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HomeMy WebLinkAboutCOM2017-00036 COM2011-00036 Change Tenant - COM Permit / Conditions - 4/5/2017 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Inspection Line (360)427-7262 Phone: (360)427-9670, ext. 352 Mason County ( ' ' 615 W Alder St 1 1 Shelton, WA 98584 COMMERCIAL BUILDING PERMIT COM2017-00036 OWNER: THE SALAD SHACK RECEIVED: 4/5/2017 CONTRACTOR: LICENSE: EXP ISSUED: 4/17/2017 SITE ADDRESS: 23490 NE STATE ROUTE 3 BELFAIR EXPIRES: 10/17/201 i PARCEL NUMBER: 123294390160 LEGAL DESCRIPTION: PCL 2 OF BLA#89-102 PTN TR 16 OF SW SE S 27/233 PROJECT DESCRIPTION: DIRECTIONS TO SITE: CHANGE IN TENANT CHANGING FROM HOODSPORT FOLLOW ST RT 3 TO BELFAIR TO SITE ADDRESS ON THE RIGHT SIDE COFFEE TO A DRIVE THROUGH FOR SALAD & SMOOTHIES (no interior seating) General Information Construction & Occupancy Information Type of Use: DRIVE THRU FOC Insp. Area: No. of Units: Type of Constr.: VB Type of Work: TRA Fire Dist.: 2 No. of Bathrooms: Occ. Group: B 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?: COM2017-00036 Please refer to the following pages for conditions of this permit. Page 1 of 6 Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt IFC Plan Check Fee MARA d/r,/9nl7 1,7n Fn C39n17nn Change of Use r:KAM d/5/9(117 T1d1 nn S,.i?nl7nn Change of Use (:MARA disnnl7 a1d1 nn C,Agnl7nn EH Minor Plan Review (:KARA d/5/9nl7 1;1n5 nn C3?nl7nn Building State Fee TVV di17nn17 c.d rn gign17nn Total $462.00 CASE NOTES FOR COM2017-00036 CONDITIONS FOR COM2017-00036 1) Proponent has indicated that no material changes will be made to the footprint of the pre-exisitng structure nor the layout of the property. The subject change of use permit only grants the change of use. It does not imply approval to any material change to the building nor the site plan. 2) Application a k w dges that the structure is only permitted for a use consistent with the current zoning of the parcel. Zoning is Mixed Use (Belfair). X COM2017-00036 Page 2 of 6 3) Post i s on all exits. X Fire extinguisher(1) (minimum rating of 2A:106C) shall be mounted not more than 5' above the ground. Travel distance cannot exceed 75'. Reco n one per portable. X Poste ns bove doors "THIS DOOR TO REMAIN UNLOCKED WHILE THE BUILDING IS OCCUPIED". X Plan approval does not relieve the designer/contractor from complying with all applicable codes and requirements as adopted by Mason County and the f Washington, not does it abrogate the requirements of the requirements of other authorities having jurisdiction. X No gre ePffialt vapors/commercial cooking allowed without commercial hood, suppression system, and appliances. X -SQJZ) 4) 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 po n i ks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at 1-800- 2. T person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 5) All approved plans are required to be on-site for inspection purposes. If inspection is called for and plans are not on site, Approval WILL NOT be granted. In addition, a reinspection fee, based on the current fee schedule, minimum one-hour will be arge and collected by the Mason County Building Department prior to any further inspections being performed or approvals granted. X 6) Owner/Age t is espo ible to post the assigned address and/or purchase and post private road si sin accordance with Mason County Title 14.28. X 7) Lever hardware is required at doors. The unlatching of any door shall not require more than ONE operation. Hardwar with locks must open with a single action from the egress side of the door. Door hardware shall allow egress doors to be readily open able fro the eg ss side without the use of a key or special knowledge or effort. Handles, pulls, latches, locks and other operable parts on accessible o shall ha e a shape that is easy to grasp with one hand and does not require tight-grasping, pinching, or twisting of the wrist erate. X 8) ALL CONSTRUCTION MUST MEET OR EXCEED ALL LOCAL CODES AND THE INTE IONAL DE REQUIREMENTS AND OCCUPANCY IS LIMITED TO THE PERMITTED AND APPROVED CLASSIFICATION. ANY CHANG SE O CCUPANCY WOULD RESULT IN PERMIT REVOCATION. CHANGE OF USE MUST BE APPROVED PRIOR TO CHANGE. x 9) Changestg tinr)og/ echanical d building plans that affect compliance to the current Washington State Energy Code(WSEC), ventilation requirements), Buildii I Codes and/or Mason County Regulations shall be approved prior to construction. X COM2017-00036 Page 3 of 6 10) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND 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 conform an a ith the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason ty ilding Inspector shall be made prior to requesting additional inspections. X 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 req final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-c I a t wit Mason County ordinances and building regulations. X 12) All permits ex ire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for c n fo a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of t e it hol r have prevented action from being taken. No more than one extension may be granted. X 13) This project is approved as an existing building. The occupancy classification has not changed, and no alterations are proposed. No change h made in the use or occupancy of any building that would place the building in a different division group of occupancies, unless the buildirkA made to comply with the requirements of this code for such division or group of occupancy. X 14) Storage racks greater than 69" and up to 8'0" in height shall be installed in accordance to manufacturer specifications for seismic attachment. When seismic attachment is not provided by the manufacturer an engineered design and attachment details shall be required. Installation specifications or engineer's design shall be available during inspections performed by the Mason County Building Department. Storage racks greater than 8-ft in height shall require an engineer's design addressing seismic conditions and attachment. In addition, storage racks 8-ft tal or ore shall require special inspection performed by the design professional or an approved representative. The special inspection report a ginee d design shall be provided to the Mason County Building Department for approval prior to the final occupancy inspection. X 15) The scope his project is limited to that shown on the approved plans and does not include installation of new plumbing, mechanical fixtures or ne . In allation of excluded elements listed shall require approval from the Mason County Building Dept. prior to making changes. X COM2017-00036 Page 4 of 6 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 PER LICATION OF WO DAY ILL INVALIDATE THE APPLICATION. -) -7_ )-7 S g�are: Date OWNER - REPRESENTATIVE - CONTRACTOR Print Name (Circle one to indicate) COM2017-00036 Page 5 of 6 MASON COUNTY (360)427-9670 Shelton ext.352 dr�H `�Nrr DEPARTMENT OF COMMUNITY SERVICES (360)275-4467 Belfair ext. 352 BUILDING•PLANNING•FIRE MARSHAL (360)482-5269 Elma ext. 352 Mason County Bldg. 8 PLANNING 1854 615 W. Alder Street, Shelton,WA 98584 www.co.mason.wa.us coM 2.0 17 . 00O3(p CHANGE IN TENANT APPLICATION PROPERTY INFORMATION Date: Assessor's Parcel Number: Legal Description: o L,(T5 Building Site Address: APPLICANT INFORMATION Name of Applicant: Mailing address: City: State: Zip: a Day phone: }-7jO-z Contact Person: L� (� M*@ phone` o= Q,3t?& PROJECT INFORMATION Proposed business name: I) Ut-e Proposed use: l^Cv-� -vo o-Number employees: Previous business name: Describe previous use: 75- STRUCTURE DETAILS Check one: Detached single level/single tenant O Single level/multi tenant Multi level/single tenant O Multi level/multi tenant Age of structure: Is structure currently If not occupied, how long sit been vacant? occupied? Yes N Yr. Mo� 0' Square Basement: First: Mezzanine: Second: Third: footage: Is the structure Type of Heat: Circle one: Furnace Heat Pum -lectric wal Radiant heated? Circle one: Ye No Fuel t e: Circle one: lectr' Liquid Propane Natural Gas Oil Will ther ny changes to the o owing cle yes or no, if applicable: Floor lay-out: Yes Lighting: Yes o Heating: Yes Exterior Finishes: Yes No Interior Finishes: Yes o Parking: es o Number of restrooms provided: Number of fixtures in e Water Closets Lavatories Bath/Shower Is structure handicap accessible? Entry: e's No Restroom(s): s o v T )iG Is the structure equipped with a fire sprinkler system? es Fire alarm system? Yes No Monitoring Station Name: 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 MAR 2 9 201T r, 1• MW V t If construction or remodeling is 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 180 days or if construction work is suspended for a period of 180 days. PROOF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. r, X na re of Applicant Date Owner/Owners Representative/Contractor (circle to indicate which one) Print Name Official Use Only o0 Accepted by Date - 6 Submittal Amount$�W Receipt number Department view Initials Date Comments Building Fire Marshal Planni;n Occupancy Change? (circle one) Yes No Land Use Designation: ant load calculated: persons Occupancy classification change from to New occupant Existing occupant load design persons. Type of construction vrv� zxj V j 4 �� COM L2 I I-QM3L2 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 �I conspicuous place on the premises. 1 PROPERTY INFORMATION Date: Assessor's Parcel Number. - {_ Legal Description: l- _ ice` Y -IDI,7a ' 2 Building Site Address: ' Method of sewage disposal: Septic O Sewer-name of district: Water source: O Individual Well O Community Well P(Public System, name of system: PEOPLE INVOLVED IN THE PROJECT Name of Applicant: L cli— Mailing address City: State: Zip: C Day pho`n Contact Person Message phone: L�rt PRO.)FCTk FORMATION Proposed business name: <- Proposed use: Number of employees: Previous business n me: T Describe previous use: ) STRUCTURE DETAILS Check one: etached single level/single tenant O Single level/multi tenant O Multi level/single tenant O Multi level/multi tenant Age of structure: Is structure curr ly If not occupied, how long 1 been vacant? occupied? es No Yr. Mo. Square footage: I Basement: First: Mezzanine: S Third: Is the structurtLheated? Heating type: Circle one: Circle one: &;1) No ectric Liquid Propane I Gas Oil it Type of heat: Circle one: Furnace Heat Pump Electric bas rd or wAVount Radiant Will there be any changes to the foilowi C e s or no,ifapplic e: Floor lay-out: Yes (&6J Lighting: �es� No HeatiU,g: Exterior Finishes: Yes (196J Interior Finishes: Yes `o', Parkin s o-) Number of restrooms provided: Number of fixture each Is structure handicap accessible? Circle one es -) Is the structure equipped with a fire sprinkler system? Yj No fire al system No Monitoring Station Name: a number: AP_PLICATIO44V- NOT BE AC P WITHOU 1. Floor Plan(5 sets): Woe rooms AY3 20 Draw the floor plan to scaleRoom Dimensions n of all exits n windows(incl dimensioLocation of lumbin and mechani ' to doors th g radius 4 W. C AR ST. 2. Site Plan(5 sets): Note scale used • Property lines, easements, &right of wa • Location all ex(mber s ru & ns • Distance, in feet,from property line&stru res • Land ap uffe On-site sewage tanks and drain fields, &reserve Wel cati • Location of fire hydrants&vehicle access roads ar in areas n a e 3. Septic records,pumper's report or O&M report. 4. Fees will be collected at time of submittal NIL 1117/ 1 Official US „ . Accepted b Date, — Submittal Amo t$ ) ecei t number Department Review Initials Date �77C nts Building NNJ 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: 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: - Legal Description: Z Building Site Address: `" r =- Method of sewage disposal: 0 Septic O Sewer—name of district: Water source: O Individual Well O Community Well CP(Public System, name of system: / PEOPLE INVOLVED IN THE PROJECT ✓� Name of Applicant: L`61i- Mailing address City: State: Zip: C Day pho`n Contact Person Message phone: t / PROJECT FORMATION Proposed business name: 1- - Proposed use: Number of employees: Previous business n me: Describe previous use: STRUCTURE DETAILS Check one: V4Detached single level/single tenant O Single level/multi tenant O Multi level/single tenant O Multi level/multi tenant Age of structure: Is structure curt iy If not occupied, how long has it been vacant? occu ied? es`) No Yr. Mo. Square footage: I Basement: I First: Mezzanine: Second: Third: Is the structure beated? Heating type: Circle one: Circle one: Y ) No ectric Liquid Propane Natural Gas Oil Type of heat: Circle one: Furnace 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 m00% Lighting: (�Yes�) No Heating: Yes �e Exterior Finishes: Yes N�o� Interior Finishes: Yes "`o) Parking: Yes (No-) Number of restrooms provided: I Number of fixtures in each Is structure handicap accessible? Circle one es > No Is the structure equipped with a fire sprinkler system? Yes No Fire alarm system? Yes No Monitoring Station Name: Phone number: APPLICATION WILL NOT BE ACCEPTED WITHOUT: 1. Floor Plan(5 sets): MAY 0 3 2011 • 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 426 W. CEDAR ST. 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 b Dat - Submittal Amount$ N Receipt number Department Review -/nit'1411S Date Comments Building 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: i c-- U { cot n � CHANGES I IT CHANGES FOR APPROVAL _ S SU RIOR TO PERFORMING WORK G N i BUILD NG RECEIVED MAY 0 3 2011 426 W. CEDAR ST. j 30VAljgMoo YTAU03 AOZAafi'O TN3MTf1A930 0N1011 z� y�o 7 , 1232-� 0 p y C o r� Z C) THESE PLANS MUST BE ON THE JOB SITE FOR INbHECTION. REVIEWED FOR CODE COMPLIANCE MASON COUNTY Site Plan UI ING DEPARTMENT Plan review checklist: Date 17— Engineering: Y (D Lateral Numher of r;:)Res.__-- flee, f 4f RECEIVED MAY 0 3 2011 P Lti' l N G 426 W. CEDAR STD FIRE HY12(?Ptt` _r 0 APPROVED , ©UNV DCD t: i,�ANNlNG tiN FgPOUIRIE D TO B OIL SITF ,.dta �UBJ ''T TO APPROVAL � I ��- 221 0 j l3Z Q� N pUMp 'cP �Z DLO T PL-/\ M . 4ZAILC ZO1-00 APPROVED MASON COUiNTY JC::) r LA*i"j'i 11-%lG SITE PI AN REQUI ?Ei? TO 3' ()IN SI i E C N ES SUBJECT TO APPROV:;L By Date 3 MASON COUNTY DEPARTMENT OF HEALTH SERVICES May 19, 2011 PO BOX 1666 Shelton WA 98584 Shelton (360) 427-9670 Fax (360) 427-8442 KIMBERLY STOLZ Elma (360) 482-5269 PO BOX 1903 BELFAIR WA 98584 Belfair (360) 275-4467 Case No.: COM2011-00036 Parcel No.:123294390160 Dear Applicant: Your building permit will not be approved by Mason County Public Health until the following items are completed and received in our office. Satisfactory Operation and Maintenance report from a licensed Operation and Maintenance Specialist with in the last year. Please call me at (360)427-9670, ext. 279 if you have any questions. Sincerely, (&aecdc- ��� Amanda Reynolds Environmental Health Mason County Health Services Comments: 5/19/2011 Page 1 of 1 COM2011-00036 It, ' COMMUNITY DEVEILOPMENT ENVIRONMENTAL HEALTH REVIEW Mason County Public Health Official llluse only 415 N. 6th Street Permit Number: PO Box 1666 rl Shelton, WA 98584 Date Received: ! . Shelton: (360) 427-9670, Ext. 400 Amount Received Belfair: (360) 275-4467 Ext. 400 Elma: (360) 482-5269 Ext. 400 Receipt Number AY Ol Fax (360) 427-7787 MAY U Applicant Information Type of Review 1 ApplicantDate_ ❑ Building Permit Mailing Address ❑ New ❑ Replacement ❑ Commercial Building Permit Ci State Zp ❑ New ❑ Replacement tY 3Lob ❑ Building/Commercial Permit Revision Daytime Phone r -P ther Phone j--Tenant Review E-Mail Address Vl o ?0 ffiSf'1ZOM ❑ Pre-Application Parcel Information 2 12-Digit Parcel Number Site Address Street Number Street Name City Type of Job Please submit a scaled plot plan Describe work showing all existing and proposed -� building, on-site sewage system, Number of Bedrooms and well. On-Site Sewage Information Water System Information ISl. On-Site Septic System ❑ New CLExisting Plumbing in structure? M Yes ❑ No ❑ Sewer Name of Sewer System If yes: Using an existing on-site septic system will require a current please submit a completed Water maintenance report and a Record Drawing (Asbuilt). Documents Adequacy Form. for both of these requirements may be on file with Mason County Public Health. Other requirements may apply. Applicant Signature Date Official use only Departmental Review Approved Denied Notes Water Adequacy On-site Sewage System Tenant Review Revision Revised 12/17/09 CD( � IJ 3 I � y I � i S �ry �(UNMENTAL i �7 HEALTH RECEIVED MAY 0 3 2011 426 W. CEDAR ST. E14VIRONMF-t At- H FIRE HY9RPrhIT 0 N 4 pIZAt nrL-P � � >_L- M . c o ` PUP N sjd i RAN F� AIL -i—A 7/ L17-Y — 3. 8�� _ EASL MEAT PLOT PAN RECEIVED MAY 0 3 2011 426 W. CEDAR ST. APPPI�'. �� MASON COUNTY OC;j A'NIN;G SITE P► AN REQUIRED T v SE UN SI i C N tS SUB}ECT TO APPROVAL By Date �'7 3 VfHoNWNEi4TAL E�1 Hp 04 FIRE HYDRPsNT 0 --- - -0 ,- _ - _ _ co/ �- \ pi Pr&D r ,o PUMP sT 0 y I . 0 3. 8�`'�. PLOT -P \ N ZUI-4N RECEIVED MAY 0 3 2011 426 W. CEDAR ST. APPROVED MASON COUNTY JCS SITE PI AN REQUi?ED TO 3c ON St i E D tS SUBJECT TU APPRUV.;L By Date '7 3 n O _ K CONCRETE (MECHANICAL MANUFACTURED H "dIE M rJ __ � OO E My 0) Footings I Sacks Gas Piping Ribbons D o interior Date By Interior-Date By Date Sy > W Exterior'gate By Exterior-Dates k3 CA Point Load r Isolated Footings INSULATIONDate By s BG t SLAB INSULATION D Date a Date By FIDE DEPARTMENT n F ndation Walls Floors bete By � Date By Data By DECKS INS wads _ S Cute By Date By data _ PROPANE TANKS PLC MEON vault Bate By Date By OTHER Groundwork rk Attic Date By Type' Date By .. ....,. _ _ Date By D.W.v DRYWALL Type: O Int Brace Weil Date By 3 Doe-, y � t FINAL INSPECTION Co Watar Ling Firs Seperation -� tte3y Date By [date By O 0 Pass or Request lips o Type of Insp. Fail Date Date Cho a ay Comments _ o J-X- i( rn rn 0 rn