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HomeMy WebLinkAboutCOM2018-00081 Cancelled Change Tenant - COM Application - 6/20/2018 MASON COUNTY 427-9670 Shelton ext.352 F DEPARTMENT OF COMMUNITY SERAIECEIV00 275-4467 Belfair ext. 352 BUILDING•PLANNING• FIRE MARSHAL JUN 2 0360) 482-5269 Elma ext. 352 _-- = Mason County Bldg, 8 189 615 W. Alder Street, Shelton, WA 98584 615 W.Aldl11W S&S11111".co-mason.wa.us oof�I CHANGE IN TENANT APPLICATION COMJC��,Pj-o PROPERTY INFORMATION Date: / Assessor's Parcel Number: 9�7A- �-. _C)00`0 Legal Description: Building Site Address: 3 730 V 5 ,5'5- APPLIG ORMATION ~ Name of Applicant: i 0 - 14 V.9 V. eA i U - ehTS Mailing address: a City: 3 (�' Sta ,¢ Zip: 8 5� Day phone: Contact Person: -73ro, Message phone: yogi PROJECT TION Proposed business name: Proposed use: T- �ytuber of employees: ,2 - y Previous business name: Describe previous use: C AILS Check one: O Detached single leve s I tenan Single level/ multi tenant O Multi level/sin le ten nt O Multi level/multi tenant Age of structure: is strpct a ently I not occupied, how long has it been vacant? 3), yes o cu I d. es Yr. /) Mo. Square Base en . First: Mezzanine: Second: Third: footage:.. Is the structure pe of Heat: Circle one: Furnace eat Pump Electric wall Radiant heated? Circle one: es No Fuel type: Circle one: lectric Liquid Propane Natural Gas Oil Will there be any changes to the following? Circle yes or no, if applicable; Floor lay-out: Yes No Lighting: Yes o Heating: Yes No Exterior Finishes: Yes N Interior Finishes: Yes No Parking: Yes No Number of restrooms provided: Number of fixtures in each: Water Closets Lavatories oZ Bath/Shower Is structure handicap accessible? Entry: Yes No Restroom(s): Ye No Is the structure equipped with a fire sprinkler system? Yes....No Fire alarm system? Yes No Monitoring Station Name: Phone number: 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 SInterior doors with swing radius and exit signs). ite 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 remt>def irtJ is proppsed 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 i ature of Appli nt Date X -Fr-ve- _ L aloe,STr/''J 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 one) Yes No Land Use Designation: Occupancy classification change from to New occupant load calculated: persons Existing occupant load design persons. Type of construction e LN MASON COUNTY �I f 427-9670 Shelton ext.352 DEPARTMENT OF COM RVI C �/ 275-4467 Belfair ext. 352 BUILDING• PLANNING•FIR*MARk1b JuN 2 0 20� 360) 482-5269 Elma ext. 352 Mason County Bldg. 8 //V ,R 615 W. Alder Street, Shelton, WA 98584 W-AkfOr Sb9@".co.rnason.wa.us COMoqcAa_Oo0ks� CHANGE IN TENANT APPLICATION PROPERTY INFORMATION Date: �; - , -/ l Assessor's Parcel Number: �,�- L- t-\- ccC\C) Legal Description: Building Site Address: ; 3 73 n APPLICANT INFORMATION Name of Applicant: l J Mailing address: fir. �,� r , :2) _ City: -?� i State: ,¢ Zip: c3,y�- Day phone: Contact Person: �r�� � f�,, Message phone: 3e PROJECT INFORMATION Proposed business name: �, cK ��,; / �,, 1'{j; �i � �__7 r 3 Proposed use: r r S�� { Number of employees: - y Previous business name: Describe previous use: STRUCTURE DETAILS Check one: O Detached single level/single tenant V Single level/ multi tenant O Multi level/single tenant O Multi level/multi tenant Age of structure: Is structure currently If not occupied, how long has it been vacant? 3 Y'sI occupied? Yes No Yr. Mo. Square Basement: First: Mezzanine: Second: Third: foots e: Is the structure Type of Heat: Circle one: Furnace Cf4eat Pump` Electric wall Radiant heated? Circle one: es ' No Fuel type: Circle one: < lectric Liquid Propane Natural Gas Oil Will there be any changes to the following? Circle yes or no, if applicable: Floor lay-out: Yes Now Lighting: Yes Igo Heating: Yes ;NoExterior Finishes: Yes No Interior Finishes: Yes Now Parking: Yes Number of restrooms provided: Number of fixtures in each: Water Closets Lavatories Bath/Shower Is structure handicap accessible? Entry: LYes No Restroom(s): iYe No Is the structure equipped with a fire sprinkler system? Yes No Fire alarm system? Yes 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 If construction or rem-odeir4s.'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 130 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 \� igiiature of Apply' a'nt Date i X VC C_ ,�,+�, Td� Owner/Owners Representative/Contractor Print Name (circle to indicate which one) Official Use Only Accepted by Date Submittal Amount $ Receipt number Department Review Initials n Date Comments Building I Fire Marshal Planning Occupancy Change? (circle one) Yes ©o Land Use Designation: Occupancy classification change from to New occupant load calculated: ZI persons Existing occupant load design persons. Type of construction V trX►�- Waterp�a�ec 36 inc Sink Toilet Heater ��� ---- ■ -let----ti CA,Ce I Sao 9e .................................... Cus�orY.er Toi --- Sink -----� .................................................. to Sink IO (� Electric C L Panel k Closet __65 inch Doors 1 N9"P/�s Hb�" `S r Fr 3G p� Main Sales Floor Area 33 de p X 30 ft wide 3 Lk I N I 3G p.Os 3 G -- Window I Entrance I Window f 7D �_ �� �� �-� ����., �-� �. 0 3 ----- -------------- ti � � � s r � �'' � �G �. a �x � . . M, L o rC.. � � .� � %� N � ' -P �� � � �, �� Water 36 inc Sink Toilet Heater - ---ti ............................................... Toilet --- Sink v I to Sink I p I I � Electric Panel �1d Closet 65 inch Doors— Main Sales Floor Area 33 ft deep X 30 ft wide Window Entrance Window