1996, 07-17 Permit: 96005288 C of O Release RequirementsPre-Final,_Date:; /1/47/tP
l
C;FRTIFICATE OF OCCUPANCY
RELEASE REQUIREMENTS
District: f7
Permit Number: ,1 O o 3-.2'g I
Occupant (if different from owner):
Building Address: 6-5-.2_ y_ f toes. CS/ 4/
Architect:
Legal Description: y6,153, , 88y
63
Contractor:
Owner & Address:
liar" c c1,"i t ifpI, 41
yOil Ade 115-S $n 4i 95..2-07Building
Plans Examiner: ,.
btiPPS
/
Inspector:
e //%
d v
Occupancy Group: GG
Land Use: 1/4 ? S
Mechanical Inspector:
�/
Construction Type: V
/
Occupant Load: /p � e 0/A s
Plumbing Inspector:
❑Plumbing #
Occupied as: 464 /t F /
//e✓
Special Inspection Agency:
�7
I/17
/
dS
Additional information: /
i2, ro✓e/./ 4r "Esti,. J
NREC Inspector:
/
Other:
41, a/45.5/.r crr 0.r a to Jac Ua it 4,-c
❑
Cyaii / /,r
0
Required Approvals
Items Required Complete/Date Initial
Action Required Complete/Date Initial
OMechanical #
0
OSite plan pulled for file
0
OMechanical #
O
❑Landscape plan pulled for file
0
❑Mechanical #
0
❑Drainage plan pulled for file
0
V-
❑Plumbing #
❑
Other plan pulled for file
�7
I/17
/
dS
❑Sprinkler/alarm #
0
❑Final inspection w/corrections
0
❑Demolition #
❑
OReinspection w/corrections
0
❑Other
0
❑Unauthorized occupancy
(Initiate compliance)
0
❑NREC final
0
Approved for Temporary Certificate of Occupancy
Date: by:
❑Special inspection final(s):
Compact/Concrete/Masonry/
Bolting/ Welding/
0
-`Reviewed
- I(
❑Hydrants/knox box/lane
0
Fee:
Expiration Date:
❑Landscaping/irrigation
0
Conditions
0208 drainage
0
❑Engineer certification/208
0
'OParking/paving
0
0 Accessibility
0
❑Critical materials/containment
0
Approved for Certificate of Occu ancy,
Date: 1/Ai /,- a 1 Revi ��d/
7 /4J
ies
0
❑Fire District
0
)fr❑UtiIi
Oonditions
❑Health District
0
OFast Track Certification
0
❑Other
Release date:
Mail to:
Copy to:
T.C.O.:
C.O.:
co 4r• n 7Z4rSQ.. 28--.... /9.3�
ro 9r��G
COMMENTS
CONSTRUCTION PLANS/ROUTING
Date
Date
Date
Active File '
Field
90 Day Hold
Compliance
ACTION: R SCREEN: PRJI USERID: M5TI
H -
BUILDING PERMIT SYSTEM INSPECTION BY PROJECT SCREEN
JURISDICTION= 11 PROJECT= 96005288
INSP INSP INSP TIME TIME
TYPE INIT STAT DATE IN OUT OCUR
01- 99999 RCO A 960711 0000 0000
02-
03-
04-
05-
06-
07-
08-
09-
10-
11-
02 -*L009 HEADER CHANGE
I14li•ab+ w. .
DErARTMENT OF
SSCCIAL ER'IICEESTM
AGING AND ADULT SERVICES ADMINISTRATION
FIRE SAFETY EVACUATION PLAN
WAC 388-76-200(11)
DATE
7/3/1996
An Adult Family Home shall have a posted plan for evacuation to safe areas in event of fire. Draw a diagram of the floor plan
of your home in the space proveded below. Indicate escape routes and designate where staff and residents should meet
outside the residence. Indicate the location of fire extinguisher(s) and smoke detector(s).
INSTRUCTIONS: Provider/Resident Manager completes and posts in a conspicuous location.
Ll,9 hi- Pas
51 c( c
`n
LNInCiP-torn
neEplAc .
.552 YN &e -S1 POrAd
rounci Levek.
ALL STAFF AND RESIDENTS ARE TO MEET IN
THE FRONT YARD AT THE LIGHT POST IN THE SOUTH
WEST CORNER OF THE YARD.'Gaoo
5/O �C etiifs L dA) g rodNc( Z2veC
SD?SMOKE DETECTORS
EXTS EXTINGUISHER
EMERGENCY EGRESS REOUIRMENTS
FROM SLEEPING ROOMS
I I NET CLEAR OPENING • 5.7 SOUARE FEET
21 NET CLEAR OPENING HEIGHT- 24 INCHES
31 NET CLEAR OPENING WIDTH - 20 INCHES
41 FINISHED SILL HEIGHT - 44 INCHES ABOVE
FLOOR MAX)I
k:au i 2E o /N 4-U—
N 6 (2C0yftS
OSHS 21-054 (REV. 05/93)