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2010, 08-24 Permit App: 10002606 Adult Family Home * DOUzc APPLICATION AND INSPECTION CHECKLIST - Adult Family Home Code References: 2006 IRC Section R325(WAC 51-51) APPLICATION NUMBER: I SECTIONS 1,2,3,AND 4 MUST BE COMPLETED BY APPLICANT BEFORE INSPECTION WILL BE PROCESSED SECTION 1 - PROPERTY INFORMATION 1 I I/ J/ SITE ADDRESS: I { `� ` �11 )cc- -ASSESSOR'S TAX/PARCEL#: - SECTION 2 -APPLICANT INFORMATION PROPERTY OWNER NAME: ) ( L{ I'V) "(--A DAYTIME PHONE: -�� I 9� /- 3 I L LICENSEE NAME(IFDIFFERENT): 'TR) L /� �� DAYTIME PHONES `1 �(1 )1, c SECTION 3 -FLOOR PLAN APPLICANT MUST DRAW A COMPLETE FLOOR PLAN ON THIS FORM. PLEASE INCLUDE ALL SLEEPING ROOMS(BEDROOMS). **ON THIS DRAWING,THE BUILDING INSPECTOR MUST THEN IDENTIFY WHICH ROOM IS SLEEPING ROOM #1, 2, 3, 4, 5,AND 6 AND LABEL ALL COMPONENTS FOR EXITING i.e. STAIRS,RAMPS, PLATFORM LIFTS&ELEVATORS. (USE BACK OF THIS PAPER IF YOU NEED MORE ROOM) e-- c/L 6 SECTION 4 —DISCLAIMER/SIGNATURE BLOCK 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 further certify that I have made application to the Department of Social and Health Services for an adult family home license and that I have also made application to the applicable jurisdiction for the appropriate license(s) to conduct such business at this location. I further 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 s a part of this application. NAME/TITLE: � V N 1Y� (`-ji� / L� Lk- r'F `r DATE: D-k'( cJ 0. PROPERTY OWNER APPLICANT LICENSEE /1-N(- 811109 • NAME OF AFH: G3 K44 L2& f F 1 k SECTION 5 MUST BE COMPLETD BY THE BUILDING DEPARTMENT IN THE JURISDICTION THE HOME W ILL BE LOCATED. PLEASE CHECK ALL APPLICABLE BOXES. PLEASE ALSO INDICATE ON THE FLOOR PLAN DRAWN BY APPLICANT. WHICH BEDROOM IS#1,2,3,4,5,OR 6 AND THE CLASSIFICATION CODE:S, NSI,OR NS2 (TO MATCH THE LIST BELOW) 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—where the only means of egress contains stairs to evacuate. Type NS1 —where one means of egress does not have stairs to evacuate. Type NS2 —where two means of egress do not have stairs to evacuate. SLEEPING ROOMS Sleeping Room #1 ❑ Type Si 0 Type NS1 0 Type NS2 YES NO Closet door/s are readily openable from the inside YES El NO ❑ Smoke alarm is installed in the bedroom ❑ ❑ Bedroom door is easily and quickly openable from the outside when locked 0 ❑ Sleeping room window has minimum dimensions at least 24"high; at least 20"wide—(NET OPENABLEAREA OF 5.7 SF**) ❑ ❑ **EXCEPT PER R310.1.1:AT-GRADE ESCAPE WINDOWS—(MAY HAVE NET CLEAR OPENING 5 SF) Sleeping room window has a maximum sill height of 44"above floor;no steps under window permitted ❑ 0 • Sleeping Room #2 0 Type S I 0 Type NS1 0 Type NS2 YES NO Closet door/s are readily openable from the inside YES❑ NO El Smoke alarm is installed in the bedroom ❑ ❑ Bedroom door is easily and quickly openable from the outside when locked ❑ ❑ Sleeping room window has minimum dimensions at least 24"high; at least 20"wide —(NET OPEN-ABLE AREA OF 5.7 SF**) ❑ ❑ **EXCEPT PER R310.1.1:AT-GRADE ESCAPE WINDOWS—(MAY HAVE NET CLEAR OPENING 5 SF) Sleeping room window has a maximum sill height of 44"above floor;no steps under window permitted ❑ ❑ Sleeping Room #3 I 0 Type S I 0 Type NS1 0 Type NS2 YES NO Closet door/s are readily openable from the inside YEsrli NO ❑ Smoke alarm is installed in the bedroom ❑ ❑ Bedroom door is easily and quickly openable from the outside when locked El ❑ Sleeping room window has minimum dimensions at least 24"high; at least 20"wide —(NET OPEN-ABLE AREA OF 5.7 SF**) ❑ ❑ **EXCEPT PER R310.1.1:AT-GRADE ESCAPE WINDOWS—(MAY HAVE NET CLEAR OPENING 5 SF) Sleeping room window has a maximum sill height of 44" above floor; no steps under window permitted ❑ ❑ Sleeping Room #4 I 0 Type S I 0 Type NS1 0 Type NS2 YES NO Closet door/s are readily openable from the inside YEsffl NO ❑ Smoke alarm is installed in the bedroom 0 ❑ Bedroom door is easily and quickly openable from the outside when locked 0 0 Sleeping room window has minimum dimensions at least 24"high; at least 20"wide (NET OPEN-ABLE AREA OF 5.7 SF**) ❑ ❑ **EXCEPT PER R310.1.1:AT-GRADE ESCAPE WINDOWS—(MAY HAVE NET CLEAR OPENING 5 SF) Sleeping room window has a maximum sill height of 44"above floor; no steps under window permitted ❑ ❑ Sleeping Room #5 I 0 Type S I 0 Type NS1 0 Type NS2 YES NO Closet door/s are readily openable from the inside YES❑ NO ❑ Smoke alarm is installed in the bedroom 0 ❑ Bedroom door is easily and quickly openable from the outside when locked ❑ ❑ Sleeping room window has minimum dimensions at least 24"high; at least 20"wide —(NET OPEN-ABLE AREA OF 5.7 SF**) ❑ 0 **EXCEPT PER R310.1.1:AT-GRADE ESCAPE WINDOWS—(MAY HAVE NET CLEAR OPENING 5 SF) Sleeping room window has a maximum sill height of 44"above floor; no steps under window permitted ❑ ❑ Sleeping Room #6 I 0 Type S I 0 Type NS1 0 Type NS2 YES NO Closet door/s are readily openable from the inside YEsril NO ❑ Smoke alarm is installed in the bedroom ❑ ❑ Bedroom door is easily and quickly openable from the outside when locked ❑ 0 Sleeping room window has minimum dimensions at least 24"high; at least 20"wide —(NET OPEN-ABLE AREA OF 5.7 SF**) ❑ ❑ **EXCEPT PER R310.1.1:AT-GRADE ESCAPE WINDOWS—(MAY HAVE NET CLEAR OPENING 5 SF) Sleeping room window has a maximum sill height of 44"above floor; no steps under window permitted 0 0 GENERAL YES NO Bathroom doors are easily and quickly openable from the outside when locked 0 ❑ Smoke alarms are installed on all levels of the dwelling, in each bedroom and common areas ❑ ❑ Any smoke alarm must be audible throughout the home when activated. ❑ ❑ Access road and water supply meet local fire jurisdictional requirements ❑ ❑ 811109 R311.6 Ramps . Inside Ramp YES NO R311.6.1 Maximum Slope one unit vertical in twelve units horizontal (8.3% slope). 0 0 R311.6.2 Landing Requirements: min. 3X3 foot landing at top/bottom,where doors open onto ❑ ❑ ramps, and where ramp changes directions. R311.6.3 Handrails required (on both sides of ramp: per state licensing requirement WAC 388-76-10730). El El Outside Ramp YES NO R311.6.1 Maximum Slope one unit vertical in twelve units horizontal(8.3% slope). ❑ 0 R311.6.2 Landing Requirements: min. 3X3 foot landing at top/bottom, where doors open onto ❑ ❑ ramps, and where ramp changes directions. R311.6.3 Handrails required (on both sides of ramp: per state licensing requirement WAC 388-76-10730) ❑ 0 **Guards below are depicted vertically as an example only. Less than 4" .'- Handrail both sides ? 1* .1.01110 Guard """—tea 36"min � „--._ in . ; � 3'x 3'min 3'x 3'mEa `� �x " 0110 landing landing -- - I 3 )118.3% min �. min ADULT FAMILY HNE RAMP per 2006 IRC ..vitn WA,. ST, AMENDMENTS *ALL RAMPS REQUIRE A BUILDING PERMIT,' R311 Means of Egress YES NO R311.4.2 Door Type and Size: Side-hinged not less than 3 feet in width and 6 feet 8 inches in height. ❑ ❑ R311.4.4 Type of lock or latch: readily openable from the side from which egress is to be made ❑ ❑ without the use of a key or special knowledge or effort. R311.5 Stairways YES NO R311.5.3.1 Riser Height: Max riser height shall be 73/4 inches (8 inches in structures built prior to July 1,2004) El ❑ R311.5.3.2 Tread Depth: Min. tread depth shall be 10 inches. (9 inches in structures built prior to July 1,2004) ❑ ❑ R311.5.6 Handrails required on both sides of one riser or more(per state licensinq requirement WAC 388-76-10730) ❑ ❑ Grab Bars in Bathrooms YES NO WAC 388-76-10730 The AFH must install and securely fasten grab bars (not suction cup style) to meet ❑ ❑ the needs of residents in: Bathing facilities such as tubs and showers; and ❑ 0 On both sides of the toilet (if structurally not feasible use type that affix to toilet seat) ❑ 0 AG101 Swimming Pool, Spa,Hot Tub YES NO AG105 Must be surrounded by a barrier that is 48 inches high, may have doors and or gates that ❑ 0 must have audible alarms when opened. AG105.5 EXCEPTION: Spas or hot tubs with a safety cover which complies with ASTM F 1346 ❑ ❑ ❑ PASSED ❑ CORRECTIONS REQUIRED ❑ PERMIT REQUIRED TNSDFCTon'S GI(:NOTUDF. RATE INSPECTOR'S ADDRESS: PHONE: 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. 811109 RECEIVED 10/01/2010 09:41 5096880037 SV PERMIT CENTERFR 8311.6 Ramps Inside Ramp YES NO R311,6.1 Maximum Slope one unit vertical in twelve units horizontal (8.3% slope). 0 0 R311.6.2 Landing Requirements: min. 3X3 foot landing at top/bottom,where doors open onto ❑ ❑ ramps, and where ramp changes directions. R311.6.3 Handrails required(on both sides of ramp: per state Jisensina reaulrement WAC 388-76-10730). ❑ 0 Outside Rarn YES NO R311.6.1 Maximum Slope one unit vertical in twelve units horizontal (8.3% slope). 0 •0 R311.5.2 Landing Requirements: min. 3X3 foot landing at top/bottom, where doors open onto 0 n ramps, and where ramp changes directions. R311.6.3 Handrails required(on both side✓of ramp: Per state iicensina requirement WAC 388-76-10730) 0 0 **Guards below are depicted vertically as an example only. Less than 4" �. Handrail both sides 1 . 34"—35" Guard ij I i 36"min ( II ' .I _:.,�.; _ 3 1 1 s •Y '''.r�+....,.n4.� 3'x 3'min 3'x3'min I. '".""•"ut• ,. � landing landing 1:12 max slope 1 � 3. ` B 3!; 111 Ir min �1�j1 mm� ADULT FAMILY HOME RAMP per 2006 1R.0 'pith- WA. ST. AMENDMENTS *ALL RAMPS REQUIRE A BUILDNQ PERMIT' R311 Means of Egress r YES NO R311.4.2 Door Type and Size: Side-hinged not less than 3 feet in width and 6 feet 8 Inches In height. 0y 0 8311.4.4 Type of lock or Latch: readily openable from the side from which egress is to be made ❑ ❑ without the use of a key or special knowled•e or effort. R311.5 Stair i% . YES NO R311,5.3.1 Riser Height Max riser height shall be 73/4 Inches (8 Inches in structures built pilar to July 1,2004) 0 ❑ R311.5,3.2 Tread Depth: Min. tread depth shall be 10 inches. (9 inches in structures built priorto July.1,2004) 0 ❑ R311.5.6 Handrails required on both sides of one riser or more(oer sate licerslna rer rement WAc Sea-76"10730) ❑ 0 Grab Bars in Bathrooms YES NO WAC 388 7640730 The AFH must install and securely fasten grab bars(not suction cup style)to meet ❑ 0 _th ne 3 f id resents In: Bathing facilities such as tubs and showers; and ❑ 0 On both sides of the toilet(if structurally not feasible use type that affix to toilet seat) �r 0 0 AG101 Swimming Pool,Spa. Hot Tub YES NO AG105 Must be surrounded by a barrier that is 48 inches high, may have doors and or gates that 0 ❑ must have audible alarms when opened. AG105.5EXCEPTION: Spas or hot tubswith a safe cover which c'rn.lies with ASTM F 1346 . 0 0 ❑ PASSED 0 RR CTI QUIRED 0 PERMfITT REQUIRED� � E1 Tim DrD-OQ'5 nwrF. CIGNA-num• " a.1-r(� 003 F 51 emevy..111 S )6^ 6lig Loon INSPECTOR'S ADD z� E: Application and Inspection Checklist developed by Washington Association of Building Officials (WABO), In cooperation with Depar ment of Soci4,i., adHealth ices (DSHS):or,use by blh departments and licensors, YInit _ c0_IC i it ,rnf1 tT Fari'bL f //l Ih-••ILJerhee 8/1/09 Jam � � c & . , ,,,,,, . c„,c__,,,,,,_ ,,, , ,,,to ,,,_ v a � J L? 0 --7---- oi Y .6-',y,\00\(\7\ &. 6-- \„05_ (2,, \NN t \,-0--L) -v.°'"''' - I QD k , ( „_,coo \N` ' % --?\(-- )7 '- '07— \ s 1.. .1) (0-f-_-- \,,,, 1 -f - , 7 lit:Witi-t Q_,S r) av f 1% of c c) i , r , )) / $ ^ U\ C--0 f ;� \\(-- c , ,y, c ' , ik? _k 1 RJ 7 ^ V 1 % ,fie`w-� , ice W RECEIVED 10/01/2010 09:41 5096880037 SV PERMIT CENTERFR • TIME AFH E.11901 12th Ave. Spokane, WA. 99206 Phone(509)921-0462 Fax(509)922-7565 PiII ' TIME AFH ADDRESS: _ PAGES: (includes Cover Sheet) FAX#: 4 J —' z7 037 DATE: 16//RE: CC: URGENT PLEASE REPLY RETURNING YOUR FAX FOR REVIEW El PLEASE COMMENT:ASICL r - .. f-C" THANK YOU f f I Privileged andior Confidential informati m may be contained in this message. If you are not the :4 indicated in this message,you may not copy or otherwise dis-getninets this message to anyone. In such case,you should destroy this message and kindly notify the sender by telephone at the number above. Thank you. Flom RobhER Faust 4/13/05 • (Effective July 1,2010) WAC 51-51-0325 Section R325-Adult family homes. SECTION R325 ADULT FAMILY HOMES R325.1 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. R325.2 Submittal Standards.In addition to those requirements in Section 106.1,the submittal shall identify the project as a Group R-3 Adult Family Home Occupancy.A floor plan shall be submitted identifying the means of egress and the components in the means of egress such as stairs,ramps,platform lifts and elevators.The plans shall indicate the rooms used for clients and the sleeping room classification of each room. R325.3 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 R325.9 is provided. 3. Type NS2-where two means of egress are at grade level or ramps constructed in accordance with R325.9 are provided. R325.4 Types of Locking Devices.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. The force required to activate operable parts shall be 5.0 pounds(22.2 N)maximum.Exit doors shall have no additional locking devices. •. • R325.5 Smoke Alarm Requirements. All adult family homes shall be equipped with smoke alarms installed as:required in Section R314.Alarms shall be installed in such a manner so that the fire warning may be audible in all parts of the_'dwelling•upon activation of a single device. R325.6 Escape Windows and Doors. Every sleeping room shall be provided with emergency escape and rescue window's 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. R325.7 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. R325.8 Grab Bars. Grab bars shall be installed for all water closets and bathtubs and showers. The grab bars effective WAC 51-51- 0325:Section R325-Adult family homes.date 7/1/10 shall comply with ICC/ANSI A117.1 Sections 604.5 and 607.4 and 608.3. EXCEPTION: Grab bars are not required for water closets and bathtubs and showers used exclusively by staff of the adult family home. R325.9 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 R325.9.1. R325.9.1 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 R311.6.3.1 through R311.6.3.3. R325.10 Stair Treads and Risers. Stair treads and risers shall be constructed in accordance with R311.7.4. Handrails shall be installed in accordance with R325.10.1. R325.10.1 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 R311.7.7 through R311.7.7.4 [Statutory Authority: RCW 19.27.190, 19.27.020, and chapters 19.27 and 34.05 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 34.05 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.] 08101110 • Adult Family Home (AFH) LOCAL BUILDING INSPECTION CHECKLIST Code References: 2009 IRC Section R325(WAC 51-51) APPLICATION NUMBER: SECTIONS 1,2,3,AND 4 MUST BE COMPLETED BY APPLICANT BEFORE INSPECTION WILL BE PROCESSED SECTION 1 - PROPERTY INFORMATION SITE ADDRESS: ASSESSOR'S TAX/PARCEL#: - SECTION 2-APPLICANT INFORMATION PROPERTY OWNER NAME: DAYTIME PHONE: AFH LICENSEE NAME(IF DIFFERENT): DAYTIME PHONE: SECTION 3— FLOOR PLAN APPLICANT MUST DRAW COMPLETE FLOOR PLAN/s ON THIS FORM(ALL FLOORS). PLEASE INCLUDE ALL SLEEPING ROOMS(BEDROOMS). ON THISDRAWING1 INDICATE WHICH BEDROOM IS A, B, C, D, E,AND F. LABEL ALL COMPONENTS FOR EXITING i.e.: STAIRS, RAMPS, PLATFORM LIFTS&ELEVATORS. SECTION 4—DISCLAIMER/SIGNATURE BLOCK 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: ❑ PROPERTY OWNER 0 APPLICANT 0 LICENSEE 08/01/10 R311.8 Ramps Inside Ramp N/A YES I NO R311.8.1 Maximum Slope one unit vertical in twelve units horizontal (8.3% slope).(Exception R311.8.1 Not allowed in AFH) 0 0 R311.8.2 Landing Requirements:min.3X3 foot landing at top/bottom,where doors open onto ramps,and where ramp ❑ 0 changes directions. R325.9.1 Handrails required on both sides of ramp in accordance with R311.8.3.1 —R311.8.3.3. 0 0 Outside Ramp 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) 0 0 R311.8.2 Landing Requirements:min. 3X3 foot landing at top/bottom,where doors open onto ramps, and where ramp ❑ ❑ changes directions. R325.9.1 Handrails required on both sides of ramp in accordance with R311.8.3.1 —R311.8.3.3. 0 0 *Guards below are depicted vertically as an example only. All Ramps must have Guards Less than 4" _ —" Handrail both sides Guard 36"min e i 6.04111 3' 3'x3'min �r, ow _ landing n landing 1:12 max slope — / . min min . /-� ADULT FAMILY HOME RAMP . per 2009 IRC with .WA, ST. AMENDMENTS *ALL RAMPS REQUIRE A BUILDING PERMIT* 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: •❑ ❑ 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 or twisting of the wrist(lever-type,emergency egress hardware). The Exit doors 0 0 shall have no additional locking devices. R311.7 Stairways I N/A YES NO R311.7.4.1 Riser Height: Max riser height shall be 7%inches (8 inches in structures built prior to July 1,2004) 0 0 R311.7.4.2 Tread Depth: Min.tread depth shall be 10 inches. (9 inches in structures built prior to July 1,2004) 0 0 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.Handrails shall be installed in accordance with R311.7.7.1—R311.7.7.4 R 325.8 Grab Bars in Bathrooms(May require"alternate"approval in accordance with IRC Sec.R104.10 and.11) YES I NO R325.8 Grab bars shall be installed for all water closets(toilets),bathtubs and showers. Bathing facilities such as tubs and showers;and 0 0 On both sides of the toilet. (shall comply with ICC/ANSI A117.1 Sections 604.5,607.4&608.3) 0 0 AG103—AG 105 Swimming Pool,Spa,Hot Tub N/A I YES I NO AG105.2 Must be surrounded by a barrier that is 48 inches high,may have doors and or gates that must have audible 0 ❑ alarms when opened. AG105.5 EXCEPTION:Pols, as or hot tubs with a safety cover which complies with ASTM F 1346 ❑ 0 0 PA' ED 0 CORRECTIONS REQUIRED 0 PERMIT REQUIRED 411/ INSPECTOR'S SIGNATURE: e 571-e_ �p7TE: 0 (E Se rG V c (/ INSPECTOR'S ADDRESS: PHO E: 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. 08/01/10 • � 1 NAME OF AFH: 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 OFA,B,C,D,E,AND F AND CLASSIFICATION CODE:S,NSI,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-where the means of egress contains stairs,elevators or platform lifts to evacuate residents to public area. Type NSI-where 1 means of egress at grade level(has no stairs),or a ramp constructed compliant with R325.9 is provided to evacuate residents to public area. T •e NS2-where 2 means of egress at•rade level both have no stairs),or ramps constructed compliant with R325.9 are provided to evacuate residents to public area. SLEEPING ROOMS Sleeping Room A 0 Type S ' ❑ Type NS1 0 Type NS2 YES NO Closet door/s are readily openable from the inside YES 0 NO 0 Smoke alarm is installed in the bedroom 0 ❑ Bedroom door is easily and quickly openable from the outside when locked ❑ ❑ Sleeping room window has a net opening of 5.7 SF* (minimum dimensions at least 24" high; at least 20"wide) ❑ ❑ *EXCEPT PER R310.1.1:AT-GRADE ESCAPE WINDOWS-MAY HAVE NET CLEAR OPENING 5 SF Sleeping room window has a maximum sill height of 44"above floor,no steps under window permitted ❑ 0 Sleeping Room B 0 Type S 0 Type NS1 Type NS2 YES NO Closet door/s are readily openable from the inside YES 0 NO 0 Smoke alarm is installed in the bedroom 0 0 Bedroom door is easily and quickly openable from the outside when locked ❑ ❑ Sleeping room window has a net opening of 5.7 SF* (minimum dimensions at least 24" high; at least 20"wide) ❑ ❑ *EXCEPT PER R310.1.1:AT-GRADE ESCAPE WINDOWS-MAY HAVE NET CLEAR OPENING 5 SF Sleeping room window has a maximum sill height of 44"above floor,no steps under window permitted 0 0 Sleeping Room C 0 Type S :0 Type NS1. 0 Type NS2 YES • NO Closet door/s are readily openable from the inside YES 0 NO 0 Smoke alarm is installed in the bedroom ❑ 0 - Bedroom door is easily and quickly openable from the outside when locked : ❑, 0 - Sleeping room window has a net opening of 5.7 SF* (minimum dimensions at least 24" high; at least 20"wide) ❑_,. ❑ *EXCEPT PER R310.1.1:AT-GRADE ESCAPE WINDOWS-MAY HAVE NET CLEAR OPENING 5 SF Sleeping room window has a.maximum sill height of 44" above floor;.no steps under window permitted. ,_ ❑ ❑ . ; Sleeping Room D 0 Type S 0 Type NS1 0 Type NS2 YES' • NO Closet door/s are readily openable from the inside YES 0 NO 0 Smoke alarm is installed in the bedroom ❑' ❑ Bedroom door is easily and quickly openable from the outside when locked ❑ ❑ Sleeping room window has a net opening of 5.7 SF* (minimum dimensions at least 24" high; at least 20"wide) ❑ ❑ *EXCEPT PER R310.1.1:AT-GRADE ESCAPE WINDOWS-MAY HAVE NET CLEAR OPENING 5 SF Sleeping room window has a maximum sill height of 44" above floor; no steps under window permitted ❑ 0 Sleeping Room E ( 0 Type S ❑ Type NS1 0 Type NS2 YES NO Closet door/s are readily openable from the inside YES 0 NO 0 Smoke alarm is installed in the bedroom 0 ❑ Bedroom door is easily and quickly openable from the outside when locked ❑ 0 Sleeping room window has a net opening of 5.7 SF* (minimum dimensions at least 24" high; at least 20"wide) ❑ ❑ *EXCEPT PER R310.1.1:AT-GRADE ESCAPE WINDOWS-MAY HAVE NET CLEAR OPENING 5 SF Sleeping room window has a maximum sill height of 44" above floor; no steps under window permitted ❑ 0 Sleeping Room F 0 Type S 0 Type NS1 0 Type NS2 YES NO Closet door/s are readily openable from the inside YES 0 NO 0 Smoke alarm is installed in the bedroom 0 ❑ Bedroom door is easily and quickly openable from the outside when locked ❑ ❑ Sleeping room window has a net opening of 5.7 SF* (minimum dimensions at least 24"high; at least 20"wide) ❑ ❑ *EXCEPT PER R310.1.1:AT-GRADE ESCAPE WINDOWS-MAY HAVE NET CLEAR OPENING 5 SF Sleeping room window has a maximum sill height of 44"above floor; no steps under window permitted ❑ ❑ GENERAL YES NO Bathroom doors are easily and quickly openable from the outside when locked 0 ❑ Smoke alarms are installed on all levels of the dwelling, in each resident sleeping room, outside each separate sleeping ❑ ❑ area in the immediate vicinit of slee inq rooms (R314) Smoke alarms are installed in suc a manner so that the fire warning may be audible in all parts of the dwelling upon ❑ ❑ activation of a single device. Access road and water supply meet local fire jurisdictional requirements 0 0 08/01/10