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HomeMy WebLinkAboutCOM2013-00062 Change Tenant, Remodel - COM Permit / Conditions - 7/12/2010 1 MASON COUNTY GEPT. OF COMMUNITY DEVELOPMENTInspection 1 ine (360)427-7262 Phone: (360)427-9670, ext. 352 Mason County Bldg. 3 426 W. Cedar P.O. Box 186 Shelton, WA 98584 1rF4 COMMERCIAL BUILDING PERMIT COM2013-00062 OWNER: LORI JOHNSON RECEIVED: 5/28/2013 CONTRACTOR: LICENSE: EXP.- ISSUED: 6/5/2013 SITE ADDRESS: 11 NE OLD BFWAIR HWY UNITA BELFAIR EXPIRES: 12/5/2013 PARCEL NUMBER: 123294200010 LEGAL DESCRIPTION: ' "1l 11 NE OLD BELFAIR HIGHWAY UNITS A& B PROJECT DESCRIPTION: DIRECTIONS TO SITE: Change in Tenant&add partition walls Belfair General Information Construction &Occupancy Information Type of Use: Insp.Area: No. of Units: Type of Constr.: Type of Work: TRA Fire Dist.: 2 No. of Bathrooms: Occ. Group: Valuation: No. of Stories: Exit Design. Load: Building Height: Pre-Manufactured Unit Information Square Footage Information Make: Length: Lot Size: Model: Width: Building: Year: Serial No.: Basement: Parking Spaces: Setback Information Shoreline& Planning Information Front: Ft. Shoreline: Ft. Rear: Ft. Slope: Ft. Water Body: Shoreline Desig.: Side 1: Ft. SEPA?: Comp. Plan Desig.: Side 2: Ft. Fire Protection System Information Auto Fire Alarm System?: Emergency Key Box?: Standpipe?: Auto Fire Sprinkler System?: Access Road?: Fire Extinguishers?: Fixed Fire Suppression System?: Fire Hydrants?: Fire Lanes?: COM2013-00062 Please refer to the following pages for conditions of this permit. Page 1 of 4 Plumbing Fixtures Mechanical Fixtures FEES Type _ Qty. Type Qty. Type By Date Amount Receipt Tenant Review Fee nAi t;r9ai,)mA (k1d1 nn c;>�ntZnn EH Plan Review kKK rv9ponii TA7 nn �, gni'�nn BLD Vio. Investigation Fe ni r. r,i?ai9ni.i T,7,i nn qi,)nt znn BLD Vio. Investigation Fe ni c snRnn1 s -Ws nn ,i gm inn Total $344.00 CASE NOTES FOR COM2013-00062 CONDITIONS FOR COM2013-00062 1) 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 1-800-64 ;0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X i D 2) Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.t. , XkJ 3) Approved per dimensions and use areas on submitted site plan. Professional personal services land use needs 8 to 12 parking stalls provided alrea X U� 4) Parking shall be sufficient for 8 standard parking stalls (9 feet by 20 feet) and 1 handicap parking stalls (12.5 feet by 20 feet)with sufficient maneuvering aisles. Handicap stalls shall be of a smooth surface at level or ramped to entry, located closest t t building entry, and shall be signed with the International Symbol of Access. Screening from adjacent residential properties is required. X� 5) All construction and demolition debris must be removed from the property after project completion. Proper 4isposal of construction debris must be on land in such a manner that debris cannot enter or cause water quality degradation of State waters. X J) 6) Install 2A106C fire extinguishers mounted no more than 60 inches above the floor to the top of the unit. Maximum travel distance is 75 feet in any X r' tI � InsIla knox box per section 506 of the 2009 International Fire Code. Please contact the local fire district for more information and inspection. X �1 , -) Th nor finish is required to be a minimum of a class C with a flame spread index of 76-200 and a smoke development index 0-450. X COM2013-00062 Page 2 of 4 r 7); All approved plans are required to be on-site for inspection purposes. " inspection is called for and plans are not on site, Approval WILL NU I be granted. In addition, a reinspection flee, based on the current fee sch'-.-dule, minimum one-hour will be charged and collected by the Mason County Building Department prior to any further inspections being performed or approvals granted. X 8) ALL CONSTRUCTION MUST MEET" OR EXCEED ALL LOCAL CODES AND THE INTERNATIONAL CODE REQUIREMENTS AND OCCUPANCY IS LIMITED TO THE PERMITTED AIND APPROVED CLASSIFICATION. ANY CHAN(3zEOF USE OR OCCUPANCY WOULD RESULT IN PERMIT REVOCATION. CHANGE OF USE MUST BE APPROVED PRIOR TO CHANGE. x �� 9) Changes to approved building plans that affect compliance to the current Washington State Energy Code (WSEC), ventilation requirements), Building/Plumbing/Mechanical Codes and/or Mason County Regulations shall be approved prior to construction. X J: 0" 10) CONSTRUCTION PROCESS TO BE FIELD CORRECTEDAS REQUIRED PER MASON COUNTY BUILDING DEPARTMENTAND THE ADOPTED BUILDING CODE. The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building Inspector shall be made prior to requesting additional inspections. � r 11) All building permits shall have a final inspection performed and approved by the 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 X n-c`o7 I' nt with Mason County ordinances and building regulations. 12) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the frmit holder have prevented action from being taken. No more than one extension may be granted. X 13) 2009 International Building code section 110.1 Construction or work for which a permit is required shall be subject to inspection by the building official and such construction or work shall remain accessible and exposed for inspection purposes until approved. All construction or work shall be exposed for inspection, all new plumbing shall be put under test per the Uniform Plumbing code standards and any mechanical work shall be exposed for inspection. All work or construction shall be subject to inspections and corrections as deemed neccessary by the'M�s County inspector to ensure that all work was done in compliance with all adopted codes. X This permit becomes null and void if work or construction authorized is not commenced within 180 days, or if construction or work is suspended for a period of 180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuati n of work is by means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate %and grants employees of. a� s,on County acces o the above described property and structure for review and inspection. OWNER OR AGENT: ( G' G l� `� DATE: COM2013-00062 Page 3 of 4 n O CONCRETE MECHANICAL MANUFACTURED HOME _ w Footings /Setbacks Date By Ribbons N Gas Piping o Interior Date By Interior-Date By Date By Z 0 N Exterior Date By Exterior-Date By Setup r Point Load 1 Isolated Footings INSULATION Date By O BG/SLAB INSULATION Date By Data By FIRE DEPARTMENT Foundation Wails Floors Date By Date By Data By DECKS FRAMING walls Date By Date By Data By PROPANE TANKS PLUMBING vault Date By Date By OTHER Groundwork Attic Date By Type- Date By Dale By D.w.v DRYWALL Type. O Int Brace Wall Date By Date By --- ? Date By FINAL INSPECTION p Water carte Fire Soperation Date By Date By Date By ca O Pass or Request Inspect. c Type of Insp. Fail Date Date Done By Comments m; s r1 t „ e n v 0 Aft `i Washington State Department of ELECTRICAL Inspection Labor & Industries ELECTRICAL Section Correction Report The corrections listed below are hereby ordered and must be completed within 16 days of issuance. Contractor/Owner Date of Inspection Permit Number KILOWATT ELECTRIC LLC 6/11/2013 12230695E Address of Inspection City 11 N. E Old Belfair Hwy Belfair WA BELFAIR NOTAPPROVED FOR COVER NOT APPROVED FOR SERVICE Is the permit fee correct � Yes No Fee due $ $0.00 Correction(s) issued on: 6/11/2013 _ 2008 NEC 110.3 (B) Installation and Use Correction Issued on: 6/11/2013 by CHICK, ROGER . Listed or labeled equipment shall be installed and used in accordance with any instructions included in the listing or labeling. DO NOT SEE THE BUCK BOOST LISTING ON TRANSFORMER IT IS A STEP DOWN TRANSFORMER 120/240 TO 12/24 VOLTS STRAPPING OF FLEX REQUIRED 36"CLEARANCE REQUIRED IN FRONT OF SERVICE PANEL. TANNING BED IN THE WAY OWNER TO TAKE CARE OF. Af inspector CHICK, ROGER . 360 415-4034 Inspection Request tine 360 415-4039 Page 1 of 1 1061 ON ►101011 r7. 11fil0ft TO M-61NNIN6 OF WO DPIViAr-Iataltl l►1 I rf1114►1' awl 11IIiilell#�a 1=1,FCTHICAI_ CONTRACTOR r1:fC*ttif:Ai- WORK VFRM1T #22M) i i6F: i .�tM1iM+hkdMw 111w{t11w!�b*► 11."444-111 � 1+. 411►'NA I 1 ri IWONI1 111'. 11411 1Or-I UllUit► '11.111sill If111N1W4:111t`Ili 1ti 1!1'1MM�i NNlkv,�.1�11Pl4 bRtiii♦r 1..M.s1.Fi.1 - . 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JI"vod HY Rdi Approvod By WALLS 111'XIMU141 Only 21k ttVICE tilt INO (nrii1.11)"ll ��nh ltil It At(l`ilAl COVni Illicit In•1�.+� 11oll 11011p A1.IA, 1111W1nU All 111u11r1116111 In1.l)erte"l At hoet 1Allen Electrical Inspector t ^ � 1 -.. �� CV��r- GJ c y �� �s•�e_� �,o�,r�� O� �� 11ttllx (!.r,ttictl �c�v \%'1I klrl'llIIIiojjk,,'11)t1't-(Hilt tl�I1�`.'t'r'rmi1- 2MRRid 15; 5112/2013 Generated by CamScanner from intsig.com or0„g i rr JJ fin• C l }Lc.A Qccr��A. R. CSt.-S-G.Is profjj 01 '4•rx+• 1q TH SE PLANS MUST BE ,, ,,, „+, N THE JOB SITE OR INSPECTION. RRMP Y Po,' � f GIhD G.. G Gk• /I MUST MEET ALL CURRENT WA HINGTON STATE CODE � _ 3 CHANGES t4 3'DooK MIT CHANGES FOR APPROVAL n p 1 IOR TO PERFORMING WOR 1/7b� (20 5TO GE S Doo1C *40WOPYs AA ;1 (� 10, 0 v,5/y N - � •� � - � N Of � J��i✓ oJ dad n MixeR ', Z---4)DDooR CHA GES SUBJECT TO APPROVAL 0 1 E� ----DAT Permit o. - 1 MASON COUNTY V BUILDING PERMIT APPLICATION �.\OAS 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 a� PLEASE PRINT cviT - #1 �r rr v i�,v 5 • f( irZ,4� Phone# 2 46 5/2 q30 Y ;7 ? 6 ifty ite Address /1 E Dec t,4 i�t l{�`/ �UI 4"E� Fire District# St ui " Zip 9;i?-S 215' Directions to Job Site 14 w 1 /4'c o,v o k. C4.1 nr 6/w-1 Owner Mailing Address e City a, St Zip r�'s 3 Lien/Title Holder C vc; .1r , 1 ,iL14 Address t'/ PO 130k Y'5-9 Clty .&,_L Ed111 '� St C/ Zip #2 Contractor Name Jc<L, Contractor Reg# Address T'G 13�EA y Expiration Date City St L=- f= Zipj ` �5 �' Phone# #3 If septic is located on project site, include records. Connect to Septic? /- Public Water Supply Well Connect to Sewer System? Name of System ,(fir A r`/i//-t w i�L r/= A (If residential, proof of potable water is required) i a30q-y Q--ocoto #4 Parcel No. 123 Z - C1141 Z Legal Description T r z-- ZV #5 Building Square Footage: (existing/ Foposed) 1st FI .3Z,.c l 2nd FI / 3rd FI / Loft / Basement / Deck / #bedrooms / #bathrooms / Garage / Carport / (Circle:Attached or Detached?) Other sq. ft. / #6 Use f building el Z Z Describe w rk Z-Z/ ' - � #7 Type of Job: New Add Alt 'yn Repair Other #8 MOBILE/MANUFACTURED HOME INFORMATION Model Year Make Model Length Width Serial No. # Bedrooms # Bathrooms Type of Heat Purchase Price $ #J Indicate by circling the applicable source if any water is on or adjacent to subject property: River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other Plumbing Fixtures ($3.25 eachl Fee Mechanical Fixtures ($6 50 each) No. Toilets 2 5' CIRCLE FUEL TYPE: Gas, Electric, Bath Basins �_ Heatpump, Other _Bath Tubs No. Units Fees TShowers 3.Z _ Furn BTU Hot Water Htr _ Heatpumps _Laundry Washer _ Vent Systems 1 Sinks 3.2 _ Spot Vent Fans •S� _Floor Drains No. Boilers/Compressors _Laundry Basins HP _Dishwasher No. Air Handling Units _Disposal cfm# _Urinals No. Fire Protection Systems _Other _ Auto. Fire Alarm Sys 50.00 Fixed Fire Supp. Sys 50.00 Permit Basic Fee 16.25 _ Auto Fire Sprink Sys 35.00 TOTAL PLUMBING $7- No. Other Gas Outlets Wood, Gas, Pellet Stove NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COM- MENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR Permit Basic Fee 16.25 WORK IS SUSPENDED OR ABANDONED FOR A PERIOD TOTAL MECHANICAL OF 180 DAYS AT ANY TIME AFTER WORK IS COM- $ MENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED MENTS OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN THE STATE OF WASHINGTON AND I RCW 18.27, AND AM AWARE OF THE MASON COUNTY AM AWARE OFTHE ORDINANCE REQUIREMENTS REGU- ORDINANCE REQUIREMENTS FOR WHICH THIS PER- LATING THE WORK FOR WHICH THE PERMIT IS ISSUED MIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN AND ALL WORK DONE WILL BE IN CONFORMANCE CONFORMANCE THEREWITH. NO CHANGES SHALL BE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUILDING DEPARTMENT. DEPARTMENT. X OWNER , 1'� X BY d �/ DATE_ IG'- / _C.L DATE FOR OFFICIAL USE ONLY: Accepted by: Date: 00 RAM P �y / 3`DooR 5TO ,E �0 Cs a a y 3 S/NKS vvnT VIAt �� rt•�" COUNTER nn t • _ � o. STbRAGE GAS c►, m ; D N � O nno] ��� n MixeR ,DOOR I Iz IX i:� ( , UPI] .1 .1.c'' C✓t/ {� c�✓11.'II) �� 5ttic CA e i ,Te O P/Z A O v.e lv Frf le u , kA, k Mop ...j -� bc S/�V f I �� vm c i PLUMBING & MECHANICAL PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 7 �/ 427-9670 DATE ISSUED PERMIT NO. 7] NAME MAIL ADDRESS CITY&STATE _ e4FA/� ZIP PHONE OWNER Stec -f Cc.�., e rV /VE R u�c u SS25 -S DIRECTIONS 1` �L TO JOB SITE Frp 4 �4 'fa; #� l 3 v To �✓G`,�i'�/ - - /T 04<' fS c,L/=r4r it 1�tv - J�T ©r,�aic c C/L �cL� ,2 tf w" p'/d�Uo✓ , a - Slv, n 4 LEGAL n > (� DESCR. R 3 Z /9 yIZCr''/CJ �- 1 �� JV � J IE CONTRACTOR NAME MAIL ADDRESS CITY ESTATE LICENSE NO. ZIP PHONE 1,9,vje USE OF /� L BUILDING PLUMBING FIXTURES MECHANICAL FIXTURES NO. 2.00 PER FIXTURE OR TRAP FEE NO. TYPE OF FIXTURE FEE WATER CLOSETS FORCED-AIR/GRAVITY TYPE FURNACE 6.00 BASINS FLOOR/SUSPENDED FURNACE 6.00 BATH TUBS BOILER/COMPRESSOR 6.00 SHOWERS REPAIR/ALTERATION 6.00 WATER HEATERS �U 3 REFRIGERATION COMPRESSOR SYSTEM 6.00 AUTO.WASHER AIR HANDLING UNITS 7.50 SINKS G HEAT-PUMPS 6.00 FLOOR DRAINS EACH GAS PIPING SYS.2.00 PER OUTLET DRINKING FOUNTAINS VENT.FAN SYS.3.00 PER UNIT o o LAUNDRY TRAYS WOOD STOVES 5.00 CONNECT TO CITY SEWER WOOD FURNACE 5.00 DISHWASHER DISPOSAL URINALS PERMIT BASIC FEE 3.00 PERMIT BASIC FEE 10.00 TOTAL ,lfG� TOTAL OSY,tTO SPECIAL CONDITIONS: NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. OWNERS AFFIDAVIT: I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF CONTRACTORS AFFIDAVIT: I CERTIFY THAT I AM A CURRENTLY REGISTERED THE CONTRACT OR REGISTRATION LAW RCW 18,27, AND AM AWARE OF THE MASON CONTRACTOR IN THE STATE OF WASHINGTON AND i AM AWARE OF THE ORDINANCE COUNTY ORDIN CE REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL REQUIREMENTS REGULATING THE WORK FOR WHICH THIS PERMIT IS ISSUED AND ALL WORK DONE (I E IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIR T INI :OVAL FR M THE BUILDING DEPARTMENT. WITHOUT FIRST OBTAINING APPR VAL FROM THE BUILDING DEPARTMENT. X OWNE DATE X BY DATE FOR OFFICE USE ON LY APPLICATION ACCEPTED BY PLANS CHECK BY BUILDING GROUP APPROVED FOR ISSUANCE PERMIT VALIDATION IBY CASH CK MO r T-pi,0, OJ0 L jQGcr+'�i�. I t. L l 1,— pc-o j JJ TH SE PLANS MUST BElt. N THE JOB SITE OR INSPECTION. RR MP Pt�^ uY «r�o��I Gr�- ' ` d �' MUST MEET ALL CURRENT � WA HINGTON STATE CODE Y oc Q0/5 ln0 CHANGES �� 3'DcQ ,q ,z" MIT CHANGES FOR APPROYAC PRIOR TO PERFORMING WOR� 5N 1l (20 o OFF lC 57-0 GE I / ,5'DOOK I .� �� S � � f♦�' CDWY(fR tibl-Ay�/ V_ \ GAS 0 vsti N !�M N CL MixeR ' 1 DOOR I dN\�-� Ifni MASON BlIll DING INSPECTOR , w� CHANGES SUBJECT TO APPROVAL 1 e. 2- TS � � IOZ � � � SR 300 �r k O D -0 rn CD D -b m 1 711, o f77 (. �7 Ocn r Ln JR: a l�J W �✓'� w %� cu F COM, I3- 145�Z MASON COUNTY CHANGE IN TENANT APPLICATION Complete the Change in Tenant Application and return with a floor plan,site plan, septic pumper'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 compliance requirements. This application is intended for tenant change only. If construction or remodeling is proposed or required a building permit will be necessary. Upon approval the permit will be issued to the applicant/tenant. After the permit is issued, schedule an inspection by calling (360)427-7262. Upon satisfactory inspection a Certificate of Occupancy will be issued and must be posted in a conspicuous place on the premises. PROPERTY INFORMATION Date: _ Assessor's Parcel Number: f -2 X &Vo Legal Description: ' Ale- �f' -ra- �a Building Site Address: // M(-' b c ri Method of sewage disposal: O Septic A Sewer-name of district: l Water source: O Individual Well O Community Well Public System, name of system: t PEOPLE INVOLVED IN THE PROJECT Name of Applicant: Cyr Mailing address:address: /0 City: h i'j Ja lam$ State: ,SO— Zip: Day phone: :J){// ontact Person: 1-7 Message p one:/-z7- ;iZ �-3i l PROJECT INFORMATI Proposed business name: . . /L1 r Proposed use: �,, Number of employees: Previous business name: Describe previous use: t�z� STRUCTURE DETAILS Check one: O Detached single level/single tenant AV Single level/ multi tenant O Multi level/single tenant O Multi level/multi tenant Age of structure: Is structure cu n If not occupied, how long has it been vacant?rr occu ied? a No Yr. Mo. Square footage: I Basement: First: -co Mezzanine: Second: Third: Is the structur heated? Heating type: Circle r '� ;L Circle one: a No Electric- Liquid Pr ane Natural Gas Oil Type of heat: Circle one: Furnace eat Pump Electric baseboard or wall mount Radiant Will there be any changes to the following?'Circle yes or no, *fR pplicab/e: Floor lay-out: Yes Lighting: s No/Va r'� ating: Ye1s1 0 Exterior Finishes: Yes N Interior Finishes: es No il. Float-Parking: Yes o Number of restrooms provided: J Number of fixtures in each , t v aY Is structure handicap accessible? Circle one es No Is the structure equipped with a fire sprinkler system? Yes o Fire alarm system? Yes No Monitoring Station Name: Phone number: APPLICATION WILL NOT BE ACCEPTED WITHOUT: 1. 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 • Interior doors with swing radius 2. Site Plan(5 sets): Note scale used • Property lines, easements, & right of ways • Location of all existing structures&dimensions • Distance, in feet,from property line&structures • Landscape buffer yards • On-site sewage tanks and drain fields, & reserve • Well location • Location of fire hydrants&vehicle access roads • Parking areas number&arrangement) 3. Septic records,pumper's report or O&M report. 4. Fees will be collected at time of submittal Official Use Only Accepted by Date Submittal Amount$ Receipt number Department Review Vitials Date Comments Building 3 Environmental Health Fire Marshal Planning Public Works Occupancy Change? (circle one) Yes No Type of construction Occupancy classification change from to Occupant load calculated: persons Existing occupant load design persons. Land Use Designation: Occupancy Classification: P COM, 13_ 14(,-Z MASON COUNTY CHANGE IN TENANT APPLICATION Complete the Change in Tenant Application and return with a floor plan, site plan, septic pumper'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 compliance requirements. This application is intended for tenant change only. If construction or remodeling is proposed or required a building permit will be necessary. Upon approval the permit will be issued to the applicant/tenant. After the permit is issued, schedule an inspection by calling (360)427-7262. Upon satisfactory inspection a Certificate of Occupancy will be issued and must be posted in a conspicuous place on the premises. PROPERTY INFORMATION Date: _ /3- Assessor's Parcel Number: 60o Legal Description: "7` �jAl Lo Sc / 01 - f/a Building Site Address: tvle` b 6 f4LA- Method of sewage disposal: O Septic brSewer- name of district: x l Water source: O Individual Well O Community Well Public System, name of system: t �� PEOPLE INVOLVED IN THE PROJECT Name of Applicant: Lapi Mailing address: �7 . �,. 40 City: �';la State: �� Zip: Day phone: ? ,o a7�--/ tno act Person: essage phone:/-Z�-,3•- "3i G PROJECT INFORMATI Proposed business name: 4L 12 lei Proposed user �, Number of employees: Previous business name: I 2-Z�� Describe previous use: QeS ty a, STRUCTURE DETAILS Check one: O Detached single level/single tenant '61 Single level/ multi tenant O Multi level/single tenant O Multi level/multi tenant Age of structure: Is structure cuWe If not occupied, how long has it been vacant? occu ied? No Yr. Mo. Square footage: I Basement: I First: 1 0e) Mezzanine: Second: Third: Is the structur heated? HE type: Circle Circle one: a No Electric. Liquid Pr ane Natural Gas Oil Type of heat: Circle one: Furnace eat Pump Electric baseboard or wall mount Radiant Will there be any changes to the following? Circle yes or no,jf.@ Hcab/e: &t, �111 Floor lay-out: Yes Lighting: s NoN'L'L' F, ieating: Yes o Exterior Finishes: Yes NF Interior Finishes: %iesNoi 1.'f�� /bac-Parkin : Yes o Number of restrooms provided: )- Number of fixtures in each Is structure handicap accessible? Circle one es No Is the structure equipped with a fire sprinkler system? Yes o I Fire alarm system? Yes No Monitoring Station Name: I Phone number: APPLICATION WILL NOT BE ACCEPTED WITHOUT: 1. Floor Plan(5 sets): • Draw the floor plan to scale 6 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 • Property lines, easements, &right of ways • Location of all existing structures&dimensions • Distance, in feet,from property line&structures • Landscape buffer yards • On-site sewage tanks and drain fields, &reserve • Well location • Location of fire hydrants&vehicle access roads • Parking areas number&arrangement) 3. Septic records,pumper's report or O&M report. 4. Fees will be collected at time of submittal Official Use Only Accepted by Date Submittal Amount$ Receipt number Department Review Initials Date Comments Building Environmental Health Fire Marshal Planning 3 Public Works Occupancy Change? (circle one) Yes No Type of construction Occupancy classification change from to Occupant load calculated: persons Existing occupant load design persons. Land Use Designation: Occupancy Classification: