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'APPLICANT� ON BEHALF OF file OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
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Letter of Transmittal
September 27, 2002 fit Washington State Department of
ioHealth
Construction Review Services
2725 Harrison Ave. NW Suite 500
PO Box 47852
Olympia, Washington 98504-7852 i
JEANNINE GRAF cot
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Post rd
CITY OF EDMONDS
Field inspect
121-5TH AVENUE NORTH
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EDMONDS WA 98020-3146 =i
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Project Info:
00-72n' Avenue West
CRS# 6715 Project 214
Aldercrest Health & Rehab Center location: Edmonds WA 98026-7702 a m
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Chapter 388-97 WAC Nursing Homes M 0
Renovation
Key People: C
Facility km-olel m
Facility Skip McDonald
Administrator: 21400-72n' Avenue West Contact: 10:4
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Edmonds WA 98026-7702
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(425) 775-1961 E:
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Architect Nor -Tex Building, Inc. Building City of Edmonds "n za
Official: Jeannine Graf
Engineer: Jerry Jennings . m
2205 West Division, Suite B-8 121_51h Avenue North
Edmonds WA 98020-3146
Arlington TX 76012 0
(817) 226-0088
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nortexjj@aol.com M 0'
Review Staff -
Fire & Life Chad E. Beebe, CS1 Architect: Richard M. Swanson
Safety and chad.beebe@doh.wa.gov richard.swanson@doh.wa.gov
Program (360) 705-6648 (360) 705-6782
Manager: Z.
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Sanitarian: John R. Templar, R.S. Mech. William M. Kingrey, PE
Electrical: william.kingray@tJoh.wat.gov
john.templar@tJoh.wa.gov
(360) 705-6783 z
(360) 705-6786
Small Projects Douglas Taylor Small Projects, Rob Bradley
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bert.bradley@doh.wa.gov
Reviewer: dougIas.tavlor@doh,wa.gqv Reviewer: Lo
(360) 705-6628 (705) 705-6685
Copies To:
Local Building Official: City of Edmonds E:I DOH Child Birth Center Licensing
DOH Office of Accommodations & Res. Care Survey 0 Washington State Patrol, Fire Protection Bureau
0 DSHS, Deb Burman, Aging & Adult Services Administration
DOH Office of Health Care Survey
Aichitect/Engineer.- Nor -Tex Building, Inc. E3 Other:
[71 Other:
0 Sub -Contractor;
CRS File
Sub -Contractor:
Page I of 4 Plan Review Comments for Project #6715
Aldercrest Health & Rehab Center
Chapter 388-97 WAC Nursing Homes
Renovation
Memo:
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NOW
The construction documents for your project have been reviewed per Chapter 388-97 WAC Nursing Homes (NH) and
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found acceptable. The stamped approved copy of the documents shall be kept and available for the licensing staff on
site. Please note the following:
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CI Nursing Home regulations do not allow occupancy of the completed project area until authorized by DSHS
Residential Care Services.
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a Final licensing approval is subject to a site inspection by DSHS Residential Care Services to verify
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compliance with Nursing Home regulations.
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The enclosed "PINIC' construction completion card must::be returned to this office before occupancy once you have
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we receive this card, we will close your project F
completed construction. When fle and notify DSHS Residential Care
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Services that you have completed the review process.
If you have any questions please feel free to contact Con :truction Review Services.
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Please take a few moments and fill out our online surveynt www.doh.wa.gov/crs.
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Page 2 of 4 Plan Review Comments for Project # 6715
ReviewKey: A=Architect F=Fire&LilcSalcty S=Sanitarian:: M =Mechanical /Electrical SP=Small Projects C= Conference Note
Facility Name: Aldercrest Health & Rehab Center Facility ID: 007667
Site Address: 21400-72nd Avenue West
Edmonds WA 98026-7702
Facility Data:
Occupancy Group: Construction Type: Applicable Code:
Number of Apartment units: Private occupancy: Two person occupancy:
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4
Automatic Fire Sprinkler System: M13 M13R [I 13D E3 Not Applicable
Automatic Fire Alarm System: Yes n Not Applicable
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Compartmentation on all floors required: [:]Yes nNot Applicable
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Special Egress Control Devices:
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Approved Smoke Control System: nYes nNo
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Maximum allowable licensable Beds:
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Based on size of rooms used for sleeping Residents
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Based on size of common rooms Residents
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The data above is based on the information presented to the Department of Health Construction Review Services.
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Any change in the facility or facility program that causes the above information to be incorrect is subi tto,
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review by DOH Construction Review Services. Approval for construction is not appr oval for licensure. A copy of
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this certificate will be sent to the licensing agency.
Approving ��ty
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Page 3 of 4 Plan Review Comments for Project 6715
Review Key: A Architect F Fire & Life Safety S Sanitarian M Mechanical Electrical SP=Small Projects C Conference Not-
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Aldercrest Health & Rehab Center
Chapter 388-97 WAC Nursing Homes
Renovation
Plan Review Comments
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IM The DOI -l/CRS Small Projects Specialist has reviewed and approved this project for
compliance with applicable regulations and codes. 09/26/2002
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Page 4 of 4 Plan Review Comments for Project # 6715
ReviewKey: A=Architect F--� Fire St Lire Safety S=Sanitarian M =Mechanical /Electrical SP=SmallProjects C Conference Note
INSPECTOR DATE APPROVED
SETBACKS ....................
FOUNDATION:
Footing......................
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Pier/Porch .................
Retaining.Wall ...........
Slab Insulation ..........
PLUMBING:
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Commercial Final
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NAILING ........... ..............
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FRAMING ... .............
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FIRST FLOOR FRAMING
INSULATION ...............
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Calling Insulation
SHEETROCK NAILING
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