2012, 11-19 AFH Checklist(He e
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: /120,C % 3 / / gj/f%f6 )E VALE-y
ASSESSOR'S TAX/PARCEL#:
SECTION 2 - APPLICANT INFORMATION
PROPERTY OWNER NAME: /7 &-A 7 P/� z_ c_c
AFH LICENSEE NAME (IF DIFFERENT): SAFE / 4 L. L-e-
DAYTIME PHONE: `
DAYTIME PHONE: 5,99- rO,� -77,7
SECTION 3 — FLOOR PLAN
APPLICANT MUST DRAW COMPLETE FLOOR PLAN/s ON THIS FORM (ALL FLOORS). PLEASE INCLUDE ALL SLEEPING ROOMS (BEDROOMS).
ON THIS DRAWING, INDICATE WHICH BEDROOM IS A, B, C, D, E, AND F. LABEL ALL COMPONENTS FOR EXITING i.e.: STAIRS,
RAMPS, PLATFORM LIFTS & ELEVATORS.
g1 E f 4 % i6 C flirJ�—T1(
Project # : — 2 -Z
RECEIVED
NOV )92012
CSV PERMIT CENTER
SUB # J 3
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 partof this application.
NAME/TITLE: 5
d21 C /f 4i ��SD•tJ
❑ PROPERTY OWNER APPLICANT ❑ LICENSEE
DATE:
08/01/10
(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•upbn
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.]
08/01/10
d
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 OF A, 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 NS1-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.
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 ROOMS
Sleeping Room A
Closet door/s are readily openable from the inside
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
Sleeping Room B
0 Type NS2
Closet door/s are readily openable from the inside
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
. Sleeping Room C
Closet door/s arereadily openable from the inside
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) ,.i
*EXCEPT PER R310.1.1: AT -GRADE ESCAPE WINDOWS -MAY HAVE NET CLEAR OPENING 5 SF
Sleeping .room.window .has amaximum .sill height of 44" above floor;,no steps under window permitted..
Sleeping Room D 0 Type S 0 Type NS1 0 Type NS2
Closet door/s are readily openable from the inside YES 0 NO ❑ 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
❑ Type S
Closet door/s are readily openable from the inside
YES ❑
YES 0
YES El
0 Type S I 0 Type NS1 I 0 Type NS2
NO 0
Smoke alarm is installed in the bedroom
0 Type S ❑ Type NS1
NO 0
0 Type S
NO 0
Smoke alarm is installed in the bedroom
0 Type NS1.
0 Type NS2
Smoke alarm is installed in the bedroom
Sleeping Room E
Closet door/s are readily openable from the inside
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
Sleeping Room F I ❑ Type S ❑
Type NS1 0
NO ❑
YES 0
YES 0
NO ID
Bedroom door is easily and quickly openable from the outside when locked
Sleeping room window has
Sleeping room window has
GENERAL
❑ Type NS1 ❑ Type NS2
Smoke alarm is installed in the bedroom
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
a maximum sill height of 44" above floor; no steps under window permitted
Bathroom doors are easily and quickly openable from the outside when locked
Smoke alarms are installed on all levels of the dwelling, in each resi ent sleeping room, outside each separate sleeping
area in the immediate vicinity of sleeping rooms (R314)
Smoke alarms are 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.
Access road and water supply meet local fire jurisdictional requirements
YES
El
El
0
YES
YES
El
NO
NO
. ❑
NO
❑
.❑
❑:. , :
YES •::. NO
❑
❑
0 El
YES
Type NS2
Smoke alarm is installed in the bedroom I ❑
YES
El
NO
NO
0
El
YES NO
El
El
08/01/10
.w...vnaniN,
Inside Ramp
1 N/A I
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 landing at top/bottom, where doors open onto ramps, and where ramp
changes directions.II
•
R325.9.1 Handrails required on both sides of ramp in accordance with R311.8.3.1 — R311.8.3.3.
■
■
Outside Ramp
YES
NO
N/A
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 landing at top/bottom, where doors open onto ramps, and where ramp
changes directions.
•
E
R325.9.1 Handrails required on both sides of ramp in accordance with R311.8.3.1 — R311.8.3.3.
■
■
uaras oelow are depicted vertically as an example only.
Guard
36" min
Less than 4"
3'x3'min
landing
min
r
1:12 max slope
8.3%
All Ramps must have Guards
Handrail both sides
34" — 38"
�sr'o'ar�,rr
ADULT FAMILY HOME RAMP
per 2009 RC with WA, ST. AMENDMENTS
*ALL RAMPS REQUIRE A BUILDING ' PERMIT*
3'x3'min
landing
3'
min
. . ....
` R311.2 Means of Egress' . �: ,. � � .:
YES :'
: tV0
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.
U
W
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
shall have no additional locking devices.
■
■
R311.7 Stairways I N/AI
I YES
NO
R311.7.4.1 Riser Height: Max riser height shall be 73/4 inches (8 inches in structures built prior to July 1, 2004)
■
■
R311.7.4.2 Tread Depth: Min. tread depth shall be 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. 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
NO
R325.8 Grab bars shall be installed for all water closets (toilets), bathtubs and showers.
Bathing facilities such as tubs and showers; and
■
■
On both sides of the toilet. (shall comply with ICC/ANSI A117.1 Sections 604.5,607.4 & 608.3)
•
IN
AG103 —AG 105 Swimming Pool, Spa, Hot Tub 1 NIA!
YES
NO
AG105.2 Must be surrounded by a barrier that is 48 inches high, may have doors and or gates that must have audible
alarms when opened.
•
a
AG105.5 EXCEPTION: Pools, Spas or hot tubs with a safety cover which complies with ASTM F 1346
■
■
❑ PASSED
❑ CORRECTIONS REQUIRED
INSPECTOR'S SIGNATURE:
0 PERMIT REQUIRED
DATE:
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.
08/01/10
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