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Home My WebLink AboutCOM2005-00067 Cancelled Retail - COM Application - 6/2/2005�iIIIIfiYr+�rc� �wr�i�fW�.� 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 icuous place on the premise--- Date: (p ti n „_ ssessor's Parcel Number: Legal Description: ta =-GOOD Building Site Address- Method of sewage disposal: Septic r—name of district: Water source: O Individual Well O Community Well Publi ystem, name of system: Name of Applicant: G LLbEASO fJ So 'F_'N " Mailing addres x State: ,d Zip. ay phone: Contact Per n: e h ne* Proposed business name: S LAS Proposed use: ^ mbe employees: �p Previous business name: Describe previous use: Check one: O Detached single level/single tenant IL gle vel/ Iti tenant O Multi le ell single tenant Multi le§tMMIti tenant Age of structure: Is structure currently not oc pied, how long has it been vacant? occupied? es No Mo. { Square footage: I Basement: IFirst: M zanine: I Second: 'Third• Is the structure heated? Heating type: Cir�E�ectn, Circle one: es No i d Pro a Natural Gas Oil Type of hea : Circle one: Furnace Heat Pu_mp_ETeZWseboard 4WA mount Radia Will there be any changes to the fo owing? CI p icable: Floor lay-out: Yes � Lighting: Yes eating: Yes Q Exterior Finishes: Yes � Interior F is Yes o P rkin , Yes o Number of restrooms provided: / Nu er ixt s in e Is structure handicap accessible? Circle on o Is the structure equipped with a fire spLjukLer sy Yes jQo I Fire alarm system? Yes No Monitoring Station Name: At I Phone number: 1. Floor ets): • Dra a floor p sca Use of rooms • Roo Dimensions • Location of all exits and windows(include dimensions) • Loca n of lumbin d kmhani ur • Interior doors with swing radius 2. Site n(5 sets). Notes used • Prop e lines,easements,&ri of w s 0 Location of all existing structures&dimensions • Distan in feet,from property fin uctures . Landscape buffer yards • On-site Vage tanks and drain fiel ,&reserve Well location • Location dUre hydrants&vehicle 41cess roads • Parking areas number&arrangement) 3. Septic rec s,pumper's report#O&M report 4. Fees will be akocted at time of bmi#al Accepted by Date Submittal Amount$ Receipt number Department Review Date Comments Building i?'PI Environmental Health Fire Marshal o —I 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: RECEIVED Occupancy Classification: % Jl1N 0 2 200 BELFAIR OFFICE corm �US- 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 icuous lace on the premisem. Date: co U awSIAZ"„- ssessor's Parcel Number: Legal Description: �a Building Site Address Method of sewage disposal: Septic O Sewer—name of district: , Water source: O Individual Well O Community Well Public System, name of system: • Ell 1101��1111qwl Name of Applicant: LL g AJ C-N 1 Mailing addres • to( ' City: t State: L,4jA Zip: Day phone: Contact Person: Message phone: Proposed business name: A CC S Proposed use: �50_QQ S Number of employees: (p Previous business name: — Describe previous use: Check one: O 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 No Yr. Mo. R Square footage: I Basement: I First: Mezzanine: Second: 'Third: Is the structure heated? Heating type: Circle o - Circle one: es No Iectri Liquid Propane Natural Gas Oil Type of hea : Circle one: Furnace Heat Pump Electric baseboard or wall mount Radiant Will there be any changes to the following? Circle yes or no,if applicable: Floor lay-out: Yes Q) Lighting: Yes Mo Heating: Yes Q Exterior Finishes: Yes � Interior Finishes: Yes Parking: Yes o Number of restrooms provided: I Number of fixtures in each Is structure handicap accessible? Circle one Yes No Is the structure equipped with a fire sprinkler system? Yes No Fire alarm system? Yes No Monitoring Station Name: Phone number: 1. Floor Plan(5 sets): • Draw the floor plan to scale 0 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 De attment 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: RECEIVED Occupancy Classification: N 'JUN 0 2 2005 BELFAIR OFFICE 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 necessarry. 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 icuous Dlace on the Dremises. Date: U t ssessor's Parcel Number: Legal Description: A U Building Site AddressMQ"P�t -- ,r C-V A 41 '--jGXX C4 AA Method of sewage disposal: Septic O Sewer—name of district: Water source: O Individual Well O Community Well Public System, name of system: Name of Applicant: ALL �j S r\JS � Mailing addres • x 9' PAN,im City State: (�,� ip: — Day phone: Contact Person: a e phone: Proposed business name: S Proposed use: Number of employees: (p Previous business name: Describe previous use: Check one: O Detached single level/single AU ingle level/multi tenant O Multi level/single tenant O Multi level/multi tenant Age of structure: Is structur rre If not occupied, how long has it been vacant? occu ied? Yes o Yr. Mo. Square footage: Basement: First: Mezzanine: Second: Third: Is the structure heated? I Heating typtaCircle Circle one:(: es No 1 ctri Liquid Propane Natural Gas Oil Type of hea : Clrcle one: Furnace Heat p Electric baseboard or wall mount Radiant Will there be any changes to the following? Circle yes or no,if applicable: Floor lay-out: Yes Q) Lighting: Yes 1 N Heating: Yes Exterior Finishes: Yes Q4a Interior Finishes: Yes o Parking: Yes o Number of restrooms provided: I Number of fixtures in each Is structure.handicap accessible? Circle one Yes No Is the structure equipped with afire sprinkler system? Yes No Fire alarm system? Yes No 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 i Accepted by Date Submittal Amount$ Receipt number Department Review Initials Date Comments Building EnvironmentalgHealth 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: R E C E I V E D Occupancy Classification: `.lUN 0 2 2005 BELFAIR OFFICE a 1 • !• r _Ci+�-.•.y��rAit. � +air "�� +' y..3'4t �..� .i• .y`p'.�,T.+� i 1 ♦ l3 • x U50 � y 0 0 N j O .0 w ".—go so .O, Q lb fl p. 3 •-" � a0i i O ca 0 !+ Ln Ircqs t� o M a -d o _.. 4-4 cv Y'7d3?11� b' b Q . 1-4 ac o u8r1/ C - � J F- WZ o <D-P �, J Cn N �� N `�° pbw go ti) cr. 7 Ul Z bu OLL. °� O �''FM 1.1� o � o < -J- 0 R�g OW U 0 -glu (,9 N Cd O O b r. .j �Q A Qa :. �lsiZ r 7VS j ooLL � y o � u � o <g2�,, � O O — a as ,• ooyco " b u Ul% O> �- tLI ,d v VOGLLz' C's 0 CA w F- W o b o� v; L W •> CL °o O U Z I lam! 2 0 ' S• 03 ° o Q Cl) Q z , 6 T-.b T TO, CT 9fly Zed S T 9 S3S I 8cl831N3 839312N S'01�1?RqS' 04/05/05 14:42:31 DEFAULTCSID-> Baxter, Mike Page 003 LU JI tj gj Ljj CEO �/ lgfzf��Ep �IPos 130 �E ` 000 (� � Y J v i f i 1 f s ENGR: CONFIDENTIAL PROPERTY OF SPECIALTY ELECTRONICS. NOT TO BE DISCLOSED TO OTHERS, .,:i REPRODUCED,OR USED FOR ANY PURPOSES EXCEPT AS AUTHORIZED IN WRITING BY AN AUTHO- - LANDRUM,SC DATE: RIZED OFFICIAL OF SEI.MUST BE RETURNED TO SEI ON DEMAND.ON COMPLETION OF ORDER,OR �7fWYW 1 29356 OTHER PURPOSE FOR WHICH LENT. ;;, D �� o � �d .-- � ' �-�a-�� MASON COUNTY DEPARTMENT OF HEALTH SERVICES August 04, 2006 PO BOX 1666 Shelton WA 98584 Shelton (360)427-9670 Fax (360)427-8442 Elma (360)482-5269 Belfair (360)275-4467 Case No.: COM2005-00067 Parcel No.: 123325090040 Dear Applicant: Your building permit cannot be approved by Mason County Environmental Health until the following are completed and turned in: 11 Please see comments at the end of this letter. Please call me at(360)427-9670, ext. 554 if you have any questions. Sincerely, Trish Woolett tw@co.mason.wa.us Environmental Health Mason County Health Services Comments: This permit continues to be on hold in our department. Please contact us within the next 10 days this application. If you do not contact us we will cancel this application. 8/4/2006 1 of 1 COM2005-00067