HomeMy WebLinkAboutCOM2001-00089 Final Tenant Review - COM Inspections - 8/14/2002 r •
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MECHANICAL MOBILE HOME
CONCRETE
Fbo*Vs•Setbsek date by Ribbons
dW* by Gas POq date by
Four- a Walt date Setup
daft by INSULATION date by
SGISLAB ration by Floors date
date by
FRAMING WaftFIRE DEFT.
date by date by date by
PLUMBING Attic OTHER
Groundwork date by
date by WALLBOARD NAILING
D.W.V.
by
date by date
Water Line FlNAL INSPECTION
date by date by date by
ITT
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Or►ti LZV 0Z 3?
Case number:
MisSonfCounty
TENANT REVIEW APPLICATION
Complete the tenant review application and return with a floor plan. site plan, pumpers report, septic records and
$100.00 fee to the Mason County Permit Assistance Center, P.O. Box 186, Shelton,WA 98584. The tenant review
application will be evaluated on Wednesday after the application has been received. During the evaluation Mason County
staff members from the Building, Fire Marshal, Environmental Health, Planning, and Public Works offices will identify
compliance requirements, if needed, and advise whether a separate building permit will be required.
Ut,%1 o r% m cam. Co_,, _�1V- 16U Lwr
Date: , - Assessor's Parcel Number:
Legal Description:O d� r p SqO--- d0 �9
1S 1Y' ,�„b /r east ay-Go c2"1 't to� �s k ►oo c,1) ,N Alir a-10 - CA
Building Site Address: 7q0 Wt 10 oo,d:.j Lra,►✓,.r rAjr (a, q,�.�,,;,r4
Method of sewage disposal: Septic O Sewer- name of district:
Water source: 0 Well 9-Community Well O Public System, name of system:
,J d✓J .SF
PEOPLE and FIRMS INVOLVED IN THE PROJECT
Name of property owner: Aretj 1<_ (L� L L
Mailing address: q2a42 4v,-T S )00c j1 _ ek7 `��(_fVtll� �/�Gp L
Day phone: ct Person: J^a\),,rl Message phone:
Name of applic nt: +k : AM '
Mailing addres m4a NNE c>teL- 1 kf;11� \ ^u;4
Day phone: . 7- 3(S' Contact person: (, �, Message phone: S "IF
Name of Tenant:
Mailing address: q0
Day phone: �-27 -3)i Contact person: k q (f : ,_V Message phone: S is
PROJECT INFORMATION
Proposed business name:
Proposed use: p armjT I Number of employees:
Previous business name: U)c z\,41
Previous use: A,,-j r
INFORMATION ABOUT STRUCTURE
Check one: ODetached single level/single tenant O single level/multi tenant 06
O Multi level/single tenant Multi level/multi tenant �EXis�� o ce czf7o�p �x�,r�,
Age of structure: Is structure currently occ d? If not occup' how long has it been vacant?
Circle one: Yes No I Yrs os.
List square footage for each floor leve
Basement: First: U Mezzanine: tJ C+ I Second: S-00 aP Third: >J A
Will strucrte
heated: Type heating fuel: Circle one:
Circle one No Electric i u Pro ane Natural Gas Oil
Type of hea : Circle one Furnace Heat Pump Electric base oard or wall mount Radiant
WIFthere be any changes to the following? Circle yes or no, if applicable:
Floor lay-out: Yes � Lighting: yes Heating: Yes No
Exterior Finishes: Yes Mo Interior Finishes No infi`-7 r. Parking: Yes o
Number of restrooms prove e-d: ;�_ N ber of fixtures in each
Is structure ADA Accessible? Circle on Yes No
Is the structure equipped with a fire sprinkler system? Yes CNo..2 I Fire alarm system?
Return this application with:
1) Floor Plan, 2) Site Plan, 3) Pumpers Report and septic records and 4)$100 Fee
1) ,poor Plan: Include existing walls,proposed walls,and walls that will be removed.
• Draw the floor plan to scale, '/:'= 1 foot min. •tUse of rooms
•;"Room Dimensions • e—Location of all exits and windows (include dimensions)
* --!�ocation of plumbing and mechanical fixtures * ,._-Interior doors with swing radius
2) Site Plan: Note scale
• .,-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 drainfields, & reserve • Well location
•. Surface&stormwater run-off routes • Parking areas (number&arrangement
• Location of fire hydrants &vehicle access roads • Slope of property
3) Pumpers Report and septic records
4) Fee: $100.00 Intake fee will be collected when submitted. Additional fees will be collected when the permit is
issued.
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Case number:
Mason County
TENANT REVIEW APPLICATION
Complete the tenant review application and return with a floor plan. site plan, pumpers report, septic records and
$100.00 fee to the Mason County Permit Assistance Center, P.O. Box 186, Shelton,WA 98584. The tenant review
application will be evaluated on Wednesday after the application has been received. During the evaluation Mason County
staff members from the Building, Fire Marshal, Environmental Health, Planning, and Public Works offices will identify
compliance requirements, if needed, and advise whether a separate building permit will be required.
Date: t, _ -OI Assessor's Parcel Number:
Legal Description: c4S ,4,0 0_y60 pi tP c,,, ,q 4�-k too ulP ,n Play or e-1 cA
Building Site Address: q0 WK lob op,d:� c»� �; L,��+ �,� F rCo. q �,;, U,1),V,-j
Method of sewage disposal: P.,Septic O Sewer- name of district:
Water source: O Well 9-Community Well O Public System, name of system:
PEOPLE and FIRMS INVOLVED IN THE PROJECT
Name of property owner: -� „ 2�of LL L,
�.
Mailing address: A ry S ��� ¢rj i `���vu�� V f` , cf:RCp L
Day phone: Contact Person: J^a\�,J Message phone:
Name of applicant: +Ke L+-9w t-z"-
Mailing address: C ,,NG v� b!L 1 c rpS�'ti
Day phone: ' ? 3(S Contact person: Message phone: S
Name of Tenant: (a L
Mailing address: kic ae— �j C-",r - oY0- qig
Day phone: �?7 -3,kn Contact person: Message phone: i
PROJECT INFORMATION
Proposed business name: t c Tb A L
Proposed use: C� , r Number of employees: ceyc Q
Previous business name:
Previous use: Rv s A,,Q
INFORMATION ABOUT STRUCTURE
Check one: ODetached single level/single tenant O single level/multi tenant 'ram
O Multi level/single tenant Multi level/multi tenant -F-Xl'
Age of structure: Is structure currently occ d? If not occupiaE6,how long has it been vacant?
Circle one: Yes No Yrs (mos.)
List square footage for each floor leve
Basement: First:16 Mezzanine: iJ (} Second: S-00�P Third: y,l ,4
Will structu heated: Type heating fuel: Circle one:
Circle one Yes No Electric Ciquid Propane Natural Gas Oil
Type of he- : Circle one Furnace Heat Pump Electric baseboard or wall mount Radiant
Wil there be any changes to the following? Circle yes or no,if applicable:
Floor lay-out: Yes Chlo�,' Lighting: Yes Heating: Yes Roo
Exterior Finishes: Yes o Interior Finishes a No, i��l-fi`I-j Parkin : Yes
Number of restrooms prove ed: Nu ber of fixtures in each ;; - Y� :Lr �Ui/ die 1 <�fcZ /
Is structure ADA Accessible? Circle one Yes No
Is the structure equipped with a fire sprinkler system? Yes No Fire alarm system?
)Jar -SJAe7
Return this application with:
1) Floor Plan, 2) Site Plan, 3) Pumpers Report and septic records and 4) $100 Fee
1) oor Plan: Include existing walls,proposed walls,and walls that will be removed.
• /�Draw the floor plan to scale, '/4" = 1 foot min. •,- Use of rooms
•-,Room Dimensions • e"Location of all exits and windows (include dimensions)
•,--�ocation of plumbing and mechanical fixtures • ,-Interior doors with swing radius
2) Site Plan: Note scale
• .,-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 drainfields, & reserve • Well location
•. Surface&stormwater run-off routes • Parking areas (number&arrangement
• Location of fire hydrants &vehicle access roads • Slope of property
3) Pumpers Report and septic records
4) Fee: $100.00 Intake fee will be collected when submitted. Additional fees will be collected when the permit is
issued.
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Office Use Only
. r
Pre-Application Review Departmental Review
Env. Health Env. Health
Planning Planning
Public Works Public Works
Fire Marshal Fire Marshal
Building Building
NREC NREC
Pre Application required? (circle one) Yes No
Building Permit required? (circle one) Yes No Engineering Required? (circle one) Yes No
Occupancy Ciassification: Occupancy Change? (circle one) Yes No
Occupancy classification change from to
Type of construction
Occupant load calculated: persons. Existing occupant load design persons.
Fee Schedule
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