1997, 12-24 Permit: 96006750 Certificate of Occupancy.,Fre -Final Date: } CERTIFICATE OF OCCUPANCY
District:
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ITEMS REQUIRED Complete/Date Initial
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ACTION TAKEN Complete/Date Initial
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Permit Number.
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Occupant:
Building Address:
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Architect:
Legal Description:
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Contractor.
Owner &Address:
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Plans Examiner o
Building Inspector.
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Occupancy Group:
Land Use:
61 R- -,7 5-
Mechanical Inspector:
Construction Type:
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Occupant Load: 5- GC C/e�/
Plumbing Inspector.
Occupied as: A-'✓ I r / ��®�
Special Inspection Agency:
Additional information �
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NREC Inspector.
❑
❑Other
Compliance Coordinator:/
OReinspection w/corrections
Other.
ONREC final
❑Special inspection final(s):
Compact/Concrete/Masonry/
Bolting/Welding/
0
O
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ITEMS REQUIRED Complete/Date Initial
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ACTION TAKEN Complete/Date Initial
❑Mechanical #
0
❑Site plan pulled for file
❑
#
❑
OLandscape plan pulled for file
E3❑Mechanical
E3 Mechanical #
❑
❑Drainage plan pulled for file
❑
E3 Plumbing #
❑
er plan pulled for file
❑Notice of completion to Assessor
O
❑Sprinkler/alarm #
❑
E3 Demolition #
❑Final inspection w/corrections
❑
❑Other
O
OReinspection w/corrections
O
ONREC final
❑Special inspection final(s):
Compact/Concrete/Masonry/
Bolting/Welding/
0
O
❑Unauthorized occupancy
(Initiate compliance)
APPROVED FOR
TEMPORARY CERTIFICATE of
. OCCUPANCY
Date:
O
REVIEWED BY
O Landscaping/irrigation
0
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Inspector.
0208 drainage
❑
Fee:
Expiration Date:
❑Engineer certification/208
O
Conditions
❑Parking/Paving
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O Accessibility
❑
❑Critical materials/containment
O
❑Fire District
❑
AFFit6' VZP FOR
C 1=C=01F0CWANCY
Date: '2 )Fy�
REVIEWED BY
❑ Utilities
O
❑Health District
❑
❑Fast Track Certification
O
Inspecto
❑Other
❑
Conditions
Release date:
Mail to:
Copy to:
T.C.O.:
C.O.:
UnP✓
Active File
Field
90 Day Hold
CONSTRUCTION PLANS/ROUTING Comments
Date I Date I Date
certificate of occupancy
DATA •
,AGING AND ADULT SERVICES ADMINISTRATION
w "j"Smff FIRE SAFETY EVACUATION PLAN
DEPARTMENT OF
R1147 SERVICESTH WAC 388-76-200(11)
An Adult Family Home shall have a posted plan forte escape routesevacuation to eareas in event of fire. Draw a diagram of the floor plan
and designate where staff and residents should meet
' of your home in the space proveded below. Ind p
outside the residence. Indicate the location of fire extinguisher(s) and smoke detector(s).
INSTRUCTIONS: ProviderlResident ManapPr comDletes and posts in a conspicuous location.
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