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PROPERTY INFORMATION Date: j 0 - Assessor's Parcel Number: 1 Z33 Z 5 0c) 63, Legal Description: TiZS TkS A F4 B c F 5 360' e-C- TV- 2.6 Building Site Address: " Z I AIA� +c t•e- Rot.,ve- 3 e-lF•-�- WA 9b51 Method of sewage disposal: OC Septic O Sewer-name of district: Water source: O Individual Well O Community Well 0 Public System,name of system: Fv eL4 *� ZI= PEOPLE INVOLVED IN THE PROJECT „ ,.. Name of Applicant: p `�,L JUc�1 t.wz ! 5=L(r�r,Y. Ce..-4c►- ECf _g " - i ,address: Qt:. Qox 21b9 C l� i,_ City: JG �r State: L j A Zip: 1 BS Z 8-2l L`/ Day phone (5bu)275-357 Contact Person: MOL4 .,-b Message phone: MAY T PROJECT INF A"ORMI1E?N Proposed business name: Pe-ci��j(l,_ AJc'ILwe t � Lj�ati. �r�I�t^ Rrs��V'cc �' w. ft s se: S+o r o,I t: Number of employees: Previous business name: j Jk y-G/ (6t5+o Describe previous use: [ks+u 04046 rC jVZ s �s STRUCTURE DETAILS Check one: a Detached single level/single tenant O Single level/multi tenant O Multi level/single tenant O Multi level/multi tenant Age of structure: Is structure currently If not occupied,how long has it been vacant? occupied? Yes o Yr. Mo. b Square footage: I Basement: I First:/!3D Mezzanine: Second: Third: Is the strut eat o Heating type:Circle one: Circle one: Y Electric Liquid Propane Natural Gas Oil Type of heat:Circle ne: Furnace Heat Pump Electric baseboard or wallmount Radiant Wilt there be any changes to the following?Circle yes or no,ff applicable: Floor lay-out: Yes Lighting: Yes N Heating:Yes Exterior Finishes: Yes o Interior Finishes: Yes o Parking:Yes Number of restrooms provided: f Number of fixtures in each Is structure handicap accessible?Circle one No Is the structure equipped with afire sprinkler system? Yes Q&o Fire alarm system? Yes o Monitoring Station Name: Phone number: s APPUCA11ON WILL NOT SEACCE1IRTROW1TF10UT; 1. Floor Plan(5 sets): • Draw the floor plan to scale Use of rooms • Room Dimensions • Location of all exits and windows(include dimensions) • Location of plumbing and mechanical fixtures Interior doors with swing radius 2. Site Plan(5 sets): Note scale used • Property tines,easements,&right of ways • Location of all existing structures&dimensions • Distance,in feet,from property line&structures Landscape buffer yards • On-site sewage tanks and drain fields,&reserve Well location • Location of fire hydrants&vehicle access roads Parkin areas number&arrangement) 3. Septic records,pumper's report or O&M report. 4. Fees will be collected at time of submittal �� = I ialF S� Onl Accepted by Date Submittal Amount$ Receipt number Department Review Initials Date Comments Building Environmental Health Fire Marshal Planning Public Works Occupancy Change? (circle one) Yes No Type of construction Occupancy classification change from to Occupant load calculated: persons Existing occupant load design persons. Land Use Designation: Occupancy Classification: COM O MASON COUNTY CHANGE IN TENANT APPLICATION Complete the Change in Tenant Application and return with a floor plan,site plan,septic pumper's report,septic records and fee to the Mason County Permit Center,P.O.Box 186,Shelton,WA 88584. Evaluation of the Change in Tenant Application will involve staff members from the Building,Fire Marshal,Environmental Health,Planning and Public Works offices who will identify compliance requirements. This application is intended for tenant change only. If construction or remodeling Is Proposed or required a building permit will be necessary. Upon approval the permit will be issued to the applicant/tenant. After the permit is issued,schedule an inspection by calling(360)427-7262.Upon satisfactory inspection a Certificate of Occupancy will be issued and must be posted in a conspicuous place on the gremises. Date: j o Assessor's Parcel Number: 1 Z33ZS onto 63 Legal Description: -i-QS -TkS A a B o S 36o' of -rP, 2.6 Building Site Address: Z 27Z 1 Wtt F R�r..�r 3 e/��r WA qy,$z Method of sewage disposal: OC Septic O Sewer-name of district: Water source: O Individual Well O Community Well 0 Public System,name of system:tie 1(:,�r w• J 5 Hv ita Name of Applicant: P C((vc (Vo,r1-1.,wej4, 5-dVw Ov.. Ce.,-Aer RECg_address: P,o, cloy, 2149 City: (fit(�•.c r State: Ind Zip: 'J Bs z s-Z(6 9 `Y ® Day phone:(W) Contact Person: nrb I Message phone: Proposed business name: P0.co�t` N©E^+l wr Sic/rtia,� �ra.�er (ZrSo+nrcr 426 W. C ® s se: $+o rA Number of employees: Previous business name: Describe previous use: Cks+n r►. Moi+rC C i� I1� Check one: PLDetached single IeveU single tenant O Single level/multi tenant O Multi level/single tenant O Multi IeveUmulti tenant Age of structure: Is structure currently If not occupied,how long has it been vacant? occupied? Yes o Yr. Mo. 6 Square footage: Basement: I First://30 Mezzanine: Second: Third: Is the struclILMeated2b, Heating type:Circle one: Circle one:cyev Electric Liquid Propane Natural Gas Oil Type of heat:Circle dne: F Heat Pump Electric baseboard or wal mount Radiant Wurnace i t ere be any changes to the following?Circle yes or no,ff applicable: Floor lay-out: Yes & Lighting: Yes Heating:Yes Exterior Finishes: Yes M Interior Finishes: Yes o Parking:Yes Number of restrooms provided: J Number of fixtures In each V. Is structure handicap accessible?Circle one Qe No Is the structure equipped with a fire sprinkler system? Yes o Fire alarm system? Yes o Monitoring Station Name: Phone number: 1. Floor Plan(5 sets): • Draw the floor plan to scale Use of rooms • Room Dimensions • Location of all exits and windows(include dimensions) • Location of plumbing and mechanical fixtures • Interior doors with swing radius 2. Site Plan(5 sets): Note scale used • Property lines,easements,&right of ways • Location of all existing structures&dimensions • Distance,in feet,from property line&structures . Landscape buffer yards • On-site sewage tanks and drain fields,&reserve . Well location • Location of fire hydrants&vehicle access roads Parking areas number&arrangement) 3. Septic records,pumper's report or O&M report. 4. Fees will be collected at time of submittal Accepted by Date Submittal Amount$ Receipt number Department Review Initials Date Comments Building Environmental Health Fire Marshal Planning Public Works Occupancy Change? (circle one) Yes No Type of construction Occupancy classification change from to Occupant load calculated: persons Existing occupant load design persons. Land Use Designation: Occupancy Classification: COM X05 O ( � MASON COUNTY CHANGE IN TENANT APPLICATION Complete the Change in Tenant Application and return with a floor plan,site plan,septic pumper's report,septic records and fee to the Mason County Permit Center,P.O.Box 186,Shelton,WA 98584. Evaluation of the Change in Tenant Application will involve staff members from the Building,Fire Marshal,Environmental Health,Planning and Public Works offices who will identify compliance requirements. This application is intended for tenant change only. If construction or remodeling is Proposed or required a building Permit will be necessary. Upon approval the permit will be issued to the applicant/tenant. After the permit is issued,schedule an inspection by calling(360)427-7262.Upon satisfactory inspection a Certificate of Occupancy will be issued and must be posted in a conspicuous place on the remises. Date: J o Assessor's Parcel Number: 12,33ZS oove 63 Legal Description: TQS -ril 4 p B o.( S 3&o' of TO, 2b Building Site Address: Z2721 4/f= }�}� Rv,,.><� 3 /f�;r^ WA q$51 Method of sewage disposal: OC Septic O Sewer-name of district: Water source: O Individual Well O Community Well 0 Public System,name of system:Ile 1l;,�r to.. A 5 Hv,t4 ) Name of Applicant: PaCi(v,( (Vcr41, je4A7 5'dvw -' Cc--Vey- REC i-TTIMaddress: P o, aox 2141 City: (3c(��,�r State: W A zip: 1 gS Z 8-Z 16 el U Day phone:hbb)275-35 Contact Person: a f{ drlJ Message phone: r y, Proposed business name: Pc�c�`�Pc Al©t9l,we S•c/rti a, �r�.i ev R rs�+�rc� �U� �h 426 W. ft s se: s}P v ct Number of employees: Previous bUsinessname: Y-O/ t`4t5}o= Describe previous use: Cks+r, MOU i-C 1 r- Check one: jaDetached single IeveV single tenant O Single level/multi tenant O Multi IeveV single tenant O Multi IeveVmulti tenant Age of structure: Is structure currently If not occupied,how long has it been vacant? occupied? Yes Co Yr. Mo. 6 Square footage: I Basement: I First://30 Mezzanine: Second: Third: Is the struc eat Heating type:Circle one: Circle one: Ye Electric Liquid Propane Natural Gas Oil Type of heat:Circle ne:C Furnace Heat Pump Electric baseboard or wall mount Radiant Wi t ere be any changes to the following?Circle yes or no,if applicable: Floor lay-out: Yes ® Lighting: Yes N Heating:Yes Exterior Finishes: Yes Interior Finishes: Yes o Parking:Yes Number of restrooms provided: f I Number of fixtures in each Is structure handicap accessible?Circle one a No Is the structure equipped with afire sprinkler system? Yes o Fire alarm system? Yes o Monitoring Station Name: Phone number: 9-41 WE 1. Floor Plan(5 sets): • Draw the floor plan to scale Use of rooms • Room Dimensions Location of all exits and windows(include dimensions) • Location of plumbing and mechanical fixtures • Interior doors with swing radius 2. Site Plan(5 sets): Note scale used • Property lines,easements,&right of ways • Location of all existing structures&dimensions • Distance,in feet,from property line&structures Landscape buffer yards • On-site sewage tanks and drain fields,&reserve . Well location • Location of fire hydrants&vehicle access roads Parking areas number&arrangement) 3. Septic records,pumper's report or O&M report. 4. Fees will be collected at time of submittal Accepted by Date Submittal Amount$ Receipt number Department Review Initials Date Comments Building Environmental Health (� Fire Marshal Planning Public Works Occupancy Change? (circle one) Yes No Type of construction Occupancy classification change from to Occupant load calculated: persons Existing occupant load design persons. Land Use Designation: Occupancy Classification: 3�v � CA1'. COM MASON COUNTY CHANGE IN TENANT APPLICATION Complete the Change in Tenant Application and return with a floor plan,site plan,septic pumper's report,septic records and fee to the Mason County Permit Center,P.O.Box 186,Shelton,WA 98584. Evaluation of the Change in Tenant Application will involve staff members from the Building,Fire Marshal,Environmental Health,Planning and Public Works offices who will identify compliance requirements. This application is intended for tenant change only. If construction or remodeling Is Proposed or required a building permit will be necessary. Upon approval the permit will be issued to the applicant/tenant. After the permit is issued,schedule an inspection by calling(360)427-7262.Upon satisfactory inspection a Certificate of Occupancy will be issued and must be posted in a cons conspicuous lace on the remises. EMEMMEMMMMMEMM Date: J o Assessor's Parcel Number: 1 Z332.S Dap© 63 Legal Description: - tZS -rpS 4 & g o(- S 3601 of- T2 " Building Site Address: Z,27Z 1 4/A; +,(,}-r Rc,,ve 3 WA 155i Method of sewage disposal: 01 Septic O Sewer—name of district: Water source: O Individual Well O Community Well 0 Public System,name of system: Name of Applicant: %,r i(t'L Ncrt-L,vje4f 15*jv oVX Cc^AC-r RECg_address: po. (�ofC 21L9 City: gc�4ti.c r State: L4 Zip: 18S z 8—2-U 9 AY o Day phone:(3yb,)275-357 Contact Person: A* &A Message phone: ` 426 W Proposed business name: po_c11QI— A)©r'}(.,welt� .,.,��) +� trti.��r i?rS�+&r'ce- 13u;�,h C QA s se: $+o i-A r_ Number of employees: jo Previous usinessname: 144y-d If �ct5}o, Describe previous use: 09009109 Check one: ADetached single level/single tenant O Single IeveU multi tenant O Multi le single tenant O Multi level/multi tenant Age of structure: Is structure currently If not occupied,how long has it been vacant? occupied? Yes o Yr. Mo. 6 Square footage: I Basement: I First://3p Mezzanine: Second: Third: Is the struc eat Heating type:Circle one., Circle one: Ye Electric Liquid Propane Natural Gas Oil Type of heat:Circle ne: Fumace Heat Pump Electric baseboard or wall-mount Radiant Wi t ere be any changes to the following?Circle yes or no,if applicable: Floor lay-out: Yes & Lighting: Yes N Heating:Yes Exterior Finishes: Yes &qZD Interior Finishes: Yes o Parkin :Yes Number of restrooms provided: f I Number of fixtures In each Is structure handicap accessible?Circle one 04ej No Is the structure equipped with a fire sprinkler system? Yes Vjo Fire alarm system? Yes o Monitoring Station Name: yy Phone number: AN 1. Floor Plan(5 sets): • Draw the floor plan to scale Use of rooms • Room Dimensions • Location of all exits and windows(inclul a dimensions) • Location of plumbing and mechanical fixtures • Interior doors with swing radius 2. Site Plan(5 sets): Note scale used • Property lines,easements,&right of ways . Location of all existing structures&dimensions • Distance,in feet,from property line&structures Landscape buffer yards • On-site sewage tanks and drain fields,&reserve . Well location • Location of fire hydrants&vehicle access roads Parkin areas number&arrangement) 3. Septic records,pumpers report or O&M report. 4. Fees will be collected at time of submittal i Accepted by Date Submittal Amount$ Receipt number Department Review -'1 i s Dgfe-' � Comments Building Environmental Health Fire Marshal Planning Public Works Occupancy Change? (circle one) Yes No Type of construction Occupancy classification change from to Occupant load calculated: persons Existing occupant load design persons. Land Use Designation: Occupancy Classification: FORM MUST BE COMPLETED IN INK it I PLEASE PRESS HARD MASON COUNTY PROJECT SITE INFORMATION f Case No. Name kL_ SE)Nsa s CRs . PARCEL NUMBER Date M-Z► SS SHOW THE FOLLOWING ON SITE PLAN Show Direction by indicationg N, S, E, W in relation to the site plan Lot Dimensions Fences Existing Structures Driveways Structure Setbacks Shorelines Water Lines Topography N Well Location (including adjacent) Drainage Plan Names of Streets Easements Names of Fronting Streets Septic System W DRAW SITE PLAN BELOW Include adjacent properties if on shoreline or within 100 feet of adjacent property line. adjacent property lined I Li.��i _ <—adjacent property line I 1 I I 3a I I I I f I I • I I I I I 4�rT--•c c' l.oe r L W�'EN'c-ti: _i I fl M Ti�►14. A t I �v� I I I I I I adjacent property line- I ' Fadjacent property line SAMPLE SITE PLAN adja�nt property line4 21.o' . _ _ _ f adjacent property line I D 30' �RESCRvE 3o-,I .SE/iCo aJ AL �• ^� fi �I- Hom PRo Pas ate) aGi�caa,N,t.a � \ I r4— I I VAGn,T c�nrtnccs I /, 3� I I(� P0.oPa. s o y I \ \ T AGRiCU-MOLAL I I I 1 I 90 I \ I t_.-.t_LL I I adjacent property lined ; a~. \i Fadjacent ro ert line TOPOGRAPHY PROFILE(Show a side view of property. Show slopes, cuts and fills. If possible include height and the degree of slopes. See sample topography profile.) SAMPLE TOPOGRAPHY PROFILE dist�r.Ga. to SrFrutfiLa.Y� di'S't•a►'+LG f G Slopa to¢ dlsha..aa to t Signature Date MASON COUNTY PROJECT SITE INFORMATION Case No. Name i�� i� _ �, ; . , s I-r.s PARCEL NUMBER Date :j L% SHOW THE FOLLOWING ON SITE PLAN Show Direction by indicationg N, S, E, W in relation to the site plan Lot Dimensions Fences Existing Structures Driveways Structure Setbacks Shorelines Water Lines Topography p.1 ` Well Location (including adjacent) Drainage Plan Names of Streets Easements Names of Fronting Streets Septic System DRAW SITE PLAN BELOW Include adjacent properties if on shoreline or within 100 feet of adjacent property line. adjacent property line—> I Z.�-��t+ �a .� . E-adjacent property line I � I I I I � I I •�� I I i I I � i 4F+.c� I I tt I i o adjacent property line4 1 I f-adjacent property line SAMPLE SITE PLAN adjar�nt property line-> 3zo� _ _ _ Fadjacent property line D 30' F%LSr vE.P 3o--)I SEASD.JAL_ I � _�PTSL 1 � HOM tr I F �• I Hou.sE , I ) PROPO]GD Sept.c I 7� R\ I VAC.AKiT I 1 GARAGE P0.oPasCD T �\ 1 A&R=LLLrLLMAL SO i 1 I I � I B O I ' l I i i I L. eLL I I 1 i I x /00' adjacent. r ert lined Fad'acent property line TOPOGRAPHY PROFILE(Show a side view of property. Show slopes, cuts and fills. If possible include height and the degree of slopes. See sample topography profile.) SAMPLE TOPOGRAPHY PROFILE d1S+a.,c0_ to Sh r•u.Lt'L4.1'e_ di.S't'ar+LG *o Slops to¢ des+a�ca. to � t p �• �p ram-�^•^^^--•�-• Signature Date Town &Country_" Suite B • 16521 Highway 99 • Lynnwood, WA 98037-3161 STEEL BUILDINGS Everett Line: (206) 258-4171 To//Free: 1-800-824-9552 Administrative Headquarters: (206) 743-1555 � DIVISION OF TT-MAM;;V Quality: Our Future Depends On If" Site Plan PLEASE CHECK: El Property dimensions ❑Septic and drainfield ❑Access to proposed building ❑Existing buildings ❑Sewer lines El Lot size ❑Proposed building ❑Setbacks of proposed and UElevation of property ❑Easements existing buildings ❑Bodies of water ❑Main road with name ❑Floorplan Job name: Job Site Address: Legal Description , Owner has verified and approved the location of accessories,orientation of the building to the north,and verifies that all items specified in paragraph B of the contract are shown on this drawing and vice versa. Customer signature: ©1984 PermaBilt Industries office(white) production(canary) customer(pink) 12/87 UP- 0 Q . j(L -O w � / � -- - - w 0- V .9U9 0L-.9z Z 0 O G o t � ,-• � 'C N � mom. 0) — 0 4. t,. JI 3 cn CJ a o 3 >a o _ °.� o w ��3 —9 o s O a> -• -�' N III ° O (n 00 i� 4) p rn qv7 o f d o J 42, o •� �n � � v ' � a cC Y (> w s� c , c 'g. , ID (� cC CO.) y, 5 u C) t o 0 E a �/ca r rn 'o r� a J LJ I " ° ° ° �. M n - a �: 3 o b > 9 $ 4 9P S 4J y l v cl a 0 A a°x -d b N C 0 VI 0 Nil, -24 32 I N UI Aa m 5 L g<L I K 2 n �m � a � v 0 N r c� c � O O y 0 O O n3 �r p 0.5 Z co m � c °fin. N u a w C Q p N v „W9 M-.SZ 1.4,8Z I M !V P, t— zo ai M I M C O I r -I I N o c M M o f N o rm E a °o 70cc 4a o E a o o v3i °I Ism ' y...ao o F o w Lo LO(/� M § 'o _C o y W J � OMM N � Z X Z m 3 c a jNa TW $ 1.91/9 0l-I8Z 7-7 ,o N - 7 O it ���•t' ,d T I c T P7 0 M ,0 L O o o _ a rn n s N c O N o c M coI o °� w a r c 0 ry E a 0 yli c my� �I a O'p y A ° N Cco 4) j fn f' fn d L O U) fh c c O O d W N LLZQ' Z # wIL) Wo- dUNa'II i 4P $ y G VP N ,a iN F � I o g �m a C N a 1 nI N C 0 � Imo � No N2 z°m' � m w a 'i U m m m a y N