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Home My WebLink AboutCOM2018-00160 - COM Permit / Conditions - 8/18/2019 MASON COUNTY BUILD ! t I S (360)427-9670 Shelton ext.352 DEPARTMENT OF COMMUNITY SEjC 360)275-4467 Belfair ext. 352 BUILDING•PLANNING•FIRE MARSHAL I'� VEIVEL.,360)482-5269 Elma ext. 352 1 ! 1 Mason County Bldg. 8 DEC 19 2018 615 W.Alder Street, Shelton,WA 98584 www.co.mason.wa.us Aldo;ra45 VV. szkf694 COM2.012) - G01La CHANGE IN TENANT APPLICATION PROPERTY INFORMATION Date: a ` e • Assessor's Parcel Number: \ �J Legal Description: Building Site Address: APPLICANT IN`FORMAYfd& Name of Applicant: Mailing address: City: State: Zip: Day phone.'�=kQ) ntact Person: Message phone: PROJECT INFORMATION Proposed business name: \ Proposed use: \ Number of employees: Previous business name: _ cribe previous use: Q'MUCTURE,DETAILS 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 c tly If not occupied, how long has it been vacant? 7 occupied? Yes No Yr. Mo. Square Basement: First: Mezzanine: Second: Third: footage: Is the structure Type of Heat: Circle one: Furnace Heat Pump Ql ectric wall` Radiant heated? Circle one: es No Fuel e: Circle one: Electric Liquid Propane Natural Gas Oil Will therebQ any changes to the following90i, le yes or no, if applicable: Floor lay-out: Yes Lighting: Yes Heating: Yes No Exterior Finishes: Yes No Interior Finishes: Yes Parking: Yes No Number of restrooms provided: Number of fixtures in ea h: ater Closets Lavati2ties 1 Bath/Shower Is structure handicap accessible? Entry Yes No Restroom(s): (Ye3 No Is the structure equipped with a fire sprinkler system? Yes No Fire alarm,system? Yes No Monitoring Station Name: I Phone number: APPLICATION WILL NOT BE ACCEPTED WITHOUT: 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 counters, tables, shelving, benches, fire exits • Interior doors with swing radius and exit signs). Site Plan (1): Note scale used • Property lines, easements, &right of ways • Location of all existing structures & dimensions • 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 • Parking areas number&arrangement) Continued on back 't v-%C-.)l L&S 06/30/2009 15:50 FAX 980 427 7798 MASON CTR 4 001 IECEIVEL come 260 600-rl MASON COUNTY TENANT REVIEW APPLICATION ,e� bVEC Complete the Tenant Review Application and return with a floor plan, site plan,septic pumper's report, septic r $141.00 fee to the Mason County Permit Center, P.O.Box 186, Shelton,WA 98584. During the evaluation of your Tenant Review Application staff mertiber:. 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 aroposedlreguired a separate 11 ermi;l will be n ry.ecessa Upon approval the permit will be issued to the applicant/tenant. After the permit is Issued, din p 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 .dace on the remises. MOM Date: Assessor's Parcel Number; Z 5 Z 1 Z Od Q(O Legal Descri t n._ o t4 Zs- Building Site Addnass: Z( ow e�L Method of sewage! disposal: Septic O Sewer- name of district: Water source: O IndNidual Well 0 Community WPII.11 ,-Public System, name of system: L�,�„� z� MOM,y 16,., IUR � � � it � vdi:. Nf Name of Applicanl: S Mailing address: �o City: State: Zip: o za E-Mail Address: Day phone: ?llQ aSSS FAX phone: Contact Person: , Proposed business narne: N u mb r o f em to ees: Proposed use: � i �S p Y Previous business name: Describe previous.use — w rrt Check one: 0 IDeta-;hed single level/ single tenant 0 Single level/multi tenant 0 M.Ilti It::vel/sin le tenant 0 Multi level/multi tenant Age of structure: Is structure currently If not occupied, how long has it been vacant? _ occupied? Yes o Yrs mos. Square footage: Bwiement: First: 3 Mezzanine: Second: Third: Is the structure heated? I Heating type: Circle one: r° circle on es Nc is Liquid Prop ane Natural Gas Oii Type of heat: Circh?ones: Furnace ea um Electric baseboard or wall mount Radiant Will there anges to the following? Circle yes or no, if applicable: Floor lay-out: Ye;. IN Lighting, Yes Heating. Yes �No1 Exterior Finishes: Ye,., 0 Interior Finishes: Yes o ;- Parkin ; Yes 0 , Number of restrocims I:rovided: Number of fixtures in each Is structure handicap accessible? Gircly one Yes No Is the structure eq;uipp,:A with a fire sprinkler system? Yes o Fire alarm system? Yes No Monitoring Station Name: "15-0 .1" Z Phone number: r 1. Floor Plan(5 sets): Use o floor F • f rooms Draw the or Ian t r scale• • 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,4aserients. & right of ways Location of all existing structures&dimensions Distance, in feed,froi In property line&structures Landscape buffer yards • On-site sewage,tank,and drain fields, & reserve Well location • Surface&storm wator run-off routes Parking areas (number&arrangement) • Location of fire;)Ydr;,nts &vehicle access roads 3. Septic records, pumper's report or O&M report. 4. Fees will be codectrd at time of submittal. Balance due will be collected when the permlt Is approved and issued. p .P. r r ` 1 Submittal Amount$ 1} 1 Receipt number Acce ted b )C,(-_ Date , If construction or remodeling is proposed an additional Building Permit and construction documents/drawings may be required. After permit issuance and compliance to all conditions is complete, schedule an inspection by calling 360.427.9670 ext. 352 OWNER/ BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner, owners legal representative, or contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This permit/application becomes null & void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLIEATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. s re of Applicant Date X C tl Owner/Owners Representative/Contractor Print Name (circle to indicate which one) Official Use Only VJL� Accepted by�, u,L Date lo'�-N-1 V Submittal Amou�t$ �I' eceipt number f� 9 Departme t Roview Initials Date Comments 14i Buildin �U� LL no p 1 )0.0 o Fire Marshal 3 Planning Occupancy Change? (circle one) Yes No Land Use Designation: Occupancy classification change from to New occupant load calculated: persons Existing occupant load design persons. Type of construction f If construction or remodeling is proposed an additional Building Permit and construction documents/drawings may be required. After permit issuance and compliance to all conditions is complete, schedule an inspection by calling 360.427.9670 ext. 352 OWNER/ BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner, owners legal representative, or contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This permit/application becomes null &void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X 2 I t l 4 re of Applicant Date X L�tk C6 Owner/Owners Representative/Contractor Print Name (circle to indicate which one) Official Use Only W Accepted by Date Submittal Amou t$ I eceipt number Departme t R view Initials Date Comments BuildingI I D.DO Fire Marshal 3�l Planning Occupancy Change? (circle one) Yes No Land Use Designation: Occupancy classification change from to New occupant load calculated: persons Existing occupant load design persons. 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Height, lowest level to peak or top of parepet 2. Construction 3. Roof type 4. Roof attachments 5. Type floors HYDRANT 1. Area hydrants, number and available fire flow ALARM 1. Alarm Co. and phone number 2. Reset, how SPRINKLER 1. Number of fire dept. connections 2. Number of control valves or risers 3. If building is partially sprinklered, define sprinklered and non-sprinklered areas MASON COUNTY PRE-FIRE PLAN Bldg/X-ST 901: OCC: Bus. Name Phone Address Suite FMZ: FMA: Bus. Owner Phone Bldg. Onwer Phone Person Making Pre-Fire Plan Date N E Contact Phone Make one diagram for the complex and one diagram for each fire area or building. E Contact Phone This is page of a set of pages SHOW ON EVERY DIAGRAM 1. Arrow North 2. Street and Number 3. Height 4. Fire Walls 5. Stairs and Fire Escapes fi. Doors 7. Vertical Openings 77 RECEIVED DEC 19 2018 f 615 W. Alder Street PLANNING: 1 PLANNING: \6') AtL SETBACI«ARE MEASURED FROM THE FURTHEST PRQJECTiON OF.THE,BUtLpIt�dCf _ - IV } MASON COUNTY PRE—FIRE PLAN Bldg/X-ST 901: OCC: Bus. Name Phone Address Suite JFMZ: JFMA: Bus. Owner Phone Bldg. Onwer Phone Person Making Pre-Fire Plan Date N E Contact Phone Make one diagram for the complex and one diagram for each fire area or building. r� E Contact Phone This is page of a set of pages t I SHOW ON EVERY DIAGRAM �•/ 1. Arrow North 2. Street and Number 3. Height 4. Fire Walls rr 5. Stairs and Fire Escapes 6. Doors 7. Vertical Openings RE DEC 19 2018 t (. 615 W. Alder Street •t - �--- ENVIRONMENTAL ENTAL s _ HEALTH PROVE s JAN-3 0 1018 MASON COUNrY ENVIRONME 1AL HE tO ? AI�T Q�' f WLJ/" t r � �` Gad