HomeMy WebLinkAboutCOM N/A Storage Area - COM Application - 3/21/2011 GOM
MASON COUNTY
TENANT REVIEW APPLICATION
Complete the Tenant Review Application and return with a floor plan, site plan, septic pumper's report, septic records and $141.00 fee to
the Mason County Permit Center, P.O. Box 186, Shelton,WA 98584. During the evaluation of your Tenant Review Application staff
members from the Building, Fire Marshal, Environmental Health, Planning and Public Works offices will identify compliance requirements.
This application is intended for tenant change only. If construction or remodeling is proposed/required a separate building permit
will be necessary. Upon approval the permit will be issued to the applicant/tenant. After the permit is issued, schedule a site 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 premises.
PROPERTY INFORMATION
Date: 12-011 Assessor's Parcel Number: 1'ol3�r'f • GIIJI
Legal Descripti n:
Building Site Address: �� n E �j-{ � ( A L I4,2-1
Method of sewage disposal: O Septic O Sewer- name of district:
Water source: O Individual Well O Community Well O Public System, name of system:
PEOPLE INVOLVED IN THE PROJECT
Name of Applicant:
Mailing address: 3-2
�-
City: S �� Zip: E-Mail Address:
Day phone:3UO2o4.y41 FAX phone. Contact Person:
_,,,PROJECT INFORMATION
Proposed business name: Hio�_A 5 6 0 P_)e l < - ,'_ i 1.,�.
Proposed use: �1l L �� Number of employees:
Previous business'name:
Describe previous use:
STRUCTURE DETAILS
Check one.- 0 Detached single level/single tenant * Single level/multi tenant
O Multi level/sin le tenant O Multi level/multi tenant
Age of structure: Is structure current If not occupied, how long has it been vacant?
occupied? Yes No Yrs mos.
Square-To ag Basement: rst: lcc,-) Mezzanine: Second: Third:
Is the structure heatep Heating type: Circle one: t w
Circle one: Yes N Electric Li u id Pr ane Natural Gas Oil
Type of heat: Circle one: Furnace Heat Pump Electric basebo d or wall mount Radiant
Will there be any changes to the following? Circle yes or no, if applicable:
Floor lay-out: Yes No Lighting: Yes No Heating: Yes No
Exterior Finishes: Yes No Interior Finishes: Yes No Parking: Yes No
Number of restrooms provided: Number of fixtures in each
Is structure handicap accessible? Circle one Yes No
Is the structure equipped with a fire sprinkler system? Yes No Fire alarm system? Yes No
Monitoring Station Name: Phone number:
_ Return this application with:
1. Floor Plan (5 sets):
• Draw the floor plan to scale 0 Use of rooms
• Room Dimensions • Location of all exits and windows(include dimensions)
• Location of plumbing and mechanical fixtures • Interior doors with swing radius
2. Site Plan (5 sets): Note scale used Ex I S n
• Property lines, easements, & right of ways • Location of all exis' s ructures nsions
• Distance, in feet,from property line&structures • Landscape buffe Ards
• On-site sewage tanks and drain fields, &reserve • Well location
• Surface&storm water run-off routes • Parking areas(number&arrangement)
• Location of fire hydrants&vehicle access roads
3. Septic records, pumper's report or O&M report.
4. Fees will be collected at time of submittal. Balance due will be collected when the permit is approved and issued.
Official Use Only
I cc _tz;c: (,Q� ua'.e J12112LLSubmittai Amount l`� l .' --- (Receipt number
I'1\rVG �Viw �J
Department view Initials Date Comments
Building D I I + coo I e>
Environmental Health
Fire Marshal
Planning
Public Works
Pre Application required? (circle one) Yes No Buildirg Permit required? (circle one) Yes No
Engineering Required? (circle one) Yes No Type of construction
Occupancy Change? (circle one) Yes No New Occupant load: persons
Occupancy classification change from to __ Valuation: $