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Home My WebLink AboutCOM2015-00001 - COM Permit / Conditions - 1/30/2015 MASON COUNTY (360)427-9670 Shelton ext352 DEPARTMENT OF COMMUNITY DEVELOP NT (360)275-4467 Belfair ext. 352 BUILDING a PLANNING•FIREMARSf �E (360)482-5269 Elma ext. 352 Mason County Bldg. III, 426 West Cedar SSa a 5 201 PO Box 279, Shelton, WA 98584 www.co.rnason.wa.us COM 145 - 6000 I CHANGE IN TENANT APPLI ATiON PROPERTY IIYF 'R TION; Date: - _ Assessor's Parcel Number. p Legal Description: Building Site Address: Qj APPLICAPq)PffbRMAiCION Name of Applicant: o5 Mailing address: 4D E" ro n LACE City: 5h,,14n State: ,Q Zip: Day phone:3 Lpp Con act Person: foSE I Mesage phone: 1 tol PROJECT ESITORMATION Proposed business name: r Proposed use: Numper of employees: Previous business name: Des ribe previous use: GC S.TR170TTJRE DETAILS Check one: • Detached single level/single tenant O Single lev U multi tenant O Multi level/single tenant O Multi leve multi tenant Age of structure: -t is stricture currently If not occupied, w long has it been vacant? 20 occu ied? Yes No Yr. Mo. ="I asement: r First: Mezzanine: Secon : Third Square —7 footage: I.F. ` D Is the structure Type f Heat: Circle one: Furnace Heat ump Electric wall RE diant heated? U n htc #--r-d ACE- Circle one: Yes No Fuel pe: Circle one: Electric Liquid ropane Natural Gas Oil Wil ere bae any changes to the following? ircle y or no, if applicabLe- Floor lay-out: Yes Lighting: Yes Heating: Yes Exterior Finishes: Yes o interior Finishes: Yes No Parking: Yes N Number of restrooms prove ed Number of fixtures in each: o%Wqter Closets I avatorip-sBath/3hower Is structure handicap accessible? Entry: Yes No troom( ): Ye No If is the structure equipped with fire sprinkler system? Yes No Fire larm system? Yes No Monitoring Station Name: Phor e number: AP_ LICATTON:VVIi,L NOT BE ACCEPTED OUT: 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, table , shelving, benches, fire exits • Interior doors with swing radius and exit signs), Site Pla (1): Note scale us d Pr erty lines, eas e & right of ways a Location of all fisting structures & dim nsions • istance, fVle & structures a Location of all e isting structures & dime sions • O site se t Ids, & reserve • Landscape buffer yards Loca ion of fire hydrants & access roads ® Well location • Parking areas (number & arrangement) Continued on back r If construction or remodeling is proposed an additional Building Permit and construction documents/drawings may be requ red. 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 informatio 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 permitiapplication becomes null & void if work or authorized construction is not commenced within 180 days or if construction work is suspended fora 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. 5 X 6 t Signature of Appl cant Dal X Owner/ wners Representative/Contractor riot Name (ci cle to indicate which one) Official Use Only Accepted by Date Submittal Amount$ Receipt number Department Review Initials Date Comments Buildin ga Fire Marshal Planning Occupancy Change? (circle one) Yes 3No Land Use Designation: Occupancy classification change from �/ to New occupant load calculat ed : persons Existing occupant load design persons. Type of construc ion �Z� i .�...Y. 1 f PLANNIN(3 CE IVED N 0 5 2015 426 W. CEDAR ST a r�