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Home My WebLink AboutCOM2001-00027 Change Coffee to Antiques Retail - COM Application - 3/26/2001 o F-Ve V19 .dCase numberLOVA a I'Ctal Mason County ENANT REVIEW APPLICATION Y tegarit F view application and return with floor plan. site plan, pumpers report, and $100.00 fee to p �M, e ason County Permit Assistance Center, attn. M MacSems, P.O. Box 186, Shelton, WA 98584. The tenant review application will be evaluated on Wednesday after the application has been received. During the evaluation Mason County staff members from the Building, Fire Marshal, Environmental Health, Planning, and Public Works offices will identify compliance requirements, if needed, and advise whether a separate building, t•w M17 Date: - _I-i_p / Assessor's Parcel Nun-per: 23 2 L (SOU I U Legal Description:NC (, Nw ,4 = . 2 Building Site Address: Ne t ) t7l() Method of sewage disposal: O Septic O Sewer- name of district: Water source: O Well O Community Well ® Public System, name of system: PFOPLE and FIRMS I! VOUlED !N THE PRO ECT Name of property owner: CONWIE Mailing address: Q ,p N, -1 jd� 'N U NUNA-DA c�fl 53 Day phone: b _'jo _(,,3-Contact Person:(��y� - c-i Message phone: Name of applicant: J�tLTE Mailing address: Q 0• 6A ZS3 W I WA- c -cD-2_ , Day phone: Z-IS_ 2l� Contact person: ulz _ / ,� _� Message phone: Name of Tenant: btu Mailing address: p •36C ZS�_ A(e.ti1A c i(_)-2_ Day phone: Z-IS�.l�cl Contact person: J t�k- -r Message phone: PROJECT INFORMATION Proposed business name: Iltjbl- -L cam/ L ,`> Proposed use: �� i L. Number of employees: Previous business name: COTi=L Previous use. �pQ r r ly INFORMATION ABOUT STRUCTURE Check one: ODetached single level/single tenant @single level/multi tenant I a) Multi level/single tenant Multi level/multi tenant Age of structure: Is structure current) occupied? If not occupied, how long has it been vacant? Circle one: es No Yrs mos. List square footage for each floor level Basement: J First: j31 7 Mezzanine: I Second: Third: Will structure be heated: Type heating fuel: Circle one: Circle one:CYQ�. No I Electric Li uid Pro na a Natural Gas Oil Type of heat: Circle one: urnace Heat Pump Electric a-s(woar or wall mount 'Radian Will there be any changes to the following? Circle yes or no, if applicable: Floor lay-out: Yes (j!aT::) Lighting: Yes <=::,, Heating: Yes Exterior Finishes: Yes o Interior Finishes Yes Parking: Yes Number of restrooms provided: (�_ I Number of fixtures in each k .I.b, tl f 15,ok Is structure ADA Accessible? Circle on Yes No Is the structure equipped with a fire sprinkler system? Ye<IVo Fire alarm system? Yes No Return this application with: 1) Floor Plan, 2)Site Plan, 3) Pumpers Report, a_rd 4)$100 Fee 1) Floor Plan: Include existing walls,proposed walls,and walls that will be removed. • Draw the floor plan to scale, '/4"= 1 foot min. • 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: Note scale • 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 drainfields, & reserve • Well location • Surface &stormwater run-off routes Parking areas (number&arrangement • Location of fire hydrants&vehicle access roads • Slope of property 3) Pumpers Report 4) Fee: $100.00 Intake fee will be collected when submitted Additional fees will be collected when the permit is Issued. Office Use Only Pre-Application Review Departmental Review Env. Health Env. Health Planning Planning Public Works Public Works Fire Marshal Fire Marshal Building Building NREC NREC Pre Application required? (circle one) Yes No Building Permit required? (circle one) Yes No Engineering Required? (circle one) Yes No Occupancy Classification: Occupancy Change? (circle one) Yes No Occupancy classification change from to Type of construction Occupant load calculated: persons. Existing occupant load design persons. Fee Schedule PLAK)NSN G- � � �,l Case numberl.C)YVI a(V��,. �, hJ Mason County JJ �CC JView ENANT "'EVIEW APPLICATION �°'f` ��&)._ PUeWM,(�e0aht application and return with floor plan. site plan, pumpers report, and $100.00 fee to -alsor, County Permit Assistance Center, attn. M MacSems, P.O. Box 186, Shelton, WA 98584. The tenant review application"will be evaluated on Wednesday after the application has been received. During the evaluation Mason County staff members from the Building, Fire Marshal, Environmental Health, Planning, and Public Works offices will identify compliance requirements, if needed, and advise whether a separate building permit will be required. Date: �� _i-�_p 1 Assessor's Parcel Number: 23 Z c) Ly Z (,nU I U Legal Description: c _ _ ,ZG. Building Site Address: NC: i ` OCZ C9_r-0T-(L 1-3at Atri: vu A-61 OZ. 1S Method of sewage disposal: O Septic O Sewer- name of district: Water source: O Well O Community Well ® Public System, name of system: PEOPLE and FIRMS INVOL VED IN THE PROJECT Name of property owner: bN N rE Mailing address: -1'K 'DSO N L-VA-DA T`153 Day phone: 53o _`j6j _(.35-pontact Person:( k)fjk Message phone: Name of applicant: -TULLIE 1 Mailing address: Q Q. t6Y ZS3L4 W/- C 157 r, Day phone:3 .21 Contact person: GtL.. - k L Message phone: Name of Tenant: tt k_ Mailing address: p ,36Y_ ZS_�q FA-iev-1A cl ic�Z Day phone: Z l� �.1�c1 Contact person: tALI ,U - I Message phone: PROJECT INFORMATION Proposed business name: fit hC-L ,_/ A �� Proposed use: pj7T-A i L_ Number of employees: Previous business name: 1i} - CjXr(x µb�� Previous use: —'pQ T-!x'o) Ell` INFORMATION ABOUT STRUCTURE Check one: ODetached single level/single tenant Osingle level/multi tenant f a� Multi level/single tenant Multi level/multi tenant Age of structure: Is structure currently occupied? If not occupied, how long has it been vacant? Circle one: es No Yrs mos. List square footage for each floor level Basement: First: ;3 ` .1 ^".- z"�i^e: Set u,;; . Third: Will structure be heated: Type heating fuel: Circle one: _ Circle one:Q e D No I Electric Li uid Pro ane Natural Gas Oil Type of heat: Circle one: Furnace Heat Pump Electric a-seGoar or wall mount R dian Will there be any changes to the following? Circle yes or no, if applicable: Floor lay-out: Yes la—' Lighting: Yes cNn_, Heating: Yes �v Exterior Finishes: Yes (IT&D Interior Finishes Yes Parking:Yes Number of restrooms provided: �_ I Number of fixtures in each Is structure ADA Accessible? circle on Yes No Is the structure equipped with a fire sprinkler system? Yes(2No ' Fire alarm system? Yes No Return this application with: 1) Floor Plan, 2)Site Plan, 3) Pumpers Report, and 4) $100 Fee 1) Floor Plan: Include existing walls,proposed walls,and walls that will be removed. • Draw the floor plan to scale, V= 1 foot min. • Use of rooms • Room Dimensions Locatic6 ;f aii exi(s and windows (include dimensions) • Location of plumbing and mechanical fixtures • Interior dcors with swing radius 2) Site Plan: Note scale • 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 drainfields, & reserve Well location • Surface &stormwater run-off routes • Parking areas (number& arrangement • Location of fire hydrants &vehicle access roads • Slope of property 3) Pumpers Report 4) Fee: $100.00 Intake fee will be collected when submitted Additional fees will be collected when the permit is issued. Office Use Only Pre-Application Review Departmental Review Env. Health Env. Health Planning Planning L - cD / 3 1G/vi Public Works Public Works Fire Marshal Fire Marshal Building Building NREC NREC Pre Application required? (circle one) Yes No Building Permit required? (circle one) Yes No Engineering Required? (circle one) Yes No Occupancy Classification: Occupancy Change? (circle one) Yes No Occupancy classification change from to Type of construction Occupant load calculated: persons. Existing occupant load design persons. Fee Schedule