HomeMy WebLinkAboutCOM2022-00050 Channge Tenant - COM Application - 5/31/2022 '��'�� �� 615 W.Alder St.Bldg 8, SHELTON,WA 98584
� �� MASON COUNTY
SHELTON: 360-427-9670, EXT 352
COMMUNITY SERVICES
BELFAIR: 360-275-4467, EXT 352
Building,Planning.Environmental llealth,Community Heath ELMA: 360-482-5269, EXT 352
y
www.co.mason.wa.us
INSPECTION CARD AND CERTIFICATE OF OCCUPANCY** n
To schedule an inspection call or visit http://www.co.mason.wa.us/community-services/bid-inspection.php
Permit Number COM2022-00050 Date Issued 06/28/2022 Issue y
Project CHANGE IN TENANT FROM MARI MART TO BELFAIR CANNABIS CO.
Site Address 24090 NE STATE ROUTE 3 SUITE A
Applicant TIMOTHY GOAD-MEMENTO VIVERE LLC
Contractor
Contractor Phone
Primary Code UPC IBC, IRC, IFC,IEC,IMC, & Type
Permit Type CHANGE IN TENANT Occupancy
-APPROVED PLANS MUST BE ONSITE FOR ALL INSPECTIONS.
-DO NOT PROCEED BEYOND EACH STAGE OR COVER WORK UNTIL APPROVAL IS GRANTED.
-THIS CARD MUST BE POSTED IN A CONSPICUOUS LOCATION, FRONT OF THE PREMISES IS BEST FOR MAKING ENTRY.
-ALL PERMITS EXPIRE 180 DAYS AFTER THE PERMIT IS ISSUED OR 180 DAYS AFTER DATE OF LAST INSPECTION.
-OWNER/AGENT IS RESPONSIBLE FOR REQUESTING ALL INSPECTIONS THROUGH FINAL INSPECTION.
**THIS STRUCTURE MAY NOT BE USED OR OCCUPIED UNTIL ALL APPROVALS ARE GRANTED.**
PRIOR TO CALLING FOR FINAL INSPECTION,ALL CONDITIONS OF THE PERMIT MUST BE MET
Public Works Access/Driveway Other
Health Septic Well
Deptartment
Planning Site Inspection
Department
Fire Marshall Fire Apparatus Access Fire Sprinkler
Auto Fire Alarm Hood and Duct
Other Final
Building
Department Building Official: Community Services Designee
Concrete Setbacks Slab
Footing Perimeter Point load Footing
Footing Interior Footing Decks/Porches
Foundation Stem Walls Other
Rough-In Groundwork Plumbing Framing
Groundwork Mechanical Plumbing
Groundwork Gas Pipe Mechanical
Gas Piping Shear Wall Nailing
Underfloor
Other
Insulation Slab Ceiling
Floor Vaulted Ceiling
Walls Vapor Barrier
Other
Wallboard Interior Wall Brace Panels Fire Walls
Nailing
Other
Final Building \.Zb
Manufactured Setbacks Setup
Home
Concrete Foot/Runners Final
Other
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Yeti'�_ _
Mason County
Mason County - Division of Community Development
�-
�,�� 615 W. Alder St. Bldg.8
584
360 427-96\ 0 ext 98352
www.co.mason.wa.us
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2-00050 CHANGEINTENANT
DESCRIPTION: CHANGE IN TENANT FROM MARI MART TO ISSUED: 06/28/2022
ANNABIS CO.
ESS: 24090 NE STATE ROUTE 3 SUITE A BELFAIR EXPIRES: 12/25/2022
PARCEL: 123283290030
APPLICANT: TIMOTHY GOAD- MEMENTO VIVERE LLC OWNER: GIMS PROPERTY MANAGEMENT LLC
1001 COOPER PT RD SW SUITE 140-159 7115 MUIRKIRK LN SW
OLYMPIA, WA98502 PORT ORCHARD, WA98367
1.404.406.3054
FEES: Paid Due
IFC Plan Check Fee $78.00 $0.00
State Fee-Commercial $25.00 $0.00
Technology Surcharge $3.12 $0.00
Change in Tenant- Minor EH $125.00 $0.00
Plan Review
Planning Review Fee $240.00 $0.00
Change in Tenant Application $156.00 $0.00
Totals : $627.12 $0.00
REQUIRED INSPECTIONS
BLD-Final Inspection
CONDITIONS
The use, handling and storage of hazardous materials or flammable and combustible liquids in excess of 10 gallons is not
allowed without the approval of the Mason County Fire Marshal.
. All building permits shall have a final inspection performed and approved by Mason County Building Department prior to
permit expiration. The failure to request a final inspection or to obtain approval will be documented in the legal property
records on file with Mason County as being non-compliant with Mason County ordinances and building regulations.
Printed by:Amber Selby on:06/28/2022 01:49 PM Page 1 of 2
Mason County
Mason County - Division of Community Development
f
615 W. Alder St. Bldg.8
Shelton, WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
CHANGE IN TENANT COM2022-00050
Lever hardware is required at doors. The unlatching of any door shall not require more than ONE operation. Hardware with
locks must open with a single action from the egress side of the door. Door hardware shall allow egress doors to be readily
open able from the egress side without the use of a key or special knowledge or effort. Handles, pulls, latches, locks and
other operable parts on accessible doors shall have a shape that is easy to grasp with one hand and does not require tight-
grasping, pinching, or twisting of the wrist to operate. X
* Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries,
Contractor Compliance Division. There are potential risks and monetary liabilities to the homeowner for using an
unregistered contractor. Further information can be obtained at 1-800-647-0982. The person signing this condition is either
the homeowner, agent for the owner or a registered contractor according to WA state law.
* 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.
* If construction or remodeling is proposed an additional Building Permit and construction documents/drawings may be
required.
* Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance
with Mason County Title 14.28 and 14.17.
* All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building
Official may grant a one time extention of 180 days, upon the receipt of a written extension request prior to permit expiration.
Letter must indicating that circumstances beyond the control of the permit holder preventing action from being taken. No
more than one extension may be granted.
* Disabled access shall be provided for parking, entry and interior features as noted on the plans.
I hereby certify that I have read and examined this application and know the same to be true and correct.
All provisions of Laws and Ordinances governing this type of work will be complied with whether
specified 4inot. he granting of a permit does not presume to give authority to violate or cancel
the provi o er state/I regulating construction or the performance of construction.
Issued By
Contractor or Authorized Agent: Date: 6 0l a2
Printed by:Amber Selby on:06/28/2022 01:49 PM Page 2 of 2
5O4 CO&1
MASO� ' IN G (360)427-9670 Shelton ext-352
DEPARTMENT OF COMMUNITY SERVICES (360)275-4467 Belfair ext. 352
- BUILDING•PLANNING•FIRE MARSHAL RECEIVED(360)482-5269 Elma ext. 352
Ka -Y Mason County Bldg. 8
615 W. Alder Street, Shelton,WA 98584 MAY 3 1 2022 www.co.mason.wa.us
bEI &4-06jA - (jC. 615 W. Alder Street COM ZoZZ-CW50
CHANGE IN TENANT APPLICATION
PROPERTY INFORMATION
Date: /' i Assessor's Parcel Number:
Legal Description: yvT g 0r 5to7y PTN 3 /VW 5(v
Building Site Address: dLIoI?e) Vr 57x?� A c 5cIZ71t, g- I<tLf l'�
APPLICANT INFORMATION
Name of Applicant: i/.lvo,ffy ,) _ r�-_Je,17-6 III Vz Cc 4,&c
Mailing address: /00/ 6ee?p'2 PT krl SW E-tY►cv-L
City: �1.�,.z,oj State: C1/� — Zip: y ��a
Day phone:ycy.y� -j , Contact Person: Message phone: yc -�o�- •'vy
PROJE INFORMATION
Proposed business name: !' n„U1 :zs cz7
Proposed use: M,92sTv,9n� ',TRIc Number of employees: S'
Previous business name: /'r+r?�s• M�2T Describe previous use: 'a/�TU�+,A✓A/r,-f?,L_
STRUCTURE DETAILS
Check one: ❑ Detached single level/single tenant Single level/ multi tenant
❑ Multi level/ single tenant ❑ Multi level/multi tenant
Age of structure: Is structure urrently If not occupied, how long has it been vacant?
Lf occupied? 2jYes []No Yr. Mo.
Square 50E-a Basement: First: Mezzanine: __[Second: Third:
foots e:x 1W
Is the structure Type of Heat: Circle one: JMFurnace ❑Heat Pump ❑Electric wall ❑Radiant
heated?
Circle one0Yes ❑No Fuel type: Circle one: ❑Electric ❑Li uid Propane bjNatural Gas ❑Oil
Will the a be any changes to the following? Circle yes or no, if applicab e:
Floor lay-out: ❑Yes No Lighting: ❑YesElNo Heating0Yes No
Exterior Finishes❑Yes No Interior Finishes❑Yes KjNo Parkin ❑Yes No
Number of restrooms provided: Number of fixtures in each:
_:Z I Water Closets 1 Lavatories Bath/Shower
Is structure handicap accessible? Entry es❑No Restroom(s)- Yes ❑No
Is the structure equipped with a fire sprinkler system❑Yes No Fire alarm system? OVes []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
• i Y
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
Signature of Applicant Date
X Owner/Owners Representative/Contractor
Print Name (circle to indicate which one)
Official Use Only
Accepted by n 1 Dates- -2-62Z Submittal Amount$ Receipt number
Department Review Initials Date Comments
Building
Fire Marshal
Flannin (I 2 -
Occupancy Change?'(circle one) Yes Land Use Designation: �C ,2 U61 A
Occupancy classification change from to New occupant load calculated: persons
Existing occupant load design persons. Type of construction
cot, MASON COUNTY B U I L D I N 1�0)427-9670 Shelton ext.352
•COON`.
DEPARTMENT OF COMMUNITY SERVICES (360)275-4467 Belfair ext. 352
''- BUILDING•PLANNING•FIRE MARSH
E C E 1 V E D (360)482-5269 Elma ext. 352
-_n, Mason County Bldg. 8
4 1e54 615 W. Alder Street, Shelton,WA 98584 MAY 3 1 2022 www.co.mason.wa.us
615 W. Alder Street COM Zo 47 _O f5o
CHANGE IN TENANT APPLICATION
PROPERTY INFORMATION
Date: j /�' ,;cam Assessor's Parcel Number:
Legal Description: v i e or 5 /7y pTN `fk 3 IVW St41
Building Site Address: dqoo, 0 A)j�5 5-rxt+-e Rve SG%.Tc:
APPLICANT INFORMATION
Name of Applicant: i mvo2-#V 0- _lVtMe 17-d Vivo,26 4,&e
Mailing address: (Odl LoelpeC RT 0601 Sc4J SU�Te l v-/�'�' ' -MCULL «`h
City: ��c;.v,�oj State: la/A Zip:
Day phone:,fcy-y,) j Contact Person: 1 Message phone: o/=`ion-c>✓may
PROJE INFORMATION
Proposed business name: r
Proposed use: ,7 FNumber of employees: S'
Previous business name: � 2�. /v� ►2T Describe previous
STRUCTURE DETAILS
Check one: ❑ Detached single level/single tenant a Single level/ multi tenant
❑ Multi level/single tenant ❑ Multi level/multi tenant
Age of structure: Is structure Furrently If not occupied, how long has it been vacant?
occupied? 0Yes ❑No Yr. Mo.
Square 51f/F-a Basement: First: Mezzanine: Second: Third:
footage:x iYa''
Is the structure Type of Heat: Circle one: WFurnace ❑Heat Pump ❑Electric wall ❑Radiant
heated?
Circle one0Yes ❑No Fuel e: Circle one: ❑Electric ❑Li uid Propane WNatural Gas []Oil
Will the jNo
be any changes to the following? Circle yes or no, if applicab e:
Floor lay-out: ❑YesNo Lighting: ❑Yesg]No Heating❑Yes No
Exterior Finishes❑Yes Interior Finishes❑Yes ZNo Parkin ❑Yes No
Number of restrooms provided: Number of fixtures in each:
Water Closets I Lavatories Bath/Shower
Is structure handicap accessible? Entry es❑No Restroom(s): Yes []No
Is the structure equipped with a fire sprinkler system❑Yes No I Fire alarm system? Mes ❑No
Monitoring Station Name: 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
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
Signature of Applicant Date
X Owner/Owners Representative/Contractor
Print Name (circle to indicate which one)
Official Use Only
Accepted by Date�5 -'2-62Z Submittal Amount$ Receipt number
Department Review Initials Date Comments
Buildin
Fire Marshal
Planning
Occupancy Change?'(circle one) Yes DN Land Use Designation: fC4.t,4 (JET�4
Occupancy classification change from to New occupant load calculated: persons
Existing occupant load design persons. Type of construction
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