HomeMy WebLinkAboutChange of Use - COM Application - 8/31/2010 1 1
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
$125 fee to the Mason County Permit Center, P.O.Box 186,Shelton,WA 98584. During the evaluation of your Change in Tenant
Application staff members from the Building, Fire Marshal, Environmental Health, Planning and Public Works offices will identify
compliance requirements. This application is intended for tenant change only. If construction or remodeling is proposed/required a
separate building permit will be necessary. Upon approval the permit will be issued to the applicant/tenant. After the permit is issued,
schedule a site inspection by calling(360)427-7262. Upon satisfactory inspection a Certificate of Occupancy will be issued and must be
posted in a cons icuous elace on the eremises.
Date: Assessor's Parcel Number:
Legal Description:
Building Site Address:
Method of sewage disposal: O Septic O Sewer—name of district:
Water source: O Individual Well O Community Well O Public System, name of system:
`� 1 SIN THE PROJE �;
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Name of Applicant:
Mailing address:
City: State: Zip:
Day phone: Contact Person: Message phone:
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ACT ..NCO MATIOE
Proposed business name:
Proposed use: Number of employees:
Previous business name:
Describe previous use:
€;.Check o
ne: O Detached 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 currently If not occupied, how long has it been vacant?
occu ied? Yes No Yrs mos.
Square footage: I Basement: First: Mezzanine: I Second: Third:
Is the structure heated? Heating type: Circle one:
Circle one: Yes No I Electric Liquid Propane Natural Gas Oil
Type of heat: 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 No Lighting: Yes No Heating: Yes No
Exterior Finishes: Yes No Interior Finishes: Yes No Parking: Yes No
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): Use of rooms
• Draw the floor plan to scale • Location of all exits and windows(include dimensions)
• Room Dimensions • Interior doors with swing radius
• Location of lumbin and mechanical fixtures
2. Site Plan(5 sets): Note scale used • Location of all existing structures&dimensions
• Property lines, easements,&right of ways • Landscape buffer yards
• Distance,in feet,from property line&structures . Well location
• On-site sewage tanks and drain fields,&reserve 0 Parking areas(number&arrangement)
• Surface&storm water run-off routes
• Location of fire hydrants&vehicle access roads
3. Septic records,pumper's report or O&M report.
4. Fees will be collected at time of submittal
4140
Accepted by Date Submittal Amount $ Receipt number
Department Review Initials Date Comments
Building
Environmental Health
Fire Marshal
Planning
Public Works
Pre Application required? (circle one) Yes No Building Permit required? (circle one) Yes No
Engineering Required? (circle one) Yes No Occupancy Classification:
Occupancy Change? (circle one) Yes No Type of construction
Occupancy classification change from to Occupant load calculated: persons
Existing occupant load design persons.
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Debbera Coker - Change of use, retail space to restaurant
From: Debbera Coker
To: cameo@hctc.com
Subject: Change of use, retail space to restaurant
CC: Jess Mosley; McAboy, Kell; Woolett,Trish
It has come to our attention that you may be changing the use in a part of the existing structure from a retails (M occupancy) to
a restaurant(A-2/R occupante
When a change of use occurs a "Tenant Review Application" must be submitted and approved
prior to making the change. purpose of the application is to verify that existing conditions, and proposed remodel when
applicable, meet requirements pertaining to the building code, environmental health, and planning regulations. A copy of the
Tenant Review Application is attached to this e-mail.
If you have questions about specific regulations or the application form and process please contact one of the following staff
representatives at the extensions listed below:
(360) 427-9670
Debbera Coker, Building Department, ext. 510
Trish Woolett, Environmental Health, ext. 554
Jess Mosely, Food permit, ext. 361
Kell McAboy, Planner, ext. 363
Ou
aboutNank 4/12/2007
L(4/12/2007) Debbera Coker- Cameo Boutique Page 1
From: Diane Zoren
To: Debbera Coker
Date: 4/12/2007 10:55 AM
Subject: Cameo Boutique
CC: Jess Mosley
Hi Debbera, please send the necessary paperwork for"change of use"to the Cameo Boutique,Gary&Pam Hanson,6871 E
Hwy 106, Union 98592. Jess knows the details. Thanks, Diane x747
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