HomeMy WebLinkAboutCOM2018-00106 Change Tenant - COM Application - 8/24/2018 RECEIVED
MA ILDING AUG 3 0 2018
SON C 6 27-9670 Shelton ext.352
DEPARTMENT OF COMMUNITY SERVI��fbw• Alder 0 75 4467 Belfairext. 352
BUILDING•PLANNING•FIRE MARSHAL (360) 482-5269 Elma ext. 352
F Mason County Bldg. 8
615 W. Alder Street, Shelton,WA 98584 www.co.mason.wa.us
COM a0 -oa D(P
CHANGE IN TENANT APPLICATION
PROPERTY INFORMATION
Date: Assessor's Parcel Number: /�,Z ,'Z0 '<-0 'R-ama
Legal Description: AU LK: W 4ah 3 -k v - VAC
Building Site Address:
APPLICANT INFORMATION
Name of Applicant:
Mailing address: Itjp
City: State: W A- Zip: qks 3
Day phone: 3 Contact Person: Message phone:
PROJECT INFORMATION
Proposed business name: n
Proposed use: el! Number of employees:
Previous business name: Describe previous use:
STRUCTURE DETAILS
Check one: ® 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 currently If not occupied, how long has it been vacant?
/a 'ed I occupied? No Yr. Mo.
Square Basement: First: Mezzanine: Second: Third:
footage: $w Fez)
Is the structure Type of Heat: Circle one: Furnace Heat Pump ectric w I Radiant
heated?
Circle one: & No Fuel type: Circle one: c r Liquid Propane Natural Gas Oil
Will there be any changes to the following? Circle yes or no, if applicable:
Floor lay-out: Yes d�D Lighting: Yes Heating: Yes ao
Exterior Finishes: Yes Interior Finishes: Yes Parking: Yes
Number of restrooms provided: Number of fixtures in each:
/ Water Closets Lavatories Bath/Shower
Is structure handicap accessible? Entry: YesX No Restroom(s): e o
Is the structure equipped with a fire sprinkler system? Yes 63 Fire alarm system? Yes o
Monitoring Station Name: • As d;"I l Phone number: o 07,r- pg�q
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
Ja- �w
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 180 DAYS WILL INVALIDATE THE APPLICATION.
X /il q b r
Signature of Applicant <:2T
Date
X Owners Representative/Contractor
Print Name (circle to indicate which one)
Official Use Only
Accepted by Date Submittal Amount$ Receipt number
Department Review Initials Date Comments
Building
Fire Marshal
Planning
Occupancy Change? (circle one) A Land Use Designation: V G
Occupancy classification change from t New occupant load calculated: EL persons
Existing occupant load design 141 _persons. Type of construction V b
RECEIVED
AUG 3 0 2018
MASON COU4075-4467
27-9670 Shelton ext.352
W. AlderDEPARTMEN b�S Belfair ext. 352
BUILDING•PLA I NG (360)482-5269 Elma ext. 352
f Mason County Bldg. 8
615 W.Alder Street, Shelton, WA 98584 www.co.mason.wa.us
CHANGE IN TENANT APPLICATION
PROPERTY INFORMATION
Date: Assessor's Parcel Number: /� ,Z 2 o 57 R-ma
Legal Description: ALL #j LIG: W 4oA -3 v ' VACCaw
Building Site Address:
APPLICANT INFORMATION
Name of Applicant: - e✓ ,,,
Mailing address: ?
City: IZ State: W A Zip: qk.5 3 '
Day phone: 3 Contact Person: Message phone:
PROJECT INFORMATION
Proposed business name: n
Proposed use: aUe e I Fee of Number of employees:
Previous business name: 5 t 1 Describe previous use:
STRUCTURE DETAILS
Check one: ® 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 currently If not occupied, how long has it been vacant?
/a y occupied? No Yr. Mo.
Square Basement: First: Mezzanine: Second: Third:
footage: ?0b
Is the structure =NoFyupe
of Heat: Circle one: Furnace Heat Pump ectric w I Radiant
heated?
Circle one: e: Circle one: c r Liquid Propane Natural Gas Oil
Will there be any changes to the following? Circle yes or no, if applicable:
Floor lay-out: Yes d4D Lighting: Yes Heating: Yes ao
Exterior Finishes: Yes Interior Finishes: Yes Parking: Yes
er of fixtures in each:
Number of restrooms provided: Numb
Water Closets Lavatories Bath/Shower
Is structure handicap accessible? Entry: YesX No Restroom(s): e o
Is the structure equipped with a fire sprinkler system? Yes Fire alarm system? Yes No
Monitoring Station Name: r_„C, f�;s ,;�f l Phone number: o '273- �Pggq
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
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 180 DAYS WILL INVALIDATE THE APPLICATION.
-75!�P- 75 2�2qbr
Signature of Applicant Date
X L:�31Loy,CL-, P <f!g .r Owners Representative/Contractor
Print Name (circle to indicate which one)
Official Use Only
Accepted by Date Submittal Amount$ Receipt number
Department Review Initials Date Comments
Building
Fire Marshal
Planning go-'a J6 DA 4
Occupancy Change? (circle one) � No Land Use Designation: V G
Occupancy classification change from to New occupant load calculated: persons
Existing occupant load design persons. Type of construction
f RECEIVED
AUG 3 0 2018
MASON COUNTY 27-9670 Shelton ext.352
-i.°�u� COLhTF DEPARTMENT OF COMMUNITY SERVI��§ 75-4467 Belfair ext. 352
BUILDING• PLANNING• FIRE MARSHAL T10t 4(R36'�O)482-5269 Elma ext. 352
f Mason County Bldg. 8 MARSHAL
615 W.Alder Street, Shelton, WA 98584 www.co.mason.wa.us
COM ov.9 -00\ D W
CHANGE IN TENANT APPLICATION
PROPERTY INFORMATION
Date: Assessor's Parcel Number: 12.22o 5D g-ma
Legal Description: (ALL iU LIG: -3 v ' VAC �w
Building Site Address:
APPLICANT INFORMATION
Name of Applicant: e✓
Mailing address: j1jP
City: G; State: w A Zip: eM3 3 '
Day phone: 3 Contact Person: Message phone:
PROJECT INFORMATION
Proposed business name: -, n
Proposed use: Number of employees:
Previous business name: Describe previous use: ,
STRUCTURE DETAILS
Check one: ® 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 currently If not occupied, how long has it been vacant?
/. .ej occu ied? C2No Yr. Mo.
Square Basement: First: Mezzanine: Second: Third:
footage: $w VCY)
Is the structure Type of Heat: Circle one: Furnace Heat Pump ectric w I Radiant
heated?
Circle one: No Fuel type: Circle one: c r Liquid Propane Natural Gas Oil
Will there be any changes to the following? Circle yes or no, if applicable:
Floor lay-out: Yes M Lighting: Yes Heating: Yes CA?O
Exterior Finishes: Yes Interior Finishes: Yes Parking: Yes
Number of restrooms provided: Number of fixtures in each:
/ Water Closets Lavatories Bath/Shower
Is structure handicap accessible? Entry: YesX No Restroom(s): e o
Is the structure equipped with a fire sprinkler system? Yes a I Fire alarm system? Yes No
Monitoring Station Name: `m, As ,;,( r j41 1 Phone number: UO 07,T �96-,4
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
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 180 DAYS WILL INVALIDATE THE APPLICATION.
I
x �
Signature of Applicant Date
x �f d�ti � 5 ( Owners Representative/Contractor
Print Name (circle to indicate which one)
Official Use Only
Accepted by Date Submittal Amount$ Receipt number
Department Review Initials Date Comments
Building
Fire Marshal
Planning
Occupancy Change? (circle one) es No Land Use Designation: V G
Occupancy classification change from to New occupant load calculated: persons
Existing occupant load design _persons. Type of construction
Sail On In, LLC 66vy-�9
RECEIVED 12220-50-80001 1 inch = 20 feet
SEP 13 2018 18191 E. S R-3
Allyn, WA, 98524 �s��
615 W. Alder 4W-t , , 120'
P13
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P8 P9 1ZOP 11
landscape 20 landscape 1 0'
Pi�P6 storage 'well ADA P7
P4
P3
P2 nT
P1 zz
3 5,
landscape
Sail On In. LLC (-6vy-�9bb & co`ow
RECEIVED 12220-50-80001 1 inch = 20 feet
SEP 13 2018 18191 E. S R-3 _
Allyn, WA, 98524 �►s-� nq
615 W. Alder 404t , , 120'
01
P13
J
�a 0' P 12
O
P8 P9 10 P11
landscape landscape 1 0'
P�6 storage ' ADA
well P7
P4 ZIP
P3 m
m
P2 H
P1 35' CL
landscape �
Sail On In, LLC
freezer freezer 18191 E. SR-3 12220-50-80001
Water tank Allyn, WA, 98524
Nstorage
' storage
1 inch = 5 feet
E
36" swing 36" swing
Well hea
20'
40'
entrance/exit Order
window window window
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ch air ch air on 36" swing ridg
bathroom ride o
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w ndow 36" swing
ha. aj -- Barista
�\ Dining area area wir dow
115.5 / i { 16x15 ® ; 9x14
order here
window
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