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HomeMy WebLinkAboutCOM2006-00140 Cancelled Change in Tenant - COM Permit / Conditions - 11/2/2006 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Inspection Line(360)127-7262 Mason County Bldg. 3 426 W. Cedar P.O. Box 1'36 ' Phone: (360)427-9670,ext. 352 Shelton, WA 98584 COMMERCIAL BUILDING PERMIT COM2006-00140 OWNER: IRON PIRATE RECEIVED: 11/27/200E CONTRACTOR: LICENSE: EXP: ISSUED: 2/2/2007 SITE ADDRESS: 22551 NE STATE ROUTE 3 BELFAIR EXPIRES: 8/2/2007 PARCEL NUMBER: 123325000103 LEGAL DESCRIPTION: SAM B. THELER'S HOME & GAR TRS TR 43 PROJECT DESCRIPTION: DIRECTIONS TO SITE: CHANGE IN TENANT- Iron Pirate ST RT 3 TO BELFAIR LEFT SIDE ACROSS FROM HANK'S BISTRO. General Information Construction &Occupancy Information NV No. of Units: Type of Constr.: VB Type of Use: Insp.Area: o. of Bathrooms: 1 Occ. Group: B/M Type of Work: TRA Fire Dist.: 2 No. of Stories: 1 Occ. Load: 107 Valuation: c ` Building Height: Pre-Manufactured Unit Information v Square Footage Information Make: Length: Lot Size: Model: Width: Building: 3,198 Year: Serial No.: Basement: Parking Spaces: Setback Information Front: Ft. Shoreline: Ft. Shoreline&Planning Information Rear: Ft. Slope: Ft. Water Body: Shoreline Desig.: Side 1: Ft. SEPA?: Comp.Plan Desig.: Side 2: Ft. Fire Protection System Information Auto Fire Alarm System?: Emergency Key Box?: 9 Y Y Standpipe?: Auto Fire Sprinkler System?: Access Road?: Fire Extinguishers?: Fixed Fire Suppression System?: Fire Hydrants?: Fire Lanes?: COM2006-00140 Please refer to the following pages for conditions of this permit. 1 of 4 0 O CA A W N v -� f N O O c n. 0r- OOo � � co D � vn xo c o - 3cocs. _v i � o 0 o y. 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Z T Cn tv CT CL O 0, oo � CD CD � � 0 m D M CD5. v c � - 0 d � a o O is 0 r1j X Z-1 CONCRETE MECHANICAL MANUFACTURED HOME 0 C) z 0 Date 17, Footings/$44backs Gas Piping By Ribbons _0 CD ate Interior Data By Interior-Date By L By ;5 C� 1b, CD _P�- Ext8riDr Dale By Exterior-Date By Set-up '__4 Point Load I Isolated Footings INSULATION Date By m BG I SLAB INSULATION Date By Dato By FIRE DEPARTMENT Foundation Walls Floors Date By Date By (Data By DECKS FRAMING Walls Date By Date BY Data By PROPANE TANKS PLUMBING Vault Date By Date By OTHER Groundwork Attic Date B Date By Type- y Date 12A DWV DRYWALL Type: 0 Int Brace Wall Date By 0 Date By 9 Date By FINAL INSPECTION 1%t4w Line Fire Seperatio4i Date b Date Eby ?ate B C) C) Pass or Request Inspect. Type of Insp. Fail Date Date Done By Comments .0, Vc-, 2-22-o-I 2-2-6-07 0 41 Building Permit # MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location Z -S,5 l This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items List below must be corrected to gain code compliance ? S e ti i roc o-, v� s , You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK Call for re-inspection when corrections are made before continuing Make corrections, items will be checked on next inspection ❑ OK to I ❑ This is not a complete inspection Department C Date 2— 2- G — r) ;7 Inspector G c� 11040 AnT M� �V THU ,_ TR ,* m Mason County Dept. of Community Development Mason County Bldg. 3 426 W. Cedar P.O. Box 186 (360) 427-9670 Local (360) 482-5269 Elm@ i Shelton, WA 98584 (360) 275-4467 Belfair Notice to Obtain Final Inspection November 27, 2007 JOHN MCQUEARY 140 NE RAINIER PLACE NORTH BELFAIR WA 98528 Case No.: COM2006-00140 Parcel No.: 123325000103 Proiect Description: CHANGE IN TENANT - Iron Pirate The Mason County Department of Community Development is currently reviewing all permits that are expired and have not been approved for occupancy and use. Pursuant to Mason County Code, Title 14 Building and Construction, a permit and final inspection for this type of activity is required under the 2006 International Building Code or the code your permit was issued and your property is currently in violation status of occupancy and use. Please contact our office to make the necessary arrangements 21 days from the date of this letter. Failure to contact our office to make the necessary scheduled inspections will result in enforcement actions. To bring your site into compliance, you must schedule an inspection. One (1) $64.00 site investigation fee will need to be paid prior to inspection along with any outstanding fees currently due on your building permit. For every inspection required after that, you will be charged $64.00 again, per inspection until final inspection and conditions are met. To schedule an inspection, please call (360) 427-9670 ext. 262. If you should have any questions regarding this notification, please contact me at (360) 427-9670 ext 359. Sincerely, ✓��,_ ��� Terry Ryan / Mason County Department of Community Development Cc: Property File November 27, 2007 COM2006-00140 conna��.7�'-w1�n MASON COUNTY CHANGE IN TENANT APPLICATION Complete the Change in Tenant Application and return with a floor plan,site plan,septic pumpers report,septic records and fee to the Mason County Permit Center,P.O.Box 186,Shelton,WA 98584. Evaluation of the Change In Tenant Ap lication will involve staff members from the Building,Fire Marshal,Environmental Health,Planning and Public Works offices who will i compliance requirements. This application is intended for tenant change only. if n remodeling Is propose o 1I a buildin permit will be necessan_ Upon approval the permit will be issued to the applicantttenant. After the permit is W schedu u��G9/ Inspection by calling(360: 427-7262.Upon satisfactory inspection a Certificate of Occupancy will be issued and fdik poste cons icuous ace on the remises. 421 Date: '� p Assessor's Parcel Number: 23 3 2C 0 Legal Description: Building Site Address: Method of sewage disposal: Septic O Sewer-name of district: , Water source: O Individual Well O Community Well O Public System, name of system: Name of Applicant: Mailing address: City: 1�.A I R: State: Zip: 98 Ski Day phone: 0.60 Contact Person:${ -E ut. Message phone: v- -53'-1 Proposed business narr e: T Proposed use: ?S;rVk-% ol? -(t Number of employees: Previous business name: Describe previous use, i Check one: 0 Petached single level/single tenant O Single level/multi tenant O Multi level/sin le tenant O Multi level/multi tenant Age of structure: is structure cuiftnft If not occupied, how long has it been vacant? occupied? Ye No Yr. -- Mo. f. 1. Square footage: Basement: t First: $pb' Mezzanine: Second: 'Third: Is the structureeated? Heating type: Circle Circle on No (fiectricD Liquid Propane Natural Gas Oil Type of heat: Circle one: Furnace Heat Pump Electric baseboard wall mo Radiant Will there be any changes to the following? Circle yes or no,lfapplicable: Floor lay-out: Yes Lighting: Yes Heating: Yes Exterior Finishes: Yes I co Interior.Finishes: Yes R Parkin a: Yes No Number of-restrooms prow, ed: Number of fixtures in each Is structure handicap:aa:essibie? Circle one<M2No Is the structure equippec with a fire sprinkler system? Yes No Fire alarm system? No Monitod ig Station Name: Phone number: 1. Floor Plan(5 sets): • D6W the floor.plan to E cale • Use of rooms • Rcom'Dimensions • Location of all exits and windows(include dimensions) • Location of plur binaand mechanical fixtures • Interior doors with swing radius 2. Site Plan(5¢aelss) 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 tied drain fields,&reserve . Well location Is Location of fire hydrants&vehicle access roads • Parking areas number&arran ement 3. Septic records,pumpees report or O&M report 4. Foes will be collected at time of submittal Accepted by ;,(A .. Date 21-do__Submittal Amount .00 Receipt number Gonna 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 Ap lication will involve staff members from the Building,Fire Marshal, Environmental Health, Planning and Public Works offices who will i compliance requirements. This application is intended for tenant change only. If construction r remodelingis ro osed o Wed a building permit will be necessary. Upon approval the permit will be issued to the applicant/tenant. After the permit is isrd,sctliedu inspection by calling (360)427-7262. Upon satisfactory inspection a Certificate of Occupancy will be issued and lit posted cons icuous lace on the remises. 4 Date: '� O Assessor's Parcel Number: Legal Description: ,�S (jam S ,► Building Site Address: Method of sewage disposal: 0 Septic O Sewer-name of district: , Water source: O Individual Well O Community Well O Public System, name of system: Name of Applicant: Mailing address: 90 © 6 City: A I A- State: wA Zip: 9g cjZB Day phone: o-tbj-5311 Contact Person:Stj-Eiw Message phone. O- -53 y1 M w ,Proposed business name: Tro Proposed use: of Number of employees: Previous business name: Describe previous use: 4 G Ch�one: etached single level/single tenant O Single level/multi tenant O Multi level/single tenant O Multi level/multi tenant Age of structure: Is structure c If not occupied, how long has it been vacant? occupied? 'Yea, No Yr. Mo. Square footage: Basement: First: g� Mezzanine: Second: 'Third: Is the struc eated? Heating type: Circle o + Circle on No lectric Liquid Propane Natural Gas Oil Type of heat: Circle one: Furnace Heat Pump Electric baseboard wall mo Radiant Will there be any changes to the following? Circle yes or no,if applicable: Floor lay-out: Yes Lighting: Yes Heating: Yes Exterior Finishes: Yes No Interior Finishes: Yes Parking: Yes9 No Number of-restrooms provi ed: Number of fixtures in each Is structure handicap:accessible? Circle one° a No Is the structure equipped with a fire sprinkler system? Yes No Fire alarm system? 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. ets) 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 b Date Submittal Amount$JoIQ. Receipt number Department vi 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: coMao -�J°5�� 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 A loation will involve staff members from the Building,Fire Marshal, Environmental Health,Planning and Public Works offices who will i ' compliance requirements. This application is intended for tenant change only. If construction or remodefina is iDrovosed o a buiidin permit will be neceasary Upon approval the permit will be issued to the applicantttenant. After the permit is isAmd,sc d � u inspection by calling(360)427-7262. Upon satisfactory inspection a Certificate of Occupancy will be issued and it posted conspicuous Place on the oremises. 4 6 Date: Assessor's Parcel Number: 23?j 2�©� 4 Legal Description: ,N 1 Building Site Address: Method of sewage disposal: JK Septic O Sewer—name of district: Water source: O Individual Well O Community Well O Public System, name of system: Name of Applicant: Mailing address: PQ b O 6 City: A i I- State: Zip: 98 S� Day phone: _ab_ Contact Person: Message phone: .Proposed business name: T� Proposed use: ZN of Number of employees: Previous business name: A Describe previous use: G Check one: etached single level/single tenant O Single level/multi tenant O Multi level/sin le tenant O Multi level/multi tenant Age of structure: Is structure c I If not occupied, how long has it been vacant? occupied? Ye No Yr. -- Mo. f, t Square footage: Basement: First: g Mezzanine: Second: 'Third: Is the strut, Bated? Heating type: Circle on,-- Circle on No lectric Li uid Propane Natural Gas Oil Type of heat: Circle one: Furnace Heat Pump Electric baseboard wall mo Radiant Will there be any changes to the following? Circle yes or no,ffapplicable: Floor lay-out: Yes Lighting: Yes Heating: Yes Exterior Finishes: Yes No Interior Finishes: Yes Parkin : Yes No Number of�restrooms prove ed: ( Number of fixtures in each Is structure handicap.accessible? Circle one a No Is the structure equipped with afire sprinkler system? ,Yes No Fire alarm system? No Monito.Ing Station Name: Phone number: 1. Floor Plan(5 sets): • Dfa*the floor plan to scale Use of rooms • Rsiom Dimensions • Location of all exits and windows(include dimensions) • Location ofplumbing.and mechanical fixtures' • Interior doors with swing radius 2. Site Plan54e " le sed (,_. .; ): Notesca u• Property lines;easements,&right of ways • Distance,in feet, property line structures . • Location of all existing structures&dimensions • from li & Landscape buffer yards • -On-site sewage tanks and drain fields,&reserve • Well location • Location of fire hydrants&vehicle access roads 3. Septic records,pumper's report or O&M report • Parkin areas number&arran ement 4. Fees will be collected at time of submittal Accepted byapni Dated— Submittal Amount$ 9. Recei t number De artment vi Initials Date Comments Building Environmental Health Fire Marshal Planning Public Works Occupancy Change? (circle one) Yes No w Type of construction Occupancy classification change from to Occupant load calculated: persons Existing occupant load design persons. Land Use Designation: Occupancy Classification: 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 i compliance requirements. This application is intended for tenant change only. If construction or rem delin is ro Deed o a buildin permit will be necessary, Upon approval the permit will be issued to the applicantttenant. After the permit is is d,sc du pry Inspection by calling(360)427-7262. Upon satisfactory inspection a Certificate of Occupancy will be issued and ik be posted4r1� cons ous ace on the remises. 4 C Date: Assessor's Parcel Number: 23 3 2e Legal Description: J>t ej,"s04 Building Site Address: ;Z-2-551 Vj r. at Method of sewage disposal: A Septic O Sewer-name of district: , Water source: O Individual Well O Community Well O Public System, name of system: Name of Applicant: t Mailing address: O 6 City: A i (_ State: 1VA Zip: 98,5z Day phone: -db-S3 Contact Person:�t '6 �t t.I Message phone;_ ,Proposed business name: T� Proposed use: col^ Number of employees: i Previous business name: ti Describe previous use: G Check one: etached single level/single tenant O Single level/multi tenant O Multi level/sin le tenant O Multi level/multi tenant Age of structure: Is structure c If not occupied, how long has it been vacant? occupied? Ye No Yr. Mo. t Square footage: I Basement: First: ,bob 924t Mezzanine: Second: Third: Is the stru eated? Heating type: Circle ODA- Circle on NoO'lectric— D Liquid Pro ane Natural Gas Oil Type of heat: Circle one: Furnace Heat Pump Electric baseboard wall mo Radiant Will there be any changes to the following? Circle yes or no,if applicable: Floor lay-out: Yes Lighting: Yes Heating:Yes Exterior Finishes: Yes No Interior.Finishes: Yes Parkin : Yes.S Number of restrooms prove ed: Number of fixtures in each Is structure handicapaccessible? Circle Qne' a No Is the structure equipped with a fire sprinkler system?-.Yes No Fire alarm system? *]::N� Monitoring Station Name: Phone number: 1. Floor Plan(5 sets): • 9r1 the floor,plan to scale Use of rooms • Rpom Dimensions • Location of all exits and windows(include dimensions) • Location of pluri&na and mechanical fixtures' • Interior doors with swing radius 2. Site Plan nets,'"Note scale used • Property lines;easements,&right ofways • 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. F4es will be collected at time of submittal I Accepted bw Date - Submittal Amount$ a�. Recei t number Department vi4 Initials Date Comments Building Environmental Health Fire Marshal Planning tt i a P Public Works Occupancy Change? (circle one) Yes No k Type of construction Occupancy classification change from to Occupant load calculated: persons Existing occupant load design persons. Land Use Designation: Occupancy Classification: cM O�-�J�fi�,.,p MASON COUNTY CHANGE IN TENANT APPLICATION Complete the acrige in Tenant Application and return with a floor plan,site plan,septic pumper's report,septic records and fee to the Mason County 12 armlt 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 office,s who will compliance requirements. This application is intended for tenant change only. building permit will be necessary; Upon approval the permit will be Issued to the applicant/tenant. After the permit is isyyged,schedu R inspection by calling(360;.427-7262.Upon satisfactory inspection a Certificate of Occupancy will be Issued and tiat bg poste 4 conspicuous, on the 1wernises. Date: '' p Assessor's Parcel Number: j rj 3 3 -; O •4 Legal Description: f.) li�t Q_ti If./ Building Site Address: - t-2-5 : , Method of sewage dispiisal: 4 Septic O Sewer-name of district: � Water source: O Individual Well O Community Well O Public System, name of system: Name of Applicant: -• -A-+4 Mailing address: a1 b i CRY: '?�F A 1 R. State: , zip: 99 -Z Day phone: p-�_�; Contact Person:S c lA))4jjAA0 Message phone: v- RD 1-5 "1 .Proposed business nary-3: -Crj Proposed use: kaL. �, Number of employees: Previous business name: i Describe previous use: Check one: etached single IeveV single tenant O Single level/multi tenant O Multi Tavel/Sin le tenant O Multi Ieveltmulti tenant Age of structure: Isetructure c If not occupied, how long has it been vacant? occupied? C Y No Yr. Mo. S Square footage: I Basement: First: gam' Mezzanine: Second: 'Third: Is the afro sated? Heating type: Circle ' Circle on No I dlectric Liquid Propane Natural Gas Oil Type of heat: Circle one: Furnace Heat Pump Electric baseboard wall rnq91 Radiant V rill there be any changes to the following? Circle yes or no,if applicable: Floor lay-out: Yes Lighting: Yes Heating: Yes Exterior Finishes: Yes ;No Interior-Finishes: Yes Parkin :Yes No Number of•restrooms pn ed: Number.of fixtures in each Is structure handicap;a :essible?Cimle.one' No .Is the structure equippec with a fire sprinkler system? Yes No Fire alarm system? No Monitoft Sta on NamE: Phone number: 1. Floor Plan(3 sets): • •D&W thb floor,plan to x cale Use of rooms • Rpom•Dimension • Location of all exits and windows(include dimensions) • Location of pluAing al-id mechanical fixtures • Interior doors with swing radius 2. Site Plan(EMets): Na to scale used • Property lines,easements.,&dght•of ways . Location of all existing structures&dimensions i • Distance,in feet,from Property line&strubtures . Landscape buffer yards r • -On-site sewage tanks amd drain fields,&reserve • Well location Location of fire h dram 3&vehicle access roads . Parkina areas number&arrangement) 3. Septic records,pumpoes report or O&M report ' 4. Fees will be collected at time of submittal A ce fed (1 r Date l 21-do Submittal Amount 3�o�a�• _ Receipt number . iI 2r 7-0 1 rd(?-.,j COM O&4-P �n MASON COUNTY CHANGE IN TENANT APPLICATION Complete the CI range in Tenant Application and return with a floor plan,site plan,septic pumper's report,septic records and fee to the Mason County 1,ermit Center,P.O.Box 186,Shelton,WA 98584. Evaluation of the Change in Tenant ARplication will involve staff members from the B illding,Fire Marshal, Environmental Health,Planning and Public.Woiks offlces who will compliance requirements. This application is Intended for tenant change only. din Hermit will be neca:san j Upon approval the permit will be Issued to the appiieant/tenant. After the permit is scitiedu Inspection by caging(360.427-7262.Upon satisfactory inspection a Certificate of Occupancy will be issued and���g poste cons an the 4 "Da : p Assessor's Parcel Number: �,3 2r� O ,Q Legal Description: Building Site Address: �- s m Method of sewage disposal: 111F Septic O Sewer—name of district: Water source: O Individual Well O Community Well O Public System, name of system: Name of Applicant: Mailing address. 9 , l City: .E•A R State: Zip: °1F3 5-& Day phone: • _d�—05 3 Contact Person:S 6 ljjti, Message phone; .Proposed business nary e: T Proposed use: c3 Number of employees: Previous business namf Describe previous use: LAALOLA Check one: tacked single level/single tenant O Single level/multi tenant i O Multi Isvel/sin le tenant O Multi Ievel/multl tenant Age of structure: Is structure c If not occupied, how long has it been vacant? occu led? Y No Yr. Mo. f, S Square footage: I Basement: First: Sjb Mezzanine: Second: 'Third: j is the strucWatLeated? Heating type: Circle Clrrle on No lectric Li uid Propane Natural Gas Oil Type of heat: Circle one: Fumace Heat Pump Electric baseboard wall moot Radiant 5171'11 there be any changes to the following?Circle yes or no,If applicable. Floor lay-out: Yes Lighting: Yes Heating: Yes Exterior Finishes: Yes ' No Interior•Finishes: Yes Parking: Yes rNo Number of restrooms prcivi ed: Number.of fixtures in each Is structure handicapaccesslble?Clrrlle one' No .Is the structure equipped with a fire sprinkler system? . Yes No Fire alarm system? No MonitortiV Stsition Name: Phone number: 1. Floor Plan(S sets): • ;Oi kthe floor..plan to mimle • Use of rooms • Room Dimensions • Location of all exits and windows(Include dimensions) • Location of Plur461na&A Mechanical fixtures • Interior doors with swing radius � 2. Site Plan(S, e;s) Nai'e scale usual • Property lines,easements,&rightof ways . Location of all existing structures&dimensions j • Distance,In feet,from property line&structures . • Landscape buffer yards ! • *On-site sewage tanks aid drain fields,&reserve • Well location • Location of fire h dranti &vehicle access roads • Parking areas number&arrangement) 3. Septic records,pumpiies report or O&M report 4. Fess will be co/iecled+tt Bme of submittal I Accepted b a'! ; Date 27(xis Submittal Amount$J 12-40 Receipt number _ connao�-t�oJ`' � 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 Ap lication will involve staff members from the Building,Fire Marshal, Environmental Health,Planning and Public Works offices who will f compliance requirements. This application is intended for tenant change only. If construction or r modelln is DroDosed 1199arl a bulldin hermit will be necessary_ Upon approval the permit will be issued to the applicant/tenant. After the permit is ft sc du inspection by calling(360)427-7262.Upon satisfactory inspection a Certificate of Occupancy will be issued and�{{�st be posted {conspicuous plaW on the oremises. 4 C I Date: '1 p Assessor's Parcel Number: 2'v 3 2 (�� q j Legal Description: ,N 1>t Building Site Address: Method of sewage disposal: 18)L Septic O Sewer-name of district: Water source: O Individual Well O Community Well O Public System, name of system: Name of Applicant: �� Mailing address: o 6 r City. A State: Zip. Day phone: _ _ Contact Person:�' -E fjL l Message phone; v- -S3 yl ,Proposed business name: T� Proposed use: of Number of employees: Previous business name: 111Z 'A Describe previous use: Check one: etached single level/single tenant O Single level/multi tenant O Multi level/sin le tenant O Multi level/multi tenant Age of structure: Is structure c If not occupied, how long has it been vacant? occu led? Ye No Yr. -� Mo, s Square footage: Basement: First: g� Mezzanine: Second: 'Third: Is the stru eated? Heating type: Circle Circle on No lectric Liquid Propane Natural Gas Oil Type of heat: Circle one: Furnace Heat Pump Electric baseboard wall mo Radiant Will there be any changes to the following?Circle yes or no,lfapplicable: Floor fay-out: Yes Lighting: Yes Heating:Yes Exterior Finishes: Yes No Interior Finishes: Yes Parkin : Yes. No Number oUrestrooms provi ed: ( Number of fixtures in each Is structure handicapaccessible? Circle cane`. a No Is the structure equipped,with a fire sprinkler system? .Yes No Fire alarm system? No Monitor([g Station Name: Phone number: 1. Floor Plan(5 sets): • Dfaw the floor,plan to scale Use of rooms • Room Dimensions • Location of all exits and windows(include dimensions) • Location of lumbin .and mechanical fixtures` • Interior doors with swing radius 2. Site Plan(5M.00 Note scale used . . ) • Property Imes,,easements,&right of • • Distance,in feet,from property line&structures . Location of all existing structures&dimensions • -On-site sewage tanks and drain fields,&reserve ' Landscape buffer yards • Location of fire hydrants&vehicle access roads ' Well location 3. Septic records,pis report or O&M report • Parkin areas number&arrangement) 4. Fees will be collocted at time ofsubm/ttal Acce ted b Date - Submittal Amount$1012. Recei t number i De artment vi Initials Date Building — Comments Environmental Health Fire Marshal Planning Public Works Occupancy Change? (circle one) Yes No Type of construction Occupancy classification change from to Occupant load calculated: t Existing occupant load design persons. Land Use Designation: persons Occupancy Classification: _. .........._.. .o._�.._.�.`.; _.;. ....ice. � Z ���.._ : __ _. w. : _�.�' __ � ._._..__ . ... - � ...•. .. . . .... . . ... ... .... ...... . .: _ +..� _�13-_i..._.jl_ITVi_'_� f^ ?•�., "''.�'yl'-."'_.._......._..... —I 1 i i 1 .1. J .. .. -----r --- �--` jr.'! :--• t i ?__ t i ; i' 1 ! uj.]/� --- --SSA f �$In• w_. .... ; �, - 1 -'�;--�— ,u: -=�--+-'pair-•---`r- '•w-_.�._:._..,.;_.�p.,._,.�,.�:'.�.._�__''----•1---i--. -1 1 { � ! i , 2 ! t �` � � } r SWUL ___..-. -- 37 --- --_�--_-- . - _ . .........................._ WTI ...__._. _•..._.-._._.. _...q__. ...... _ ..._ .. .... • ._ •y _ . .. .. v..•_r ___ ....... _ . Fco N10 I _ ...__ .«_.. ___..._........... ... .. 570 _ a03 ; 5,5, FL 0 to � e o._ _,.. ... ..... _.._... .. . ..._.a, _. m -t, ? - ._. ... ..__.._.. 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