AFH CHECKLISTForm #B3
PERMIT SUBMITTAL REQUIREMENTS FOR
Adult Family Home
"?C. 1,0'
PERMITTING & DEVELOPMENT
BUILDING
DIVISION
121 5th Avenue N
P: 425.771.0220
www.ed mondswa.gov
ADULT FAMILY HOMES:
Adult Family Homes are private residential homes
licensed by the Department of Social and Health
Services (DSHS) that contain living facilities (including
provisions for sleeping, eating, cooking and sanitation
and where personal care, special care, and room and
board are) for six (6) or fewer residents.
PERMIT REQUIRED:
1) A Compliance Permit and City inspections
(building and fire code) are required for all Adult
Family Homes (including change of ownership on
pre-existing approved homes). Minimum life -
safety dwelling requirements, i.e., for egress
windows or doors, smoke alarms (detectors), fire
walls, and minimum light and ventilation in
habitable spaces, etc. is verified.
2) A remodel or addition permit is required for
existing or new Adult Family Homes in which
alterations will be made to the residence.
LOCAL SIGN REGULATIONS:
Because commercial signs are not permitted in single
family zones, signs identifying licensed Adult Family
Homes located in single family zones may not include
advertising or identify the home as a commercial
operation. Signs for Adult Family Homes may contain
information such as the name, address or phone
number of the home, and shall not exceed four (4)
square feet in area (no sign permit is required). For
more information on signs for Adult Family Homes that
are located in commercial zones contact the Planning
Division for sign area limitations, design criteria and
permitting requirements.
SUBMITTAL REQUIREMENTS:
1) Complete page one of the DSHS inspection
checklist and upload with your other application
documents. Pages 7,8 and 9 shall be completed
by the City Building Inspector.
Link to DSHS Inspection checklist:
https://www.dshs.wa.gov/sites/default/files/ALT
SA/res/documents/afh/AFH%20Loca1%2OBui Id
%201nspection%20Check1 ist. pdf
2) PROVIDE FLOOR PLAN OF THE HOME WITH THE
FOLLOWING INFORMATION:
❑ Designate the use and size of all rooms and
spaces including headroom (i.e., living room 10
feet by 12 feet, 8 foot ceiling, etc.)
❑ Dimension all sleeping rooms, windows and
doors. Indicate windowsill height.
❑ Show smoke alarms (detectors).
❑ Show location of all heating appliances and
thermostats, (i.e., furnace, wall heaters, etc.)
❑ Each sleeping room shall be designated by at least
one of the following State Licensing code
requirements:
• Type S — where the means of egress contains
stairs, elevators or platform lifts.
• Type NS1 — where one means of egress is at
grade level or a ramp is constructed in
accordance with IRC Section 311.8 is provided.
• Type NS2 — where two means of egress from
the sleeping room are at grade level or ramps
constructed in accordance with IRC Section
311.8 are provided.
Updated on 3.15.21 Page 1 of 2
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Indicate the path of travel (including stairs, ramps,
platform lifts, etc.) from sleeping rooms to a yard,
alley or public way (i.e., street or alley)
If a ramp will be installed, separate permit
approval is required regardless of height or size.
To obtain a Ramp Permit provide construction
details of how it will be constructed and a site plan
showing where it will be located.
EACH SLEEPING ROOM IN THE ENTIRE RESIDENCE
SHALL MEET THE FOLLOWING REQUIREMENTS:
Emergency egress. Egress is provided by either a
door that leads directly to the outside OR a window
with a minimum net clear openable area of 5.7
square feet (5.0 sq ft minimum if at grade level).
Windows must have a minimum clear openable
height of 24 inches and minimum clear openable
width of 20 inches. The window sill height cannot
be more than 44 inches above the finished floor.
No alternatives to the sill height such as steps,
raised platforms, or other devices placed by the
openings will be approved as meeting this
requirement.
Smoke alarms are required in each sleeping room
throughout the entire residence, in the outside
hallway of all sleeping room areas and on each floor
of the residence. All smoke alarms shall be
hardwired and interconnected throughout the
entire home 0RC 314.2). Wiring shall be
permanent without a disconnecting switch. Alarms
shall sound an alarm audible in all sleeping areas of
the dwelling unit in which they are located.
All bedroom and bathroom doors shall be openable
from the outside when locked. Every closet that is
provided with a door lock shall be readily openable
from the inside.
A Fire Exit plan shall be developed for emergency
evacuation of residents and must be submitted to
the City for review with the compliance permit.
Once approved, the Fire Exit plan shall be posted in
the house in a conspicuous place.
Show location of fire extinguishers. Note, a
minimum of 2-A:10-B:C fire extinguisher shall be
provided at an approved location and be easily
accessible.
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CITY BUILDING & FIRE INSPECTION REQUIREMENTS:
The following is inspected by City Building and
Fire District 1 inspectors for compliance to the
codes.
❑ Address numbers shall be placed in a conspicuous
place on the exterior of the building to be plainly
visible and legible from the street or road fronting
the property. Minimum size 6 inch letters of 3/4 inch
stroke in a contrasting color to the building.
❑ Fire Extinguishers
❑ Fire Exit Plan
❑ Accuracy of floor plan
❑ Location, hard -wiring and interconnection of all
required smoke alarms
❑ Inspection Checklist (pages 4, 5 and 6 of the form)
shall be completed by the City Building Inspector.
Any items needing correction that are noted during
this inspection will require re -inspection for final
approval.
Note: Site inspections may reveal additional
requirements and/or violations unrelated to the Adult
Family Home which must be resolved before occupancy
is granted and the City business license issued.
FINAL APPROVAL REQUIREMENTS AND ISSUANCE OF
CITY BUSINESS LICENSE:
The Adult Family Home provider shall submit a copy of
the State Department of DSHS Adult Family Home
License to the Building Official within 10 days of receipt
from the State.
After the inspection has been approved and the State
License has been received the City Business License will
be issued. Note, the Provider is required to have a City
business license prior to receiving residents. (Chapter
4.72 Edmonds City Code)
APPLY ONLINE:
Mybuildinaaermit.com
Adult Family Home (AFH) LOCAL BUILDING INSPECTION CHECKLIST
Code References: 2018 IRC Section R330 (WAC 51-51)
APPLICATION NUMBER: BLI)
SECTIONS 1, 2, 3. AND 4 MUST BE COMPLETED BY APPLICANT BEFORE INSPECTION WILL BE PROCESSED
SECTIONPROPERTY"•' •
SITE ADDRESS: / v �-lJi ASSESSOR'STAX/PARCELo��66o00AIo�
PROPERTY OWNER NAME: e ` 2 G lit ! �I C� �. t� DAYTIME PHONE: �ff" Off"—
AFH LICENSEE NAME (IF DIFFERENT):
SECTION 3 - FLOOR PLAN
DAYTIME PHONE:
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.
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and that I am
requesting or I am authorized by the owner of the above premises to request inspection for the operation of an Adult Family Home
at this location. I agree to hold harmless the jurisdiction conducting such inspections, at my request, as to any claim (including costs,
expenses, and attorneys' fees incurred in the investigation of such claim), which may be made by any person, including the undersigned,
and filed against the jurisdiction, but only where such claim arises out of the reliance of the jurisdiction, including its officers and
employees, upon the accuracy of the information supplied to the jurisdiction as a part of this application,
NAME/TITLE: DATE:
OPROPERTY OWNER QAPPLICANT Q LICENSEE
Implementation Date: 2021 February 01
Updated: 2021 February
(Effective Feb. 1, 2021
WAC 51-51-0330
Section R330 — Adult family homes.
SECTION R330
ADULT FAMILY HOMES
R330.1 General. This section shall apply to all newly constructed adult family homes and all existing single family homes being
converted to adult family homes. This section shall not apply to those adult family homes licensed by the state of Washington
department of social and health services prior to July 1, 2001.
R330.2 Reserved.
R330.3 Sleeping room classification. Each sleeping room in an adult family home shall be classified as:
1. Type S - Where the means of egress contains stairs, elevators or platform lifts.
2. Type NS1 - Where one means of egress is at grade level or a ramp constructed in accordance with R330.9 is provided.
3. Type NS2 - Where two means of egress are at grade level or ramps constructed in accordance with R330.9 are provided.
R330.4 Types of locking devices and door activation. All bedroom and bathroom doors shall be openable from the outside when
locked.
Every closet shall be readily openable from the inside.
Operable parts of door handles, pulls, latches, locks and other devices installed in adult family homes shall be operable with one
hand and shall not require tight grasping, pinching or twisting of the wrist. Pocket doors shall have graspable hardware available
when in the closed or open position.
The force required to activate operable parts shall be 5.0 pounds (22.2 N) maximum. Required exit doors shall have no additional
locking devices.
Required exit door hardware shall unlock inside and outside mechanisms when exiting the building allowing reentry into the adult
family home without the use of a key, tool or special knowledge.
R330.5 Smoke and carbon monoxide alarm requirements. All adult family homes shall be equipped with smoke and carbon
monoxide alarms installed as required in Sections R314 and R315.1. Alarms shall be installed in such a manner so that the
detection device warning is audible from all areas of the dwelling upon activation of a single alarm.
R330.6 Escape windows and doors. Every sleeping room shall be provided with emergency escape and rescue windows as
required by Section R310. No alternatives to the sill height such as steps, raised platforms or other devices placed by the openings
will be approved as meeting this requirement.
R330.7 Fire apparatus access roads and water supply for fire protection. Adult family homes shall be served by fire apparatus
access roads and water supplies meeting the requirements of the local jurisdiction.
R330.8 Grab bar general requirements. Where facilities are designated for use by adult family home clients, grab bars for water
closets, bathtubs and shower stalls shall be installed according to this section.
R330.8.1 Grab bar cross section. Grab bars with a circular cross section shall have an outside diameter of 1 1 /4 inches minimum
and 2 inches maximum. Grab bars with noncircular cross section shall have a cross section dimension of 2 inches maximum and a
perimeter dimension of 4 inches minimum and 4 5/8 inches maximum.
R330.8.2 Grab bar installation. Grab bars shall have a spacing of 1 1/2 inches between the wall and the bar. Projecting objects,
control valves and bathtub or shower stall enclosure features above, below and at the ends of the grab bar shall have a clear space
of 1 1/2 inches to the grab bar.
EXCEPTION: Swing -up grab bars shall not be required to meet the 1 1/2 inch spacing requirement.
Grabs bars shall have a structural strength of 250 pounds applied at any point on the grab bar, fastener, mounting device or
supporting structural member. Grab bars shall not be supported directly by any residential grade fiberglass bathing or showering
unit. Acrylic bars found in bathing units shall be removed.
Fixed position grab bars, when mounted, shall not rotate, spin or move and have a graspable surface finish.
R330.8.3 Grab bars at water closets. Water closets shall have grab bars mounted on both sides. Grab bars can be a combination
of fixed position and swing -up bars. Grab bars shall meet the requirements of R330.8. Grab bars shall mount between 33 inches
and 36 inches above floor grade. Centerline distance between grab bars, regardless of type used, shall be between 25 inches
minimum and 30 inches maximum.
Implementation Date: 2021 February 01
Updated: 2021 February
R330.8.3.1 Fixed position grab bars. Fixed position grab bars shall be a minimum of 36 inches in length and start 12 inches from
the rear wall.
R330.8.3.2 Swing -up grab bars. Swing -up grab bars shall be a minimum of 28 inches in length from the rear wall.
R330.8.4 Grab bars at bathtubs. Horizontal and vertical grab bars shall meet the requirements of R330.8.
R330.8.4.1 Vertical grab bars. Vertical grab bars shall be a minimum of 18 inches long and installed at the control end wall and
head end wall. Grab bars shall mount within 4 inches of the exterior of the bath tub edge or within 4 inches within the bath tub. The
bottom end of the bar shall start between 36 inches and 42 inches above floor grade.
EXCEPTION: The required vertical grab bar can be substituted with a floor to ceiling grab bar meeting the
requirements of R330.8 at the control end and head end entry points.
R330.8.4.2 Horizontal grab bars. Horizontal grab bars shall be provided at the control end, head end, and the back wall within the
bathtub area. Grab bars shall be mounted between 33 inches and 36 inches above floor grade. Control end and head end grab bars
shall be 24 inches minimum in length. Back wall grab bar shall be 36 inches minimum in length.
R330.8.5 Grab bars at shower stalls. Where shower stalls are provided to meet the requirements for bathing facilities, grab bars
shall meet the requirements of R330.8.
EXCEPTION: Shower stalls with permanent built-in seats are not required to have vertical or horizontal grab
bars at the seat end wall. A vertical floor to ceiling grab bar shall be installed within 4 inches of
the exterior of the shower aligned with the nose of the built-in seat.
R330.8.5.1 Vertical grab bars. Vertical grab bars shall be 18 inches minimum in length and installed at the control end wall and
head end wall. Vertical bars shall be mounted within 4 inches of the exterior of the shower stall or within 4 inches inside the shower
stall. The bottom end of vertical bars mount between 36 inches and 42 inches above floor grade.
R330.8.5.2 Horizontal grab bars. Horizontal grab bars shall be installed on all sides of the shower stall mounted between 33
inches and 36 inches above the floor grade. Horizontal grab bars shall be a maximum of 6 inches from adjacent walls. Horizontal
grab bars shall not interfere with shower control valves.
R330.9 Ramps. All interior and exterior ramps, when provided, shall be constructed in accordance with Section R311.8 with a
maximum slope of 1 vertical to 12 horizontal. The exception to R311.8.1 is not allowed for adult family homes. Handrails shall be
installed in accordance with R330.9.1.
R330.9.1 Handrails for ramps. Handrails shall be installed on both sides of ramps between the slope of 1 vertical to 12 horizontal
and 1 vertical and 20 horizontal in accordance with R311.8.3.1 through R311.8.3.3.
R330.10 Stair treads and risers. Stair treads and risers shall be constructed in accordance with R311.7.5. Handrails shall be
installed in accordance with R330.10.1.
R330.10.1 Handrails for treads and risers. Handrails shall be installed on both sides of treads and risers numbering from one riser
to multiple risers. Handrails shall be installed in accordance with R311.7.8.1 through R311.7.8.4
R330.11 Shower stalls. Where provided to meet the requirements for bathing facilities, the minimum size of shower stalls for an
adult family home shall be 30 inches deep by 48 inches long.
[Statutory Authority: RCW 19.27.031 and chapters 19.27 and 34.005 RCW. 13-04-068, § 51-51-0325, filed 2/1/13, effective 7/1113. Statutory
Authority: Chapter 19.27 RCW. 10-18-036, § 51-51-0325, filed 8/25/10, effective 9/25/10. Statutory Authority: RCW 19.27.190, 19.27.020, and
chapters 19.27 and 3405 RCW. 09-04-023, § 51-51-0325, filed 1/27/09, effective 7/1/10. Statutory Authority: RCW 19.27.074, 19.27.020, and
chapters 19.27 and 3405 RCW. 07-01-090, § 51-51-0325, filed 12/19/06, effective 7/1/07. Statutory Authority: RCW 19.27.031 and 19.27.074. 04-
01-109, § 51-51-0325, filed 12/17/03, effective 7/1/04.][Statutory Authority: RCW 19.27.031 and 19.27.074. WSR 20-03-023, § 51-51-0330, filed
1/6/20, effective 7/1/20.]
Implementation Date: 2021 February 01
Updated: 2021 February
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UPPED FLOOP PLAN
SCALE: NTS
SECTION 5 MUST BE COMPLETED BY THE BUILDING DEPARTMENT IN THE JURISDICTION THE HOME WILL BE LOCATED.
PLEASE CHECK ALL APPLICABLE BOXES; MATCH THE LIST BELOW TO THE APPLICANT'S FLOOR PLAN — USING THEIR PROSPECTIVE
RESIDENT BEDROOM DESIGNATIONS OF A B CD E AND F AND CLASSIFICATION CODE S, NS1 OR NS2.
R330.3 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 R330.9 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 compliant with R330.9 are provided to
evacuate residents to public area.
SLEEPING ROOM A 10TYpe S JDType NS1 O Type NS2
YES
NO
Closet door/s are readily openable from the inside 0 Yes I 0 No ON/A I Smoke alarm is installed in the bedroom
O
0
Bedroom door opens easily and quickly from the outside when locked
0
O
Sleeping room window has a net opening of 5.7 SF (minimum dimensions at least 24"high; at least 20" wide)
EXCEPT per R310.2.1: at -grade escape windows — may have net clearance opening 5 SF
O
O
Sleeping room window has a maximum sill height of 44" above floor to clear opening; no steps under window allowed
O
O
SLEEPING ROOM B. O Type S 10 Type NS1 113Type NS2
YES
NO
Closet door/s are readily openable from the inside 0 Yes 0 No ON/A I Smoke alarm is installed in the bedroom
0
O
Bedroom door opens easily and quickly from the outside when locked
O
O
Sleeping room window has a net opening of 5.7 SF (minimum dimensions at least 24"high; at least 20" wide)
EXCEPT per R310.2.1: at -grade escape windows — may have net clearance opening 5 SF
O
O
Sleeping room window has a maximum sill height of 44" above floor to clear opening; no steps under window allowed
O
O
SLEEPING ROOM C IOType S JOType NS1 IDType NS2
YES
NO
Closet door/s are readily openable from the inside 0 Yes 0 No I ON/A I Smoke alarm is installed in the bedroom
O
O
Bedroom door opens easily and quickly from the outside when locked
O
O
Sleeping room window has a net opening of 5.7 SF (minimum dimensions at least 24"high; at least 20" wide)
EXCEPT per R310.2.1: at -grade escape windows — may have net clearance opening 5 SF
O
O
Sleeping room window has a maximum sill height of 44" above floor to clear opening; no steps under window allowed
O
0
SLEEPING ROOM D O Type S O Type NS1 I O Type NS2
YES
NO
Closet door/s are readily openable from the inside 10 Yes 0 No ON/A I Smoke alarm is installed in the bedroom
O
0
Bedroom door opens easily and quickly from the outside when locked
0
0
Sleeping room window has a net opening of 5.7 SF (minimum dimensions at least 24"high; at least 20" wide)
EXCEPT per R310.2.1: at -grade escape windows — may have net clearance opening 5 SF
O
O
Sleeping room window has a maximum sill height of 44" above floor to clear opening; no steps under window allowed
0
O
SLEEPING ROOM E JOType S JDType NS1 113Type NS2
YES
NO
Closet door/s are readily openable from the inside JCJ Yes O No ON/A I Smoke alarm is installed in the bedroom
0
0
Bedroom door opens easily and quickly from the outside when locked
0
O
Sleeping room window has a net opening of 5.7 SF (minimum dimensions at least 24"high; at least 20" wide)
EXCEPT per R310.2.1: at -grade escape windows — may have net clearance opening 5 SF
0
13
Sleeping room window has a maximum sill height of 44" above floor to clear opening; no steps under window allowed
O
O
SLEEPING ROOM F JDType S JDType NS1 113Type NS2
YES
NO
Closet door/s are readily openable from the inside 0 Yes I 0 No I ON/A I Smoke alarm is installed in the bedroom
O
O
Bedroom door opens easily and quickly from the outside when locked
0
O
Sleeping room window has a net opening of 5.7 SF (minimum dimensions at least 24"high; at least 20" wide)
EXCEPT per R310.2.1: at -grade escape windows — may have net clearance opening 5 SF
O
O
Sleeping room window has a maximum sill height of 44" above floor to clear opening; no steps under window allowed
O
O
Implementation Date: 2021 February 01
Updated: 2021 February
GENERAL
YES
NO
Bathroom doors are easily and quickly openable from the outside when locked
0
13
Carbon Monoxide alarms are installed as required in R315 on each level of the home.
Q
0
Smoke alarms are installed on all levels of the dwelling, in each resident sleeping room, outside each separate
sleeping area in the immediate vicinity of sleeping rooms (11314).
0
0
Smoke and Carbon Monoxide alarms are installed in such a manner so that the audible warning may be heard in all
parts of the dwelling upon activation of a single device.
13
13
Access road and water supply meet local fire jurisdictional requirements.
E3
1 13
R330.4 Operable parts of door handles, pulls, latches, locks and other devices installed in AFH shall be operable
with one hand and shall not require tight grasping, pinching or twisting of the wrist (lever -type).
a
Pocket doors shall have graspable hardware available when in the closed or open position.
El
0
R311.8 Ramp
I
YES
NO
Inside Ramp
I N/A [31
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a
R311.8.1 Maximum Slope one unit vertical in twelve units horizontal (8.3% slope). (Exception R311.8.1 Not allowed in j
0
0
R330.9)
R311.8.2 Landing Requirements: min. 3X3 foot landing at top/bottom, where doors open onto ramps, and where
ramp changes directions.
13
0
R330.9.1 Handrails required on both sides of ramp.
0
Outside Ramp I N/A 0 1
YES
NO
R311.8.1 Maximum Slope one unit vertical in twelve units horizontal (8.3% slope). (Exception R311.8.1 Not allowed in A
13
13
R330.9)
R311.8.2 Landing Requirements: min. 3X3 foot landing at top/bottom, where doors open onto ramps, and where
a
ramp changes directions.
R330.9.1 Handrails required on both sides of ramp.
E3
0
R312.1.1 Guards shall be located along open -sided walking surfaces, that are located more than 30 inches measured
0
1:1
vertically to the floor or grade below at any point within 36 inches horizontally to the edge of the open side.
Guards below are depicted vertically as an example only.
Guard
36" min
Handrail both sides
Less than 4" F 34" - 38"
3'x3'min
landing
3'x3'min
3' I One unit vertical in twelve units horizontal 3 —
minimum is an 8.3% slope all along surface of the ramp. minimum
Implementation Date: 2021 February 01
Updated: 2021 February
R311.2 Means of Egress _ _
YES
NO
R311.2 Door must be side -hinged with min. width of 32 inches between face of door and stop. Height not less than 78 inches.
R330.4 Operable parts of door handles, pulls, latches, locks and other devices installed in AFH shall be operable with one hand
and shall not require tight grasping, pinching or twisting of the wrist (lever -type).
[3
0
R330.4 Required exit door hardware shall unlock inside and outside mechanisms when exiting the building allowing re-entry
Q
Q
without use of key, tool or special knowledge.
R311.7 Stairways I N/A Q 1
YES
NO
R311.7.5.1 Riser Height: Max riser height shall be 7 Y4 inches (8 inches in structures built prior to July 1, 2004)
R311.7.5.2 Tread Depth: Min. tread depth shall be in 10 inches (9 inches in structures built prior to July 1, 2004)
0
0
R330.10.1 Handrails for Treads and Risers shall be installed on both sides of treads and risers numbering from one riser to multiple
risers. Handrails shall be installed in accordance with R311.7.8.1— R311.7.8.4
R330.8 Grab Bars in Bathrooms I N/A
YES
NO
Grab bars shall be installed for all water closets (toilets), bathtubs and showers according to R330.8.
0
0
Water Closets (toilet) shall have grab bars installed on both sides according to R330.8.3
Q
0
Bathtubs shall have two vertical and three horizontal grab bars installed according to R330.8.4
Q
0
Shower stalls have two vertical and horizontal grab bars mounted on all sides of shower according to R330.8.5
Q
Shower stalls must be minimum size of 30 inches deep by 48 inches long (R330.11)
Q
Q
Q PASSED
NAME OF AFH:
Adult Family Home Project Address
BUILDING DEPT. INSPECTOR'S NAME (PRINT)
BUILDING DEPT. INSPECTOR'S SIGNATURE DATE:
BUILDING DEPT. OFFICE ADDRESS OFFICE PHONE NUMBER:
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 in accordance with WAC 388-76-10700.
Implementation Date: 2021 February 01
Updated: 2021 February