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Home My WebLink AboutCOM2007-00024 Change in Tenant - COM Application - 4/1/2009 0 MASON COUNTY �,_... CHANGE IN TENANT APPLICATION Complete the Change in Tenant Application and return with a floor plan,site epumper's report, septic records and fee to the Mason County Permit Center, P.O. Box 186,Shelton, WA 98584. Evaluation of the Change in Tenant Application will involve staff members from the Building, Fire Marshal, Environmental Health, Planning and Public Works offices who will identify requirements. This application is intended for tenant change o compliance g only. If construction Permit will b y uction or remodel'e necessary. Upon approval �t is permit is i or Mred p pp oval the permit will be issued to the applicant/tenant. After the permit is issued, sched le anuildin inspection by calling (360)427-7262. Upon satisfactory inspection a Certificate of Occupancy will be issued and must be posted in a conspicuous lace on the remises. Date: ,3 T Assessor's Parcel Number: Legal Description: `/20 1 2-2 #Ci pc)'C' Building Site Address: 1 3> 5-0 Method of sewage disposal: eLIfno-- /0�Septic O Sewer—name of district: Water source: Individual Well O CommunityWell O Public System, name of system: Name of Applicant: L1 Mailing address: r s City: k 5 n r, � State: Day phone: _ Zip:3( Contact Person: Message phone: _ Proposed business name: r ,S Proposed use: E � Previous business name: n Number of employees: Describe previous use: �o I n `.S prc $ S Check one: ;0-Detached single level/single tenant O Single level/multi tenant O Multi level/sin le tenant Age of structure: O Multi level/multi tenant Is structure currently If not occupied, how long has it been vacant? --� �-z- Occupied? Yes Square f tage. Basement: Yr. Mo. First: /.�.F Mezzanine: Second: Is the structure heated? Heating type: Clrcle one: Third: Circle one: Yes No Electric Li uid Propane Natural Gas Oil Type of heat: Circle one: Furnace Heat Pump Electric baseboard or wall mount Radiant Will there be any changes to the following? circle pes or no,if applicable: Floor lay-out: Yes Lighting: Yes Heating: Yes f Exterior Finishes: Yes No Interior Finishes: Yes No o Parking: Yes No Number of restrooms provided:p le? Circle one Yes Is structure handicap accessib u r of fixtures in each No Is the structure equipped with a fire sprinkler system? Yes Monitoring Station Name: Fire alarm system? Yes Phone number: I. Floor Plan(5 sets); • Draw the floor plan to scale • Room Dimensions Use of rooms • Location of lumbin and mechanical fixtures • Location of all exits and windows (include dimensions) 2. Site Plan(5 sets): Note sc� I-e used • interior doors with swing radius • Property lines, easements, & right of ways • Distance, in feet,from propu cy line&structures • Location of all existing structures&dimensions • On-site sewage tanks and drain fields. c, reserve ' Landscape buffer yards • Location of fire hydrants&vehicle ar;, roads • Well location 3. Septic records pumper's report ts; � report • Parkin areas number&arrangement ,:; 4• Fees will be collected at time of su. Accepted by Date r L. Submittal Amount$ � Recei t number De artment Rev Initials Date Building Comments Environmental Health DD Fire Marshal - - Planning Public Works Occupancy Change? (circle one) Yes No Occupancy classification change from to Type of construction Existing occupant load design Occupant load calculated: persons Occupancy Classification: person Land Use Designation: y11- 001 -Fr LL7 'f- Gvri-e v,-f{� G- ►' 1 tc��ro� a AG STRUCTURES TABLE 3410.7 SUMMARY SHEET--BUILDING CODE Existing occupancy Proposed occupancy Existing building was constructed Number of stories Height in feet Type of construction Area per floor Percentage of open perimeter % Percentage of height reduction % Completely suppressed: Yes No Corridor wall rating Compartmentation: Yes No Required door closers: Yes No Fire-resistance rating of vertical opening enclosures Type of HVAC system serving number of floors Automatic fire detection: Yes No type and location Fire alarm system: Yes No type Smoke control: Yes No type Adequate exit routes: Yes No Dead ends: Yes No Maximum exit access travel distance Elevator controls: Yes No Means of egress emergency lighting: Yes No Mixed occupancies: Yes No SAFETY PARAMETERS FIRE SAFETY FS MEANS OF EGRESS M 3410.6.1 Building Height GENERAL SAFETY(GS) 3410.6.2 Building Area 3410.6.3 Com artmentation 3410.6.4 Tenant and Dwelling Unit Separations 3410.6.5 Corridor Walls 3410.6.6 Vertical nin s 3410.6.7 HVAC Systems 3410.6.8 Automatic Fire Detection 3410.6.9 Fire Alarm System 3410.6.10 Smoke control 3410.6.11 Means of Egress **** 3410.6.12 Dead ends **** 3410.6.13 Maximum Exit Access Travel Distance 3410.6.14 Elevator Control 3410.6.15 Means of E s Pm--P---cy Lighting 3410.6.16 Mixed occupancies 3410.6.17 Automatic Sprinklers 3410.6.18 Incidental Use +2= BUiI ng score—total value ****No applicable value to be inserted. TABLE 3410.9 EVALUATION FORMULAS° FORMULA T.3409.7 T.3409.8 SCORE PASS FS-MFS>0 �S — FAIL S = ME-MME z 0 �) — )_ GS-MGS_>0 (GS) — (MGS) a. FS=Fire Safety MFS=Mandatory Fire Safety ME=Means of Egress 8re MME=Mandatory Means of Egress GS=General Safety MGS=Mandatory General Safety 578 2003 INTERNATIONAL BUILDING CODE® ACCESS & GRADE INSPECTION PERMIT #: 7' ADDRESS �2 INSPECTOR DATE: DRIVEWAY ACCESS Length: Width: urface: Size of turn-around: Condition of shoulders: Vertical clearance: need post at end of driveway with reflective address numbers GRADE,OF DRIVEWAY % OF ROAD % ROAD ACCESS Lc- Length: Width: Su ce: Condition of shoulders: Vertical clearance: ( ) BURN PERMIT REQUIRED FOR LAND CLEARING FIRE. ( ) LOT INSIDE SMZ, 4X4 FIRES ONLY. ( ) LOT INSIDE UGA, NO OUTDOOR BURNING PERMITTED. LOT TOO SMALL FOR: BURN PERMITS 4X4 FIRES. REMARKS �V continue remarks on back)