HomeMy WebLinkAboutCOM2008-00115 Cancelled Change in Tenant - COM Permit / Conditions - 9/25/2008 f 1 CO
MASON COUNTY
CHANGE IN TENANT APPLICATION J
Complete the Change in Tenant Application and return with a floor plan,site plan,septic pumper's report,septic records aildl
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
will b e= enecessary. 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.
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Date: e + 2-S' zousy Assessor's Parcel Number: Iz332Sc�oav5�i
Legal Description: J�jt•itVS s, Carcll.,n 'Vr c 5 ZC, " 2
Building Site Address: roe 7zz-751 SQ 3 •tjQjr 1116S21g
Method of sewage disposal: Septic O Sewer—name of district:
Water source: O Individual Well O Community Well ,VPublic System,name of system:Bel p;5 'Ck 1
Name of Applicant: 7t'vr ' -Cj;an
Mailing address: Pe Fk,� 2,pSq
City: I rY State: tN p, Zip: z$
Day phone:'2-IS'-�gc� Contact Person: n;� t Message phone:
Proposed business name: TY:�K Win
Proposed use:mLee 1,ky,01 ylg, kt{- 60SS-eoA-1A Number of employees: 1
Previous business name: t n P`Y : Wy,6k5 Cko to
Describe previous use: V i,tG1c:'+ yS
MA Ma:
Check<one: •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 cupatly If not occupied,how long has it been vacant?
� tc1rl0" occupied? a No' Yr. Mo.
Square footage: I Basement: & First: 2yo o 1 Mezzanine: {;1. 1 Second: Third: -4A
Is the structure heated? Heating type:Circle one:
Circle one: es No I Electric Li uid Pro ane CEatural G Oil
Type of heat:Circle one<Fumace Heat Pump Electric baseboard or wall mount Radiant
Will there be any changes to the following?Circle yes or no,if applicable:
Floor lay-out: Yes Lighting: Yes No Heating:Yes
Exterior Finishes: Yes COO, Interior Finishes: Yes 01 Parkin a:Yes N
Number of restrooms provided: I Number of fixtures in each 1
Is structure handicap accessible?Circle one Yes No
Is the structure equipped with a fire sprinkler system? Yes o Fire alarm system? Yes N
Monitoring Station Name: FQ( ^ Phone number: P/A
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
� ta.
Acce led b Da bmittal Amount S Recei t number
Department Review Initials Date Comments
Building /O •Ag •�
Environmental Health
Fire Marshal /�,2i Q
Planning
Public Works tt
Occupancy Change? (circle one) Ye No Type of construction Y
Occupancy classification change from C3 toF/ ZDccupant load calculated: Ap persons
Existing occupant load design persons. Land Use Designation:
Occupancy Classification:
4247- 7
bay door scale
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MASON COUNTY DCD PLANNING =
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GRAPHIC SCALE