
MECHANICAL SYSTEMS
1.a. Note 6/A3.1 has been modified.
b. Per our discussion 4-3-86, gypsum sheathing will not be
required on exterior soffits.
C. Acknowledged. Section G/A3.1 revised.
d. -
Acknowledged.
Section F/A3.1 revised..
e.
Per our discussion
4-3-86,
gypsum sheathing not required.
f.
Acknowledged.
See revised
Sheet S1.1.
g.
Acknowledged.
See enclosed
Spec. Sheet 15800-2.03.
h.
Acknowledged.
Specified as
such.
2.
Acknowledged.
See revised
note 5/A1.1.
3.
Asphaltic emulsion.
4.a. Is currently shown as 3611 x 36".
b. Per our discussion, we qualify for a 90% reduction in
area. (Sec. 2516(c)6.). Subject to on site inspection.
C. Specified as such.
d. No comment.
e. Per our discussion 4-3-86, draftst6p location.are
acceptable as shown.
f. Per our discussion 4-3-86, not required.
5. Specified as Class B shingle.
6. Per our discussion 4-3-86, skylight acceptable as shown.
7. Revised to clarify. See Sheet A2.1.
dykernan, ogden,
aldridge & quinton
Mr. Harold Reeves
April 10, 1986
Page 5
architects p.s.
8. Specified as such.
9. Acknowledged. See new Note 6/A1.1.
10. Will submit shop drawing if requested. It should be noted
that this Type I hood is not required by Code, as it
serves residential appliances. Make-up air is currently
supplied from Elec. Furn. #2.
11.a. Architect to certify compliance with Sec. 404 W.S.E.C.
b. Specifications call for all three strategies (405 a,b,c).
In addition, drawings call for 'Tyvek' building wrap.
c. Acknowledged. Currently specified on Sheet M.1.
d. See comment #1 - Occupancy Comments.
STRUCTURAL COMMENTS
Response by Structural Engineer. See attached.
Please contact me if you have any questions.
Very truly yours,
K. n one IA
Assoc' t Pri i al
KJJ/dmp
CC: f ile
routing
Enclosure
V . 11
CoDt
BOARD OF DIRECTORS
CHAIRMAN
DAVID A. BASSETT, PE.
BUILDING SAFETY DIRECTOR
MEDFORD. OREGON
International Conference of Building Officials
REGIONALOFFICE: 12505 BELLEVUE-REDMOND ROAD, SUITE 208* BELLEVUE, WASHINGTON 98005 *(206)451-9541
FIRST VICE-CHAIRMAN
MARK R. RODMAN
DIRECTOR, BUILDING SERVICES
SPRINGFIELD, ILLINOIS
SECOND VICE-CHAIRMAN
CHARLES CLAWSON
DIRECTOR OF COMMUNITY
DEVELOPMENT
ARLINGTON , TEXAS
IMMEDIATE PAST CHAIRMAN
JOHN E. MAULDING, RE.
BUILDING OFFICIAL
LANCASTER, CALIFORNIA
BOB FOWLER, A.I.A., RE.
DIRECTOR OF BUILDING INSPECTION
ALBILENE, TEXAS
PHILLIP M. HERRINGTON
DIRECTOR, DEPARTMENT OF
BUILDING AND SAFETY
RENO,NEVADA
DOUGLAS E. HOOD
BUILDING OFFICIAL
COLORADO RIVER INDIAN TRIBES
PARKER, ARIZONA
SOL J. JACOBS, RE.
DIRECTOR OF INSPECTIONS
MINNEAPOLIS. MINNESOTA
JAMES L. MANSON
DIRECTOR, DEPARTMENT OF
BUILDING AND SAFETY
COUNTY OF SPOKANE
SPOKANE, WASHINGTON
MICHAEL J. NOLTE
BUILDING OFFICIAL
CRESWELL. OREGON
WILLIAM E. SCHLECHT
BUILDING OFFICIAL
COUNTY OF WASHINGTON
HILLSBORO, OREGON
JAMES R. SINGLETON
BUILDING SAFETY ADMINISTRATOR
TUCSON. ARIZONA
BRENTSNYDER
BUILDING OFFICIAL
PACIFICA, CALIFORNIA
RONALD R. TREMBLAY
B U
JILOING OFFICIAL
ASSARIA. KANSAS
STANLEYWHEELER
BUILDING OFFICIAL/
FIRE MARSHAL
LIVERMORE. CALIFORNIA
EUGENE J. ZELLER, RE.
SUPERINTENDENT OF BUILDING
AND SAFETY
LONG BEACH, CALIFORNIA
PRESIDENT'
JAMES E. BIHR, RE.
BUILDINC
APR 3 - 1966
April 2, 1986
OFFICES OF
JERRY J. BARBERA, RE.
REGIONALMANAGER
FRANK S. NATSUHARA, RE.
REG IONAL ENGINEER
GLENN C. FRANK, RE.
REGIONAL ENGINEER
Plan Check: 1856
Project: Snohomish Adult Treatment
Facility
Address: 70th Av W & 210th St SW
Edmonds, WA
Code Information: R-1/A-3 Occupancies
Type V-N Construction (checked for
V-1 hour)
Stories: I
Floor Area: 5000
Occupant Load: 14/50 (100 for multipur-
pose use)
Valuation: $240,000
1985 Uniform Building Code
Seismic Zone: 3
Basic Wind Speed: 8-0 mph
Exposure: B
Harold Reeves
Building Official
250 5th Av N
Edmonds, WA 98020
Dear Mr. Reeves:
Data and plans for the above project have been reviewed
for conformance with the Uniform Building Code and some
parts of the Mechanical Code as well as Washington State
Regulations for Energy and Bar ' rier Free Design. They
have not been reviewed for compliance with requirements
of federal, or other state and local regulatory agencies.
Most of the following comments should be reflected as
changes and notes on the plans and in the specifications.
SITE PLAN AND GENERAL COMMENTS
1. The grading shown on Sheet SD-1.2 involves both
cut and fill. If you have adopted Appendix Chapter 70,
there are requirements for compaction of the fill and also
Main Office: 5360 South Workman Mill Road 0 Whittier, California 90601 0 (213) 699-0541
I
Plan Check 1856
Harold Reeves
April 2, 1986
Page Two
requirements for keepting the toe of the slope (at the southeast corner of
the property line) I-j" away. At any rate, the footings should bear on
undisturbed soil. Section 2907(a)
2. The drainage plan should be rewiewed and approved by your Public
Works Department. Any street improvements, sewer lines, etc. should
also be reviewed by them.
3. The roof drainage should be collected such that it does not flow over
public property. Section 3207(e)
4. Onsite fire hydrants and access to the back, east, side of the building
appears to be required. Section 10.207 UFC. Fire extinguisher location
details within the building should also be checked by the Fire Department.
5. The 1:12 ramp from the Handicapped parking space should also have
handrails shown. Section 3306(j), HC Amendments.
6. The HC code requires handrails for the stairs and ramps to extend
12" beyond the top and 22" beyond the bottom. Section 3306(j)
7. Specific signs with specific verbage on them should be posted at the
entrance off of 17th Av W and the HC space. Section 5503. The HC
symbol of access is required at the main entrance.
8. The power vault transformer is built to strattle the south property
line. Is this public property?
OCCUPANCY AND EXIT COMMENTS
1. The project data on Sheet SD1.1 should be corrected to show a mixed
R-1/A-3 occupancy. My analysis is that type V-N construction is the
minimum but I will check it for V-1 hour as indicated on the plans.
2. The details of the 1 hour occupancy separation wall at the corridor
wall adjacent to rooms 02,03 and 04 should be given to show that it extends
to the roof sheathing and completely separates the two occupancies (Section
1/S1.2 does not show this). Section 503(b). It should go to the gound also.
3. If laundry room 18 is used in common by the occupants of the building,
then the walls should extend to the sheathing and doorway 18A should be
protected by 1 hour fire assemblies. Section 1202(b)
4. Exterior wall finish:
a. The cedar siding should be specified as a drop type. Item 75,
Table 43-B
I
Plan Check 1856
Harold Reeves
April .2, 1986
Page Three
b. The gable
end wall at
line
A and the southerly wall around line
B should
be sheathed
with
one hour protection both sides through
the attic.
Table 5-A
and
Section 4304(c)
5. The potential main entrances for the A-3 occupancy, doorways 01A and
08A do not strictly lie on the 201 accessway required by Section 603. How
are emergency and/or fire fighting equipment going to get to them?
6. The ventilation of the A-3 occuancy should be justified --the sizes
of the openable part of the windows F, G, etc. are not detailed on Sheet
A2. 1. Section 605
7. Note 4 on Sheet A2.1 mentions that the escape windows comply with
the code. However, the minimum dimensions and method of opening
them should be shown for the actual condition in order to verify compli-
ance. Section 1204
8. If you enforce Appendix C of the Uniform Plumbing Code, additional
water closets may be required (categories possible are dormitories or
institutions --other than hospitals, employees and residences plus assem-
blies)
9. The smoke detectors shown on on Sheet El .2 do not appear to be tied
into the electrical system as required by Section 1210(a).
10. Disabled persons requirements:
a. Which guest room will be the one accessible to the Handicapped?
Details shown in compliance with Chapters 12 and Section 5505
should be given.
b. The lavatory in rooms 19 & 24should be open underneath. Section
511 (b) . Lever operated faucets are required.
c. The bath tub and shower should be enlarged to comply with Section
511 (f)
d. Doors 19A and 24A do not have an unobstructed 1811 space on the
hull side of the strike jamb nor 12" on the room side. Section
402, Definition of Accessible Opening.
e. There should be a similar 18" space on the hull side of door
15A.
f. Lever hardware is required within t1he A occupancy and at the
main doors, toilet room doors, and accessible guest room in
the R-1 part of the building.
Plan Check 1856
Harold Reeves
April 2, 1986
Page Four
11. The one step outside of door 08A with the roof over it should be
changed to a ramp. Section 3301 (d) . Technically the one outside of
door 15B should also be a ramp.
12. Thresholds should be shown no higher than 1/2" above the floor on
either side. Section 3304(h)
13. All locksets should be openable from the inside without the use of
key, special knowledge or effort. Section 3304(c) The designer should
verify that the specified hardware complies.
14. The flush bolts included with hardware group 7 and 10 are not allowed
in the 1982 code. Section 3304(c) In the 1985 code, they are allowed for
room 33 but the others should be changed.
15. For purposes of occupant load, I considered bedrooms 11, 29, and 30
as dormitories. Sections 405 and 408, Definitions of dormitory and guest
rooms, respectively. The corridor complies as a I hour one as required
by Section 3305(g). However, if the building is derated to Type V-N
construction, then the details of the corridor envelope should be shown.
16. Doors 16A block the required width of the corridor. If they are
made to open 180', then they would be okay. Section 3305(d)
17. Note that the frames and doors should both be labeled for 20 minute
smoke and draft control assemblies. Section 3305(h)l. The door schcdule
does not make this clear.
TYPE OF CONSTRUCTION REQUIRED & ITEMS RELATING TO THE
MECHANICAL SYSTEMS
1. One hour construction, Table 17-A and related sections:
a The two layers of drywall at the bottom of the trusses should be
installed such that the joists are staggered --note 6/A3.1 should
be modified.
b. Gypsum sheathing should be applied under the cedar plywood on
the overhangs and at the entry. Detail E/A3.1 should be similar
to 16/A4.1.
c. The wall of the basement between it and the crawl space, Section
G/A3.1, should be sheathed both sides with I hour protection.
d. Similarly the walls supporting the stair, should be sheathed both
sides and detailed. F/A3.1
Plan Check 1856
Harold Reeves
April 2, 1986
Page ive
e. The horizontal part of the skylight well, Detail .7/A4.2, should be
protected with 5/8" type X gypsum board.
f. The floor joists at the southerly part of line F should be spaced
no more than 16" o.c. in order to use the system shown in Item
25, Table 43-C.
g . Fire dampers should be installed where ducts penetrate the cor-
ridor walls. Section 4306(j) . Their details and the ones for the
ceiling types should be shown on the plans.
h. The attic access should be 1 hour fire access doors. Section 4303(d)6
and 4305(a)
2. The foam plastic insulation mentioned in note 5 on Sheet A1.1 should
be labeled with a flame spread and smoke develop rating of 75 and 450 or
less respectively, and a thermal barrier is required on the room (heater?)
side. Section 1712 (a)
3. How are the basement walls clampproofed? Section 1707
4. Access, ventilation, and draft stops; Sections 2516(c,f) and 3205:
a. The crawl space access should be dimensioned as a minimum of
1811 x 24".
b. Approximately 5,200 sq in of underfloor ventilation should be
provided. The net free area of the vents shown in Detail 5/A4.1
is very small and approximately 47 of them would be required.
c. The attic access should be shown as 2211 x 30." minimum.
d. Approximately 2600 sq in of attic ventilation is required. The
eave and ridge vents should be justified to provide this but see
structural comment
e. Draft stops are required between each unit and between the units
and other areas such as the corridors and toilet rooms. Unless
a sprinkler system is installed throughout the attic. Section
2516M4 B ii. Note that the stops should also extend into the
eave mansards.
f. Draft stops should also be installed every 16 linear feet in the
mansards around the A occupancy. Section 2516(f) 4 B iii
5. Class C composition shingles should be specified as layed up so that
no more than 2 thicknesses at any point and a total weight per square
of 235 lbs or greater is provided. Section 3203(e)5
Plan Check 1856
Harold Reeves
April 2, ' 1986
Page Six
6. The skylights should be elevated 4" above the roof surface and the
lamination interlayer shown to be at least 0.0311 minimum. Section 3401
7. The glazing in door type C and windows immediately adjacent to
doors 01A and 15B should be labeled impact type (more than just
tempered glass). Sections 5402 and 5406(d). Windows B and E appear
also to require impact glazing. Section 5406(d)7
8. The fire alarm system should be designed with respect to Appendix
111-C of the Uniform Fire Code. Your.Fire Department should check them.
9. The dryer vents should be vented to outside air. Section 1903 UMC
10. The exact details of the range hood, ducts, and design of the hood
ventilation should be provided in order to check compliance with Sections
2002 and 2003, UMC. How is make-up air supplied?
11. Washington State Energy Code requirements:
a. The envelope design for the building should be provided in
order to check compliance with Section 404. Note that the
1986 code is in effect now.
b. How is infiltration minimized? Section 405
c. All showers and lavatories should have flow constrictors to
limit hot water to 3 gallons per minute and 1/2 gallons per
minute respectively. Section 423
d. The electrical lighting in the A-3 occupancy area should be
limited to 1830 watts. Section 426. The amount of wattage
provided appears to exceed this and should be redesigned.
STRUCTURAL COMMENTS
I . Quality control:
a. The trusses should be manufactured in a plant which has a
third party quality control inspection and the trusses should
bear their quality control stamp. Section 2510(h). One such
agency in Washington is the Washington Wood Truss Fabricators
Council, Evaluation Report AA579.
b. You should require that the engineer of record for this building
review the truss plans to provide for continuity between his
plan and theirs. This review should be indicated to you in
writing for your records.
Plan Check 1856
Harold Reeves
April 2, 1986
Page Seven
c. Some special connectors, Details 4/S1.1 and 3/S1.2 for instance,
are to be made for this project. You should insure that the
plant in which they are manufactured complies with the minimum
requirements of Section 306(f).
d. These connectors and a "standard" one called for on the plans
should bear quality control marks also.
2. Roof framing:
a. The roof diaphragm should have edges blocked or be equivalently
supported. Table 25-S-1
b. The truss plans should be submitted for review (see 1(b) above
also) .
c. The interior partitions should be held 3/8" below the trusses
in something like a Simpson STC clip should be used to support
the top of the wall.
d. The sizes of the hip rafters at the corners of the building should
be shown.
e. The 6 x 6 headers at bedroom #12 and over other openings are
overstressed for the possible worse case of concentrated load from
the trusses (post and timber values). A redesign is required.
f. Likewise, the three 2 x 8's (or 6 x 8) at bedroom 27 is overstressed.
g. How will the added connection shown on Detail 3/S1.2 affect the
truss plates?
3. Floor framing:
a. The 2 x 8 floor joist in the recreation and dining room areas are
overstressed for 100 lb psf assembly live load and should be
redesigned. Table 23-A
b. The 6 x 8 floor beam which supports these joists is also overstressed.
c. The
6 x 10 floor beam at the
toilet room and
which supports the
wall
and roof above plus some
floor loads are
overstressed in- bending
and
shear (beam and stringer
sizes). Table
25-A-1
d. The 4 x 10 beam over the dumpster which supports equipment
storage (125 lbs psf live load minimum) is overstressed in shear
and bending. Table 23-A, Item 18
Plan Check 1856
Harold Reeves
April 2, 1986
Page Eight
e. The joists should be shown with at least an 1811 clearance to earth.
Section 2516(c)2
f. The underfloor posts should be pressure treated or equivalent.
Section 2516(c)7
4. For the masonry veneer alternative, there should be a #9 gage hori-
zontal joint reinforcement installed at each anchor and the anchors should
be slushed with mortar to provide for compression. Section 3006(d)l
5. Lateral resistance:
a. The lateral design fo r this buiding should be submitted for review.
b. The shear walls such as shown on 1/S1.2 should be connected to
the roof sheathing to provide a continuous lateral transfer.
c. Drag struts should be provided between the shear walls at the
roof level in order to exactly carry the loads into them.
d. The roof plans should show that boundary nailing be applied over
the interior shear walls.
e. The overhangs such as at the entries should be analyzed for the
very large uplift loads which could occur for wind. Section 2311 (f)
f. You should verify that this is in an exposure B area. Otherwise
a redesign should be required.
An invoice for this plan checking service based on the valuation of $240,000
will be forwarded to you under separate cover.
I am retaining all data and plans in anticipation of telephone calls from the
designer and also that I will be doing the recheck. Please instruct him to
indicate on a separate sheet on which sheet or detail the corrections may
be found.
I am also taking the liberty of sending a copy of this list directly to them
in order to facilitate the construction process. Please feel free to contact
me if there are any questions.
rely
y Barbe P. E. ljh
_r
Pegional Manager c/DOAQ
PA *-Y
2)60,e/,OS-7 6s4l
.., 4�j
C,
APPENDIX "A"
The following table setb forth the criteria referred
-60 in Section 10-10-060 D and by this.reference is incor-
porporated therein as if set forth in full.
FIRE -FLOW
(GPM)
Item Affecting Flow
Not to
Required
Requirement
Formula
Exceed
Flow.
Item
1:
Ground area of.Building
in square feet (A)
1000 + A/10
5000
+
Item
2:
Height in Stories (H)
500 (H-1)
3000
Item,
3:
Exposure to and*from
the Building
Judgment.
2000
+
TOTAL
Item
4:.
Deduct for fireproof
semi-'Lirep�roof con-
struction
1/3 (1+2+3)
Item
5:
Add for frame con-
struction
1/3 (1+2+3)
+ <
a
BALANCE
Item
6:
Credit for small fuel
load
1/3 (1+2+3)
Item
7:
for automatic
Judgment
1000
TOTAL FIRE FLOW REQUIRED
0 -S7 6L
TO t 7fm
911n 6z
-rear-
314ol
,j� c4a,
,A,ud A