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HomeMy WebLinkAboutCOM2016-00100 - COM Application - 7/11/2016 tcot" MASON COUNTY (360)427-9670 Shelton ext.352 DEPARTMENT OF COMMUNITY DEVELOPMENT (360)275-4467 Belfair ext. 352 BUILDING•PLANNING•FIRE MARSHAL (360)482-5269 Elma ext. 352 --= Mason County Bldg. III, 426 West Cedar Street IR. PO Box 279, Shelton, WA 98584 www.co.mason.wa.us COM �' � c: ( i oo CHANGE IN TENANT APPLICATION PROPERTY INFORMATION Date: s- - j I Assessor's Parcel Number: ,q C_'L): Cj 0 rl C Legal Description: Building Site Address: AYIPLICANT INFORMATION Name of Applicant: C�,( )S Mailing address: �t, Ip City: .� State: , f7 Zip: Day phone: ° _ Contact Person: )— �; Message phone: PROJECT INFORMATION Proposed business name: - # r Proposed use: n c v Ah Number of employees: Previous business namE� Describe previous use: L,; STRUCTURE DETAILS Check one: ',Q 0etached single level/single tenant O Single level/ multi tenant O Multi level/ single tenant O Multi level/multi tenant Age of structure: I Is structure currently If not occupied, how long has it been vacant? N k_ � kjo I occupied? Yes ap Yr. Mo. K)C ko Square Basement: First: Mezzanine: Second: Third: foots e:5600 1 V\�z Is the structure Type of Heat: Circle one: Furnace Heat Pump Electric wall Radiant heated? Circle one: Yes Na) Fuel type: Circle one: Electric Liquid Propane Natural Gas Oil Wi ere be any changes to the following? Circle yes or no, if applicable: Floor lay-out: Yew' No Lighting: No Heating: Yes No Exterior Finishes: Yes No Interior Finishes: jes No Parking: Yes No Number of restrooms provided: Number of fixtures in each: C Water Closets © Lavatories Bath/Showed' Is structure handicap accessible? Entry: es No Restroom(s): es, No (tietch�ttC_dc� Is the structure equipped with a fire sprinkler system? es; No Fire alarm system? No Monitoring Station Name:l:� c, Phone number: � _ APPLICATION WILL T 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 If construction or remodeling is proposed an additional Building Permit and construction f ' documents/drawings may be required. After permit issuance and compliance to all conditions is complete, schedule an inspection by calling 360.427.7262 or 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 i �✓� 11 ! � Signature of App cant Date X &'S R)kA !E:�' k) :s t Owner/Owners Representative/Contractor Print Name (circle to indicate which one) Official Use Only Accepted by 1�� t4 Date �� A C(Submittal Amount$ Receipt number Department Review Initials Date Comments Building ]Fire Marshal Planning Occupancy Change? (circle one) Yes No Land Use Designation:,>hC-Jt-% IA j;1e4'Stn'r'- 1 Occupancy classification change from to New occupant load calculated: persons Existing occupant load design persons. Type of construction ----(--------------------- ------ - i i PRIVATE ROADWAY 0 f t rl -------- ` ice.-- - '---- �-- - r ! UV a tr �-im. Z \ mom Mso s� v �? � f J I m o D t a "^• N m k.. :y' �a ?GQm b Z D m � • I m ................. ///,// OJ o . ce a. 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CUSTOMER: DAN KIRBY TP#: PROJECT NUMBER: 42002-24-90070 SITE SITE ADDRESS: TANK. ;f s� 450 W DAYTON AIRPORT RD DAYTON-MATLOCK RD 'o_ LEGAL: LOT OF 7 SP #3027 ENVIRON MEN AL HEP LTH Co y-n i - - -,------------------------------------------------------- ( - --- --------'-=----------------------------- --------------------------- =-'---� - i _ PRIVATE ROADWAY �__� - - '---'--- ..----�-- -' J--------- ------- -----'---i� --i-�- K y I / / .......... / ////////////! .... / / .... - /////// / //...... JI-��A_��- a-�-n a�—a_ a i t••n,a o r I / a�'o "T i,y� ayo• i Z f t• to ////////////// //// IJz I / m _ 2 n N \ > / N 031 c / 7 j(Q`�//......../..//, /... / /...... ./. .. .../ ...../ q r i F-' < � s C — - - - - - - - - - - - ... �Nf _ CID -s " k :>�jo,gc, O se rn cj) t '� "4"a» Q1's= a m �' v S vFgo3 �g 00 €3 H moo= �s �xa ^>,^== cs "'� _As1A a$v8 m P z o cn $` ,. _ 3`t !"' 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