2000, 08-10 Permit App: 00007030 Adult Family HomeProject Number: 00007030
Inv: 1
. Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 08/10/2000 Page 1 of 2
Project Information:
Permit Use: ADULT FAMILY HOME W/CLIENTS I, II, III
Setbacks: Front Left:
Right: Rear:
Site Information:
Plat Key: 000000 Name: UNKNOWN
Parcel Number: 45083.0111 Block:
Contact: GAMBILL, VERNON
Address: 9515 E SHANNON AVE
C - S - Z: SPOKANE, WA 99206-4126
Phone: (509) 926-6186
Group Name:
Project Name:
Lot:
District: H
SiteAddress: 9515 E SHANNON AVE Owner: Name: GAMBILL, VERNON
SPOKANE, WA USA 00000 Address: 9515 E SHANNON AVE
Location:: SPO SPOKANE, WA 99206-4126
Zoning: UR -3.5
Water District:
Area: 32,228 Sq Ft
Nbr of Bldgs: 0
Review Information:.
Urban Residential 3.5
Width: 0
Nbr of Dwellings: 0
Department Review
BUILDING
Hold Reasons:
Permit Conditions:
BUILDING
Hold Reasons:
Permit Conditions:
Permits:
Site Plan Review
Plan Review
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Contractor: OWNER
Address: 0
000000, 00 000000
Building Permit
Firm: OWNER
Phone: (000) 000-0000
Building Characteristics
Const Category: Change Of Use
Nbr Of Dwellings: Occupant Load:
Bldg W x D: x Building Sq Ft:
Req Parking: Handicap Parking:
Group: LC -3 Type:
Building Height:
Sprinklers: ❑
Critical Materials: ❑
Item Description
CHANGE OF USE/SAFETY INSP
STATE SURCHARGE
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
Permit Total Fees:
Stories:
Fee Amount
$50.00
$4.50
$54.50
Project Number: 00007030 Inv: 1
Application.
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 08/10/2000 Page 2 of 2
Payment Summary:
Operator: DMD
Permit Type
Building Permit $54.50
Printed By: DMD
Print Date:
08/10/2000
Fee Amount Invoice Amount Amount Paid Amount Owing
$54.50
$54.50
Notes:
$54.50 $0.00
$54.50
$0.00
$54.50
SPOIcAlkE COUNCY
Project Description:
PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675 ( -- 7030
r0/117 �a)v/rA)--)2,76-
E
OF APPLICATION
O Building Permit
O Change in Use
O Grading
O Manufactured Home Permit
O Relocation
O Sign
O Tenant (New/Change)
O Other
SPECIFIC SITE INFORMATION
Street Address:
Assessor's Tax Parcel NumberTs)
Legal Description:
Department Ilse Only
Water District/Purveyor:
School District:
Sewer District/Purveyor
Fire District:
Setbacks"
Front:
Zoning
Left:
OWNER/APPLICANT INFORMATION
El Indicate who should be contacted regarding this project
Own(er: J/ / 7 io1 Phone: �X/�,t:
Manufactured Horne
Sign
Width:
Length:
What is the square footage of the sign
face?
How high is the sign?
Year:
Make:
# of signs
Area of existing signs
Relocation
Previous address
Fire :Safety
Fire Sprinkler
Paint booth Fire Alarm
Tent
Fireworks display
Proposed use
Value
Special Inspections Required?
Non -Residential Energy Code Compliance?
Firm Name
Phone
Plans Examiner
Phone
Inspectors:
Address
Inspector
Phone
O Concrete 0 Welding 0 Bolting 0 Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? 0 Yes 0 No
If yes, identify on site plan
What is the current property size?
(square feet or acres)
Is any part of the property within 250 feet of a shoreline?
If yes, identify on site plan 0 Yes 0 No
What is the current use of this property?
Is your property in a designated wildlife habitat area?
0 Don't know 0 Yes 0 No
Will the site be served by a septic system? 0 Yes 0 No
Is any part of the property within a 100 yr flood plain?
If yes, identf on site plan
0 Maybe 0 Don't know 0 Yes 0 No
Are or will there be wells located on the property?
If yes, identify on the site plan 0 Yes 0 No
Are there any wetlands, streams or ponds within 200 feet of the
property?
If yes, ident 6 on site plan 0 Yes 0 No
Is there evidence of fill or excavation on the property?
0 Yes 0 No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( /T) 0 Yes 0 No
Are critical or hazardous materials used or stored on site?
0 Yes 0 No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater.Control Area?
0, Yes O No
Is public sewer available to the site? 0 Yes 0 No
Is the property inside the ASA?
0 Yes '
O Yes
0 No
O No
Is public water available to the site? 0 Yes 0 No
Is the property inside the PSSA?
0 Yes
0 No
Is the property located within 1000 feet of a Natural Resource
Area? 0 Yes 0 No
Date Received:
Staff Representative:
Pre -Final Date: 7/;
CERTIFICATE OF OCCUPANCY
RELEASE REQUIREMENTS
District:
Building Address: C,_i---/.3--- .- J>f, „ 0
Architect:
O
0 208 Drainage
Permit Number: 00 _ , V. G
Contractor:
0 Mechanical #
'O
Legal Description: S g-3 ) // /
Plans Examiner: pa,),
,o.
0 Mechanical #
O'.
Owner & Address: VBuilding
E/4 C1-Clir�t� /1
Inspector: ��
Mechanical Inspector:
0 Grading
0
-5" 4✓/ l , j
Plumbing Inspector:
0 Landscape/Irragation
O
Occupancy Group: Z.- C
Critical Materials: /,///
Special Inspection Agency:
❑ Parking/Paving
0
/ /
Construction Type: V,i
Sprinkler: 11 )0
NREC Inspector:
❑ Health District
0
Occupied as/Occupant 4/j/ >�U.rn, / Gcp i /amu //„M///
y ��//
Compliance Coordinator:
,
/, p.e:
❑ Demolition
/,
t- e /&t€
„r9.) e,./ /4/' 31-11,),Ie/' f /0"1- J /e1-/2 rrX A'
/S
Al// C X-.1----5-1,
Get ----/HS
Li°✓act/aAeL, c5,.. 1///�
kilt -A. -a(' f- e
' Accessibili4.,16 / e A fy -0 e
.lit
47-=,1 I- d d
1- A_
0 Fire Hydrants/Knox Box/Lane
O \
N7-/
`
0 Utilities
REQUIRED APPROVALS
ITEMS REQUIRED Complete/Date Initial ITEMS REQUIRED Complete/Date Initial
❑ Mechanical # \
O
0 208 Drainage
O
0 Mechanical #
'O
0 Design Deviation/208
0
0 Mechanical #
O'.
0 Engineer Certification/208
0
0 Grading
0
,,
0 Landscape/Irragation
O
❑ Plumbing #,
O
❑ Parking/Paving
0
❑ Health District
0
\
❑ Demolition
0
❑ Fire Sprinkler
a
kilt -A. -a(' f- e
' Accessibili4.,16 / e A fy -0 e
.lit
47-=,1 I- d d
1- A_
0 Fire Hydrants/Knox Box/Lane
O \
N7-/
`
0 Utilities
0
Fire Alarm
O
\0
0 Smoking
❑
0 Fire District
0
O
0 Pylon Sign
0
0 Critical Materials/Containment
0
0 Monument Sign
0
0 NREC
O
0 On Building Sign
0
0 Special Inspection
❑Other
APPROVED FOR
CERTIFICATE OF OCCUPANCY
Date: 7 _ 1 �0 0 Inspector: / fJ x_.
REVIEWED BY
y
Mak
4SRSEINSIIMItmel—
Conditions
APPROVED FOR
TEMPORARY CERTIFICATE OF OCCUPANCY
Date: — Inspector:
REVIEWED BY
Fee:
Expiration Date:
Conditions
Release date:
Mail to:
Copy to:
T.C..O.:
C.O.:
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5.
GROUP L.C. OCCUPANCIES
ADULT FAMILY HOMES FOR "6" OR FEWER CLIENTS
GENERAL GUIDELINES
Adult Family Group Homes
# Bedrooms
Evacuation
Capability
# Egress
"Exits"
BASEMENT
________-
FIRST FLOOR
_3
J - .l
SECOND FLOOR
_
� ____L---
Persons physically and mentally capable of:
• Capability Level I ascent and descent of stairs without physical assistance of another person;
• Capability Level II unable to ascend or descend stairs without the use of mobility aids or
without physical assistance of another person;
• Capability Level III unable to walk or traverse a normal path to safety without the physical
assistance of another person.
Means of egress: "Exits"
All sleeping rooms with level II and III evacuation capability shall be on a grade level floor
with not less than two "2" means of egress. (Exception: two "2" or fewer clients)
Adult Care Homes with Level II and/or III clients must have exterior ramps. (WAC 51-30)
Escape windows, doors, and window wells: (313.4.4.2)
Required in all sleeping rooms of all L.C. Homes licensed by DSHS after 7/5/95.
NOTE: Permanently mounted step below the window may be used only when modifications to
pre-existing windows are technically infeasible. Acceptance for a permanently mounted step
below a window must be approved by the Inspector Supervisor.
Sanitation: (313.5.5)
• Not less than one water closet, one lavatory, and 1 bathtub or shower.
• Water temperature set at the hot water tank not to exceed 120 degrees fahrenheit.
• Capable of maintaining room temperature of 70 degrees fahrenheit.
Room dimension and ceiling heights: (313.6)
Sleeping rooms shall be on outside wall for actual light, single occupancy a minimum of 80 square feet
of habitable space, double occupancy a minimum of 120 square feet of habitable space with a
minimum of 36 inches between beds, and a minimum ceiling height of 7'6". Kitchen, hall, bathroom,
toilet compartments shall not be less than 7 feet.
One-hour construction required:
• Between garage and dwelling;
• Less than 3 feet from property lines.
Smoke Detectors (rooms required), Power Source and location: (313.8)
Fire Extinguishers: (WAC 388.76.765)
Fully charged #51b required on each floor of living space of the adult family home.
Eave requirements: (313.5.4.4)
No closer than 30 inches from side and rear property lines.
Inspector Comments: