HomeMy WebLinkAboutCOM2014-00072 Cancelled Change in Tenant-Antique Store to Collective Garden - COM Application - 11/7/2014 Zot 4 - 66o- Z
Aj
E
nEO -FPwe- P16K,
E VT s
c�
R
w�
N
Mason GO be mean
APP.R VE
ITi�h nt Initl
sciz = I F i Date .. .1?.�
Co iV1 zo
k4M
E
3 2 '_ 6
1 �
w�
r
3,
N
1
Mason County Uept. eatth
�p T
pov� I NG IniD JJ
sr AA
W _
4f�(ZK 1l�Ca
U'
i
J-- ,,�c
W f
°- SMALL
o
oc.
RES 1 D'Ewri L
I �
N �
O � '
• I
Z
�u
W
cn HW41#3
Q�R►t iN(a 2M I
Mason GounveN:. t-tealth County �D
App�� STOKE
Initlsla � _.._
w
I
1►-1- 00 C)
WC tk"l
. •� Z � - t'I � I � ��oR f•
� 2
N �A�K I N U
,
b TO
5C P E 1 _
�p9or Co
MASON COUNTY (360)427-9670 Shelton ext.352
-�, DEPARTMENT OF COMMUNITY DEVELOPMENT (360)275-4467 Belfair ext. 352
BUILDING• PLANNING•FIRE MARSHAL U'LD I N G360)482-5269 Elma ext. 352
_-`-= Mason County Bldg. III, 426 West Cedar Set
1834 PO Box 279, Shelton, WA 98584 www.co.mason.wa.us
I Rwu 11GrA - M txed icy f t--bu RC COM 2,0 I--I- X012,
CHANGE IN TENANT APPLICATION
PROPERTY INFORMATION
Date: ply. Assessor's Parcel Number: ( - 3— OI44()
Legal De cription: p 14 p
Building Site Address: S(Z 3 - C'�-�r ►� s
APPLICANT INFORMATION
Name of Applicant:
Mailing address: -4:C4
City: State:-tv+ Lo-\p\ Zip: of FS
Day phone:3loo•;Sfv Contact Person: Message phone: �S—
$57. PROJECT INFORhIATION
Proposed business name: ('av, a,,� : �wF
Proposed use: Number of employees:
Previous business name: I� Describe previous use � (Q�
U f✓ t�"Ot✓+E
STRUCTURE DETAILS
Check one: -4-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 cur r ntly If not occupied, how long has it been vacant?
occupied? - 'es ' No Yr. Mo.
Squarer #� Basement: irss Mezzanine: Second: Third:
foots e:-1 2
Is the structure Type of Heat: Circle one: Furnace Heat Pump Electric wall Radiant
heated?
Circle one: Yes No Fuel type: Circle one: Electric Liquid Propane Natural Gas Oil
ill therepbany changes to the following? cle yes or no, if applicable:
Floor lay-out: Yes Lighting: YesNo5 Heating: Yes NoExterior Finishes: Yes Interior Finishes: Yes o Parking: Yes o
Number of restrooms provided: ' Number of fixtures in each:
ater Closets Lavatories Bath/Shower x
Is structure handicap accessible? Entry: es No Re troom(s): Yes o
Is the structure equipped with a fire sprinkler system? Yes No Fire alarm system? Yes No 6iIIrC1
Monitoring Station Name: Phone number: 0J
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
• Prooerty 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
`'" dgcgments/drawings may be required.
After permit issuance and compliance to all conditions is complete,
schedule an inspection by calling
360.427.7262 or 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 Submittal Amount$ Receipt number
Department Review Initials Date Comments
Building
Fire Marshal
Planning
Occupancy Change? (circle grip). Yes Land Use Designation:
Occupancy classification change from to New occupant load calculated: persons
Existing occupant load design persons. Type of construction _
l "Al
C1 x �, 3418
• 7� �. s 1