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HomeMy WebLinkAboutCOM2009-00006 Change in Ownership - COM Permit / Conditions - 1/16/2009 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Inspection Line(360)427-7262 Mason County Bldg. 3 426 W. Cedar P.O. Box 186 Phone: (360)427-9670,ext.352 Shelton, WA 98584 COMMERCIAL BUILDING PERMIT COM2009-00006 OWNER: UNION BAY CAFE RECEIVED: 1/16/2009 CONTRACTOR: LICENSE: EXP: ISSUED: 2/6/2009 SITE ADDRESS: 5121 E STATE ROUTE 106 UNION EXPIRES: 8/6/2009 PARCEL NUMBER: 322325008002 LEGAL DESCRIPTION: UNION HOOD CANAL LAND & IMP CO BLK: 8 LOTS: 2-5 N OF HWY&VAC 1ST ST PROJECT DESCRIPTION: DIRECTIONS TO SITE: CHANGE IN OWNERSHIP- NO CHANGE TO STRUCTURE STATE ROUTE 106 TO UNION BAY CAFE General Information Construction&Occupancy Information Type of Use: VB Insp.Area: No. of Units: 0 Type of Constr.: VB No. of Bathrooms: 2 Occ. Group: A-2 Valuation:Type Work: TRA Fire Dist.: 6 No. of Stories: 1 Occ. Load: 96 Building Height: Pre-Manufactured Unit Information Square Footage Information Make: Length: Lot Size: Model: Width: Building: Year: Serial No.: Basement: Parking Spaces: Setback Information Shoreline&Planning Information Front: Ft. Shoreline: Ft. 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?: Standpipe?: Auto Fire Sprinkler System?: Access Road?: Fire Extinguishers?: Fixed Fire Suppression System?: Fire Hydrants?: Fire Lanes?: COM2009-00006 Please refer to the following pages for conditions of this permit. 1 of 5 Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Tenant Review Fee r FARA 1/1R/?nnQ P1d1 nn g99nnQnn IFC Plan Check Fee l AIN v99r?nna --M x;n gggnnann EH Plan Review rF%ni 1/3n/9nnQ -t1 nA nn R9gnngnn Total $314.50 CASE NOTES FOR COM2009-00006 CONDITIONS FOR COM2009-00006 1) Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. x_ � 2) ALL CONSTRUCTION MUST MEET OR EXCEED ALL LOCAL CODES AND THE INTERNATIONAL CODE REQUIREMENTS AND OCCUPANCY IS LIMITED TO THE PERMITTED AND APPROVED CLASSIFICATION. ANY CHANGE OF US4 PR OCCUPANCY WOULD RESULT IN PERMIT REVOCATION. CHANGE OF USE MUST BE APPROVED PRIOR TO CHANGE. x 3) Changes to approved building plans that affect compliance to the current Washington State Energy Code (WSEC), ventilation and Indoor Air Quality Code (.VIAQ), Building/Plumbing/Mechanical Codes and/or Mason County Regulations shall be approved prior to construction. X� 4) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED BUILDING CODE. The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building Inspector shall be made prior to requesting additional inspections. X ?� 5) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compli t w. h Mason County ordinances and building regulations. X V COM2009-00006 2 of 5 w 6) Install 2A10BC fire extinguishers throught the building so that the maximum distance of travel does not exceed 75 feet in any direction and mounted no Tgre than 60 inches above the floor to the top of the unit. X Install 1 type K fire extinguisher in the kitchen within 30 feet of the cooking appliances and no closer than 10 feet. X �-- Install a knox/key box on the front of the building per section 506 of the 2006 International fire code. Please contact the local fire district for more informs i ,nnaan inspection. X VV The building and the site are subject to inspections and corrections as deemed necessary by the Mason County Fire Marshal to meet the minimum fie and life safety requirements as adopted by Mason County. s The fire sqpAr&ssion system for the type I range hood is required to be a UL 300 system. X 7) Water qua it. is not to be degraded to the detriment of the aquatic environment as a result of this project. X '� 8) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permi� h Ider have prevented action from being taken. No more than one extension may be granted. X 9) All approved plans are required to be on-site for inspection purposes. If inspection is called for and plans are not on site, Approval WILL NOT be granted. In addition, a reinspection fee, based on the current fee schedule, minimum one-hour will be char and collected by the Mason County Building Department prior to any further inspections being performed or approvals granted. X 10) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division. There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at 1-800-647-Q9��The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 11) Approv d per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X 12) Type 1 oods A type I hood is required in all commercial kitchens. The annual inspection report shall be available for the Mason County Building Inspector prior to the final inspection. X 13) Commercial oods All kitchen hood systems shall be installed and maintained as required by the International Fire Code, Building Code and Mechanical Code. Inspection and maintenance records shall be available for inspectors during all inspections. X COM2009-00006 3 of 5 I 14) Recyclable materials &Solid Waste Storage: Space shall be provided for the storage of recycled materials and solid waste. The storage area shall be design e t he needs of the occupancy, efficiency of pick-up, and shall be available to occupants and haulers.X This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of work is by means of a progress inspection.The owner or the agent on the owners behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. OWNER OR AGENT: DATE: L COM2009-00006 4 of 5 n O C N CONCRETE MECHANICAL MANUFACTURED HOME ? cfl Date B Footings 1 Setbacks" Gas Piping µ Ribbons - — Z 0o Interior Date By interior-Date i3y Date By W CZ) Exterior Date By Exterior-Date _ B, Set-up Point Load 1 isolated Footings INSULATION ���� Date By y BG 1 SLAB INSULATION Date By Data By FIRE DEPARTMENT m, Foundation Wails Floors Date By Date By Data By DECKS FRAMING wails Date By Date By Data By PROPANE TANKS PLUMBING vault Date By Date By OTHER Groundwork Attic Date By Date By Type. Date By o.w.v DRYWALL Type_ n InL Brace Wall O Date By pate B Date By y FINAL INSPECTION c Water Line Fire Separation O Date By Date By Date By p O Pass or Request Inspect. c Type of Insp. Fail Date Date Done By Comments a, cri 0 COM-2OOc —OO MASON COUNTY TENANT REVIEW APPLICATION Co plete the Tenant Review Application and return with a floor plan,site plan,septic pumper's report, septic records and $141. 0 feet the Mason County Permit Center, P.O. Box 186, Shelton,WA 98584. During the evaluation of your Tenant Review Applicatio taff members from the Building, Fire Marshal, Environmental Health, Planning and Public Works offices will identify nee 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 conspicuous place on the premises. e z t , Date: u k Assessor's Parcel Number: 2, 2 Legal Description: Building Site Address: Method of sewage disposal: ® Septic O Sewer- name of district: Water source: O Individual Well O Community Well 40 Public System, name of system: PLk,o. V-1— iiwavlt t tF+PRt .1 G Y ; Name of Applicant: (�(y Mailing address: o, t3 L1Sa City: n`c ,� State: WA Zip: 9(�3901 E-Mail Address:/bN M��`)(o I � �mr►,i �'o�c Day phone: FAX phone: Contact Person:A,{;i4 Y9D-dry/ n e W Proposed business name: hd C Proposed use: &S.' wnI Number of employees: Previous business name: Describe previous use: rC-.S I-nJ A A,1j W y- ..r 4-^�s e 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 cu�r�t 4!tly If not occupied, how long has it been vacant? rq 7(D occupied? Cam' No Yrs mos. Square footage: I Basement: First:a /)o Mezzanine: Second:a ,. o D I Third: Is the struct heated? Heating type: Circle one: Circle one: a No Electric i uid Pro ane Natural Gas Oil Type of hea : Circle one:Curnace eat Pump Electric a and or wall mount Radiant Wi ere be any changes to the following? Circle yes or no, if applicable: Floor lay-out: Yes Lighting: Yes 6N Heating: Yes �No Exterior Finishes: Yes tN Interior Finishes: Yes No Parking: Yes Number of restrooms provided: Number of fixtures in each Is structure handicap accessible? Circle one Ye No Is the structure equipped with a fire sprinkler system? Yes o Fire alarm system? Yes o Monitoring Station Name: Phone number: gl4pp- �s,. '''"*�" 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 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 • Surface&storm water run-off routes • Parking areas(number&arrangem,-101M r(�w Location of fire hydrants&vehicle access roads AD vvli..iill �r ram, Septic records,pumper's report or O&M report. JAN 4. Fees will be collected at time of submittal. Balance due will be collected when the permit is approved and issued. s1-0 NT N w Accepted by Date 4P I OR Submittal Amount $ I Recei t number Department Review Initials Date Comments Building Environmental Health Fire Marshal Planning Public Works Pre Application required? (circle one) Yes Building Permit required? (circle one) Yes Engineering Required? (circle one) Yes No Type of construction Occupancy Change? (circle one) Yes New Occupant load: persons Occupancy classification change from Existing occupant load design V persons. Valuation: $ _7Z COM,200-I -OOP MASON COUNTY TENANT REVIEW APPLICATION DOfee plete the Tenant Review Application and return with a floor plan, site plan,septic pumper's report, septic records and $1the Mason County Permit Center, P.O. Box 186, Shelton,WA 98584. During the evaluation of your Tenant Review Apff members from the Building, Fire Marshal, Environmenta► Health, Planning and Public Works offices will identify quirements. 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 conspicuous elace on the Rremises. Date: � j�, ( OBI Assessor's Parcel Number: Legal Description: Building Site Address: �� y ,ti 1 o(, Method of sewage disposal: ® Septic O Sewer-name of district: Water source: O Individual Well O Community Well 0 Public System, name of system: RJ,,o, .0-1— Name of Applicant: 1(� �nc��✓J Mailing address: o, a� �fSa City: State: Zip: E-Mail Address: n c„rJ W n (/J A p �' 3d I o-ern i.c o,Ut Day phone: Sly._ rx0:;,D FAX phone: Contact Person:&(,,I k y7d-orb'/ Proposed business name: C Proposed use: S wr< Number of employees: Previous business name: ,o,v ,r?,,4 Describe previous use: 51 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 currm�nntly If not occupied, how long has it been vacant? rl 7v occupied? <!Gs No Yrs mos. Square footage: I Basement: I First:a j�O Mezzanine: Seconc �� Third: Is the struct heated? Heating type: Circle one: Circle one: a No I Electric i uid Pro ane Natural Gas Oil _ Type of hea : Circle one: urnace eat Pump Electric and or wall mount Radiant Wi ere be any changes to the following? Circle yes or no, if applicable: Floor lay-out: Yes Lighting: Yes IV-) Heating: Yes �Nci Exterior Finishes: Yes �Nw Interior Finishes: Yes No Parking: Yes Number of restrooms provided: I Number of fixtures in each Is structure handicap accessible? Circle one Ye No Is the structure equipped with afire sprinkler system? Yes o Fire alarm system? Yes o Monitoring Station Name: - Phone number: 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 • Surface&storm water run-off routes • Parking areas(number&arrangeme Location of fire hydrants&vehicle access roads y' $ v r Septic records,pumper's report or O&M report. (_ t. 4. Fees will be collected at time of submittal. Balance due will be collected when the permit is approved and issued. �, mg''; , Accepted b -1 Data 11IR104 Submittal Amount$ i Recei t number Department Review Initials Date Comments Building Environmental Health Fire Marshal Planning Public Works Pre Application required? (circle one) Yes Building Permit required? (circle one) Yes Engineering Required? (circle one) Yes(M) Type of construction Occupancy Change? (circle one) Yes New Occupant load: persons Occupancy classification change from `]Z> Existing occupant load design P persons. Valuation: $ -Z Z COM,2_0001 —O� MASON COUNTY TENANT REVIEW APPLICATION D plete the Tenant Review Application and return with a floor plan, site plan,septic pumper's report, septic records and $1the Mason County Permit Center, P.O. Box 186, Shelton,WA 98584. During the evaluation of your Tenant Review Apll members from the Building, Fire Marshal, Environmental Health, Planning and Public Works offices will identify quirements. 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 conspicuous elace on the Rremises. Date: JJU l 0°1 Assessor's Parcel Number: 2, . F Legal Description: Building Site Address: Method of sewage disposal: ® Septic O Sewer- name of district: Water source: O Individual Well O Community Well 0 Public System, name of system: P,Lk,a .02 Name of Applicant: 1(� (� RN Mailing address: City: State: Zip: E-Mail Address: n c c r�l w!� (/�-�A p� �';�30� L bN(�►��Jlo ) �mi,,i.c ortit Day phone: gyp_ FAX phone: Contact Person:A,l;tce . .�: 77 Proposed business name: / G1 Proposed use: S. wn Number of employees: Previous business name: Describe previous use: j2zs 1f Air,} Check one: 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 cu�rr tly If not occupied, how long has it been vacant? 7v fq occupied? (:FBiP No Yrs mos. Square footage: I Basement: I First:a 0O Mezzanine: Second:a ,_ 0,9 Third: Is the struct heated? Heating type: Circle one: Circle one: (Wjil No I Electric i uid Pro ane Natural Gas Oil Type of hea : Circle one: urnace eat Pump Electric rd or wall mount Radiant Wi 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 �N_Q) Interior Finishes: Yes No Parking: Yes No Number of restrooms provided: Number of fixtures in each Is structure handicap accessible? Circle one Ye No Is the structure equipped with a fire sprinkler system? Yes o Fire alarm system? Yes o Monitoring Station Name: -- Phone number: -- a 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 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 • Surface&storm water run-off routes • Parking areas (number&arrangem-13 Location of fire hydrants&vehicle access roads IXEC EIVED Septic records,pumper's report or O&M report. J t .- 4. Fees will be collected at time of submittal. Balance due will be collected when the permit is approved and issued. 2111, a W Acce ted b Date Submittal Amount$ i Recei t number Department Review 1Pjti4A /Date Comments Building 1 Z Environmental Health Fire Marshal Planning Public Works Pre Application required? (circle one) Yes ZZOI-) Building Permit required? (circle one) Yes Engineering Required? (circle one) Yes Q Type of construction Occupancy Change? (circle one) Yes CIT&-,, New Occupant load: persons Occupancy classification change from Existing occupant load design P _persons. Valuation: $ _7Z COM_,�200q --0� MASON COUNTY TENANT REVIEW APPLICATION D plete the Tenant Review Application and return with a floor plan,site plan, septic pumper's report, septic records and $1the Mason County Permit Center, P.O. Box 186, Shelton,WA 98584. During the evaluation of your Tenant Review Apff members from the Building, Fire Marshal, Environmental Health, Planning and Public Works offices will identify quirements. This application is intended for tenant change only. If construction or remodeling is proposed/required a separate building permit will be necessary. Upon approval the permit will be issued to the applicant/tenant. After the permit is issued, schedule a site inspection by calling (360)427-7262. Upon satisfactory inspection a Certificate of Occupancy will be issued and must be posted in a conspicuous elace on the Rremises. Date: I�, j O� Assessor's Parcel Number: Legal Description: Building Site Address: Method of sewage disposal: ® Septic O Sewer—name of district: Water source: O Individual Well O Community Well ® Public System, name of system: P,a,o, .0Z Name of Applicant: (1(- Coy, r,,� Mailing address: o, �$a City: nc e State: &,\-)A Zip: E-Mail Address: ��a Day phone: g jj:_ W:;D FAX phone: Contact Person:1t,l;lLe y7,0--0",F j Proposed business name: F C?ASIC Proposed use: S wn Number of employees: Previous business name: Q ,u,v Describe previous use: S{r,JA�nt . m 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 currp�tly If not occupied, how long has it been vacant? rl7v occupied? <JesP No Yrs mos. Square footage: I Basement: First: op Mezzanine: Second:a 00 I Third: Is the struct heated? Heating type: Circle one: Circle one: (YaO No Electric I uid Pro ane Natural Gas Oil Type of hea : Circle one: urnace eat Pump Electric rd or wall mount Radiant Wi ere be any changes to the following? Circle yes or no, if applicable: Floor lay-out: Yes Lighting: Yes N; Heating: Yes N Exterior Finishes: Yes N Interior Finishes: Yes No Parkin : Yes No Number of restrooms provided: I Number of fixtures in each Is structure handicap accessible? Circle one Ye No Is the structure equipped with a fire sprinkler system? Yes o Fire alarm system? Yes o Monitoring Station Name: ---- Phone number: 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 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 • Surface&storm water run-off routes • Parking areas(number&arrangeme -a't"V' Location of fire hydrants&vehicle access roads 16- � EPi , Septic records,pumper's report or O&M report. d AN 4. Fees will be collected at time of submittal. Balance due will be collected when the permit is approved and issued. Acce ted b��-� Date Submittal Amount$ � Recei t number Department Review Initials Date Comments Building Environmental Health C ( v UP I p �, Fire Marshal Planning Public Works Pre Application required? (circle one) Yes Building Permit required? (circle one) Yes I( Engineering Required? (circle one) Yes(MD Type of construction Occupancy Change? (circle one) Yes New Occupant load: persons Occupancy classification change from (7�> Existing occupant load design persons. Valuation: $ `7 z COM ZOOci —DOC MASON COUNTY TENANT REVIEW APPLICATION uC�� h1plete the Tenant Review Application and return with a floor plan, site plan, septic pumper's report, septic records and $141: 0 fee tfi the Mason County Permit Center, P.O. Box 186, Shelton,WA 98584. During the evaluation of your Tenant Review Applicatj9p4aff members from the Building, Fire Marshal, Environmental Health, Planning and Public Works offices will identify nce 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 conspicuous glace on the eremises. �5: �. ,k�:^:_ :. r'� t.•+ „. `��, xr�,� � ,�.f � ,..;r... ,.��u�.... � ���� � ':✓^%�, a�Ze �e '�r ::.: Date: J flu I O(� Assessor's Parcel Number: 3 L Legal Description: Building Site Address: S Id 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: 1(� 4,RAN Mailing address: o, t3 �5 City: n c State: A Zip: �' 01 E-Mail Address: Day phone: -fy _ W&) FAX phone: Contact Person: Proposed business name: 110 yr e Proposed use: as-. wn Number of employees: Previous business name: Y 0;u A C Describe previous use: rC45}N,,AA v1 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 cur�r ntly If not occupied, how long has it been vacant? (q 7C> occupied? CSz? No Yrs mos. Square footage: Basement: I First:a DO I Mezzanine: Second: 00I Third: Is the struct heated? Heating type: Circle one: Circle one: a No Electric i uid Pro ane Natural Gas Oil Type of hea : Circle one: urnace eat Pump Electric and or wall mount Radiant Wi ere be any changes to the following? Circle yes or no, if applicable: Floor lay-out: Yes Lighting: Yes N� Heating: Yes N Exterior Finishes: Yes tN Interior Finishes: Yes No Parking: Yes No Number of restrooms provided: j I Number of fixtures in each Is structure handicap accessible? Circle one Ye No Is the structure equipped with a fire sprinkler system? Yes o Fire alarm system? Yes o Monitoring Station Name: - Phone number: ;r 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 • Surface&storm water run-off routes • Parkin areas number&arran eme '' - g ( g ; Location of fire hydrants&vehicle access roads .I. v Septic records,pumper's report or O&M report. d g:�'iw 4. Fees will be collected at time of submittal. Balance due will be collected when the permit is approved and issued. A , ._. s a " rare Accepted by Date Submittal Amount$ Recei t number Department Review Initials Date Comments Building Environmental Health Fire Marshal Planning Public Works Pre Application required? (circle one) Yes Building Permit required? (circle one) Yes f� Engineering Required? (circle one) Yes C to Type of construction Occupancy Change? (circle one) Yes cift-, New Occupant load: persons Occupancy classification change from Existing occupant load design P persons. Valuation: $ -7 2 Q Q O = o - O Q O O z ............ 0000 ZOCD OO = ara a °0 O O Q 16 OO - -_- D r $ 0 O 00 O I ©o - O O 00 O00 Z -0-1W x s Q IM O 00 = �, N � o c n M f v va N a O r 20' Q O 2 0 04 H aN © � O d M w a (D Ptustubwall stub wall _ "� Stove/ovenCD s Y W 1 C n :L� J�b 1 o + a 000 �" ' VN w ;0 QrQ a.� c i Sink " ,-- =r � u v x � " O O o M < M N ,gym Men's/Unise _ ® Bathroom c . IV �- P.-fl Sink sy O Si fl nk Women's d9 �= moo ' O Bathroom Q Q Q � O ° o X- C. n Ora= Q O Z 0 3_ 0 a O V sv CL osv Oaq LnCD Q O N D o Q O n r � � Q O O CL 0 tub wall C. 2 r.aM.ni .' 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