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REVIEWED BLD2022-0465+Adult_Family_Home_Checklist+4.12.2022_4.00.50_PM+2798317Adult Family Home (AFH) LOCAL BUILDING INSPECTION CHECKLIST Code References: 2015 IRC Section R325 (WAC 51-51) APPLICATION NUMBER: SECTIONS 1. 2. 3. AND 4 MUSTBE COMPLETED By APPLICANTBEFORE INSPECTION WILL BE PROCESSED SITEADDRESS: 415 9th Ave S. Edmonds, WA 98020 PROPER Ty OWNER NAME: Cornelia Brujban-TomICI AFH LICENSEE NAME (IF DIFFERENT): Zbignl@w Barnas SECTION 3 — FLOOR PLAN 00434207103800 ASSESSOR'S TAXIPARCEL#: DAYTIME PHONE: 206-55 0-4785 DAYTIME PHONE:206-423-0564 On a separate sheet of paper (81/2x 11) draw a floor plan (including all floors) of your prospective AFH. Include all sleeping rooms (bedrooms) indicating which bedroom is: A, 61, 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 rac�c�uracy of the information supplied to the jurisdiction as a part of this application. NAME/TITLE: " � n _ DATE: 4/11/22 13PROPERTY,(fiAPPLICANT 13LICENSEE (Effective July 1, 2013.) Effective: 2013 July 01 Updated: 2017 February NAME OF AFH: SECTION MUSTBE COMPLETED BYTHE BUILDING DEPARTMENT IN THE JURISDI CTIONTHE HOME WILL BE LOCATED. PLEASE CHECK ALL APPLICABLE BOXES; MATCH THE LIST BELOW TO THE APPLICANT'S FLOOR PLAN —USING THEIR PROSPECTIVE RESIDENT BEDROOM DESIGNATIONS OF A B CD E AND F AND CLASSIFICATION CODE S, NS1 OR NS2. SECTION 5 — BUILDING INSPECTOR'S INSPECTION CHECKLIST R325.3 Sleeping Room Classification: Each sleeping room in an Adult family Home shall be classified as: Type S—wherethe means of egress contains stairs, elevators or platform lifts to evacuate residents to public area. Type NS1— where 1 means of egress at grade level (has no stairs) or ramp constructed compliant with R325.9 is provided to evacuate residents to public area. Type NS2 — where 2 means of egress at grade level (both have no stairs) or ramps constructed compliant with R325.9 are provided to evacuate residents to public area SLEEPING ROOM A Type S 113 Type NS1 [3 Type NS2 YES NO Closet door/s are readily openablefrom the i nside [3 Yes [3No I Smoke alarm is installed in the bedroom .' 0 Bedroom door opens easily and quickly from the outside when locked 0 0 Sl eepi ng room window has a net opening of 5.7SF (minimum dimensions at I east 24"high; at I east 20"wide) EXCEPT per R310.2.1:at-grade escape wi ndows —may have net clearance opening SF [3 13 Sleeping room window has a maximum sill height of 44" a bovefl oor to clear opening; no steps under winclowallowec 13 13 SLEEPING ROOM B 113 Type S 10 Type NS1 113 Type NS2 YES NO Closetdoor/sare readily openablefromthe inside DYes ONo I Smoke alarm is installed in the bedroom [3 0 Bedroom door opens easily and quickly from the outside when locked 13 13 Sl eepi ng room window has a net opening of 5.7SF (minimum dimensions at I east 24"high; atIeast 20"wide) EXCEPT per R310.2.1: at -grade escape wi ndows —may have net clearance opening 5 SF 0 0 SI eepi ng room window has a maximum sill height of 44" a bovefloor to clear opening; no steps under window a Ilowe 0 0 SLEEPING ROOM C 113 Type S 113TypeNS1 Type NS2 YES NO Closetdoor/sare readily openablefromthe inside JOYes 113No I Smokealarm is installed in the bedroom 0 Bedroom door opens easily and quicklyfrom the outside when locked © 0 Sleeping room windowhas a netopening of 5.7SF (minimum dimensions at least 24"high; at least20" wide) EXCEPT per R310.2.1: at -grade escape wi ndows—may have net clearance opening 5 SF 13 13 0 13 SI eepi ng room window has a maximum sill height of 44" a bove floor to clear opening; no steps under window a Ilowec SLEEPING ROOM D 10 Type S JU Type NS1 I EJ Type NS2 YES NO Closet door/s are readily openablefromthe inside DYes ONo Smokealarmisinstalledinthebedroom 0 13 Bedroom door opens easily and quickly from the outside when locked 13 0 Sleeping room window has a netopeningof 5.7SF (minimum dimensions at least 24"high; atIeast20"wide) EXCEPT per R310.2.1: at -grade escape wi ndows —may have net clearance opening 5 SF [3 13 Sleeping room window has a maximum sill height of 44" a bovefl oor to clear opening; no steps under window a Ilowe SLEEPING ROOM E 113 Type S 113 Type NS1 113 Type NS2 YES NO Closetdoor/sare readily openablefromthe inside DYes JUNo Smoke alarm is installed in the bedroom Bedroom door opens easily and quicklyfromthe outsidewhen locked 13 13 Sleeping roomwindowhas a netopeningof 5.7 SF (minimum dimensions at I east 24"high; at I east 20" wide) EXCEPTper R310.2.1:at-grade escape windows —may have netcl earance opening 5 SF 0 0 Sleeping roomwindowhasa maximum sill height of44" above floor toclear opening; nosteps under window allowe SLEEPING ROOM F 113 Type S 113 Type NS1 Type NS2 YES NO Closetdoor/sare readily openablefrom the inside [3Yes No I Smoke alarm is installed in the bedroom Bedroom door opens easily and quickly from the outside when locked 0 0 Sleeping room window hasa net opening of5.7SF(minimum dimensions atIeast 24"high; at I east 20"wide) EXCEPT per R310.2.1: a t-grade escape wi ndows —may have net clearance opening 5 SF 0 0 Sleeping room window has a maximum sill height of44"abovefloortoclear opening; nosteps under window allowed Effective: 2013 July 01 Updated: 2017 February GENERAL YES NO Bathroom doors are easily and quickly openablefrom the outside when I ocked Q Q Carbon Monoxide alarms are installed as requiredi n R315on eachlevel of the home. Q Q Q Q Smoke a I arms are installed on all levels of the dwel I i ng, in each resident sleeping room, outside each separate sleeping area in the immediatevicinityofsleeping rooms (R314). Smokeand Carbon Monoxide alarms are installed in such a manner scithattheaudiblewarning maybe heard ina 11 parts of the dwelling upon activation of a single device. Access road and water supply meet I ocalfi re j urisdictional requirements. Q Q R325.4 Operable parts of door handles, pulls, latches, locks and other devices installed in AFH shall be operable with one hand and shall not require tight grasping, pinching ortwistingofthe wrist (lever -type). Q Q Pocket doors shall have graspable hardware available when in the closed or open position. R311.8 Ramps YES NO Inside Ramp I N/A Q Q Q R311.8.1 Maximum Slope one unit vertical in twelve units horizontal (8.3%slope). (Exception R311.8.1 Not allowed in AFH) 1171 R311.8.2 Landing Requirements: min. 3X3 foot landingattop/bottom, where doors open onto ramps, and where rampchanges directions. Q Q R325.9.1 Handrails required on both sides of ramp in accordance with R311.8.3.1—R311.8.3.3. Q Q Outside Ramp I N/A YES NO R311.8.1 Maximum Slope one unit vertical in twelve units horizontal (8.3%slope). (Exception R311.8.1 Not allowed in AFH ) R311.8.2 Landing Requirements: min. 3X3 foot landingattop/bottom, where doors open onto ramps, and where rampchanges directions. Q Q 11325.9.1 Handrails required on both sides of ramp in accordancewith R311.8.3.1—R311.8.3.3. Q Q Guards below are depicted vertically as an example only. All Ramps must have Guards Q 1 Q Guard 36" min r Handrail both sides Less than 4" ! 34" - 38" 3'x3'min { II II I l 3' x 3' min anding landing --- -- — T — 3' One unit vertical in twelve units horizontal �— 3 --� minimum is an 8.3% slope all along surface of the ramp. minimum 11311.2 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. Q 0 R325.4 Operable parts of door handles, pulls, latches, locks and other devices installed in AFH shall be operable with one hand and shall not require tight grasping, pinching ortwisting of the wrist (lever -type). Q Q R325.4 Required exit door hardware shall unlock inside and outside mechanisms when exiting the building allowing re-entry without use of key, tool or special knowledge. Q R311.7 Stairways I N/ACFF YES NO R311.7.5.1 Riser Height: Max riser height shall be 7 % inches (8 inches in structures built prior to July 1, 2004) Q Q R311.7.5.2 Tread Depth: Min. tread depth shall be in 10 inches (9 inches in structures built prior to July 1, 2004) R325.10.1 Handrails for Treads and Risers shall be installed on both sides of treads and risers numbering from one riser to multiple risers. Handrailsshall be installed in accordance with R311.7.8.1—R311.7.8.4 Q Q Effective: 2013 July 01 Updated: 2017 February R325.8 Grab Bars in Bathrooms I N/A YES NO Gra b ba rs s ha II be i nsta lied for a I I water closets (toilets), bathtubs and showers according to R325.8. Q Water Closets (toilet) shall have grab bars installed on both sides according to R325.8—R325.8.3.1 or R325.8.3.2. Q Q Bathtubs shall have two vertical and three horizontal grab bars installed according to R325.8-R325.8.4—R325.8.4.2 13 Shower stalls have two vertical and horizontal grab bars mounted on all sides of shower accordingto R325.8— R325.8.5 - 0 R325.8.5.2. Shower stalls must be minimum size of30 inches deep by48 inches long (R325.11) AG103 — AG105 Swimming Pool, Spa, Hot Tub YES NO AF105.2 Must be surrounded by a barrier that is 48 inches high, may have doors and or gates that must have audible alarms when opened. AG105.5 EXCEPTION: Pools, Spas or Hot Tubs with a safety cover which complies with ASTM F 1346 0 PASSED 0 CORRECTIONS REQUIRED 0 PERMIT REQUIRED INSPECTOR'S NAME (PRINT) INSPECTOR'S SIGNATURE DATE: INSPECTOR'S OFFICE ADDRESS T 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. 07/01/2013 Effective: 2013 July 01 Updated: 2017 February