HomeMy WebLinkAbout18-19841 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 19841
BUILDING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 19841 Address: 6142 16TH ST stop work
Permit Type: ADDITION/ALTERATION ZEPHYRHILLS, FL.
Class of Work: 434-ADD/ALT RESIDENTIAL Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: PARK HILL
Est. Value: Parcel Number: 02-26-21-0180-00000-0760
Improv. Cost: 1,150.00 OWNER INFORMATION
Date Issued: 6/26/2018 Name: TEW JENEAN STALEY
Total Fees: 202.50 Address: 6142 16TH ST
Amount Paid: 202.50 ZEPHYRHILLS, FL. 33542
Date Paid: 6/26/2018 Phone: 813-531-5428
Work Desc: CONVERT GARAGE INTO LIVABLE SPACE -AFTER FACT PERMIT
CONTRACTORS APPLICATION FEES
HOMEOWNER BUILDING FEE 135.00
HOMEOWNER ELECTRICAL FEE 67.50
Ins ections Required
FOOTER 2ND ROUGH PLUMB MISC INSULATION CEILI G
FOOTER BOND DUCTS INSULATED SEWER MISC.
ROUGH ELECTRIC LINTEL MISC MISC.
1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY-
PRE-SLAB SHEATHING MISC. MISC.
CONSTRUCTION POLE FRAME MISC. MISC.
REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80 (2)(c)the
local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or
first reinspection,whichever is greater,for each such subsequent reinspection.
NOTICE: In addition to the requirements of this permit, there maybe additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
"Warning to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements to your property. If you intend to obtain financing, consult with your lender or an attorney
before recording your notice of commencement."
Complete Plans, Specifications Must Accompany Application. All work shall be performed in accordance with
City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
NTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
12' 8"
O
WATER HEATER
NEW BIFOLD DOOR
EXISTING 2-6"DOOR
EXISTING ELECTRIC PANEL
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3
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20' 0" N OUTLET(TYP)
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NEW 1/2"DRYWALL OVER3/4"FURRING
AND INSULATION(TYP)
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NEW 2X4 FRAMIMG WITH 1/2"DRYWALL
4 7�1 i AND 3-1/2"INSULATION ON INTERIOR
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36"X 36"SINGLE HUNG.WINDOW -
IXT.7/16"OSB WITH BUILDING BARRIER
W'16TH
WIRE LATH AND STUCCO FINISH
STREET ZEPHYRHILLS
SCALE 1/4"=1'-0"
USE: LIVING SPACE
2X4 STUD
LATH AND STUCCO
7/16"058 SHEETING
1/2" DRYWALL
8" BLOCK WALL
3/4" FURRING
1/2" DRYWALL -�
SLAB DRIVEWAY SLAB
F007IN6
FRAMED WALL SECTION BLOCK WALL SECTION
ftQ 16TH -STREET ZEPHYRHILLS
SCALE 1/2"=1'-0"
GARAGE CONVERSION TO LIVING SPACE
tI13-f5u-uuzu uny of 4epnyrnuis vermit Application rax-ola-iau i
Building Department
Date Received S'Q—C� - Phone Contact:for Permitting -
N
Owner's Name J A 6A/J 7"r Ay- Owner Phone Number m
Owner's Address ^0400o ep*1/1)2 �O �� 33�y Owrier Phone Number
Fee SimplejTitleholderName -0741.144N '57 Owner Phone.Number'
Fee Simple Titleholder Address S7 2c h ✓jtl j J 5�
JOB ADDRESS Flo!Y Z z,,�0A(vjeALC LOT#
SUBDIVISION PARCEL ID#; .
i
y (OBTAINED FROM PROPERTY.TAX NOTICE)
WORK PROPOSED NEW COiUSTR' ADD/ALT 0' SIGN 0 0" DEMOLISH
S
e INSTALL 'REPAIR
PROPOSED.USE SFR Q COMM = OTHER "
TYPE':OF.CONSTRUCTION [ 'BLOCK Q •"FRAME /Q, STEEL Q
DESCRIPTION OF WORK /a Gc 0"s ar /a
s
BUIL611,40^SIZE` 2.7: SQ'FOOTAGE ..HEIGHT .•
®�t3UILDING $ VALUATIOROF TOTAL CONSTRUCTION
=E`LECTRICAL $ /S-D AMP SERVICE _ �PROGRESS ENERGY 0 W.R.E.C.
i
=R6LUMBING $
MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION v
=GAS = ROOFING "Q SPECIALTY = OTHER '
FINISHED FLOOR ELEVATIONS FLOOD ZONq AREA =YES NO 14
001,
OkAe
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:BUILDER C014RAI _
SIGNATURE ( T Y"/ N FEE CURREI\ Y'/N
i
Address license*
ELECTRIC..I`AN COMPANY
N SIGNATURE REGISTERED Y/ N -FEE'CURREh j .
Address' - License# °
PLUMBER. 'COMPANY-
SIGNATURE REGISTERED Y-/ N:, FEE CURREN. Y/N
. r
Address •License#`
MECHANICAL C,OMP.ANY. "
SIGNATURE''.' REGISTERED Y/ N . I FEE CURREN.
Addr®sss r License.#
OTHER _,:::' ::' _ -COMPANY
"'SIGNATURE;:;;:;._: ; 'REGISTERED Y/.N FEE CURREN
Address:->• License'#
" SIDENYLALr s:;Attach`;' : Plof;Plans"'2'sets of Buildi6 -,`Plans'1 set'of Ene' Forms R=0-V11 Perrriit,for neinr'.cons
RE tiuction'.
.<:gsx ,r.r." Minimumsaent(1Q)workliigldays aftetsutirriittal;date:sRequ'ired orislte'r Gorstructlon Plans,Stormwater Plans�w/Silt Fence.installed,.
Sa 1 ryjfjaVlibes l;<1 dumpstar,Site Work fPdrmit for;=subdi.V"ions/16rge.projgcts'.:: '.
''°:COMMERCIAL Attach°(2)corriplete°sets'of'Butlding'Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit fornew donstruction:'
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stomtwater Plans w/Silt Fence.installed,
8 -
Sanitary Facilities 1 dumpster.Site Work Permit for all"new projects.All commercial requirements must meet compliance
-KSIGN!.PERMIT AttaoFi=(27`sets.of Engineered
`PROPERTY SURVEY.required,for.all,NEW construction:.---------------
.
Dit®CtlOrls:
-FilffbUt,application completely."
-Owner&:Contractor.'sign:back of application,notarised
If over:$2500;-a Notice-of'Commencement is required. (AIC upgrades over$7500)
{.
Agent(foRW--d`bhtibctor)�orPower'of'Aftomey(for'the owner)would be someone with notarized letter from owner authorizing same
•l;''�OYER'THE�.000NTER FERMI ;
�'.:•:r; E.;_.,.., .TTIN,G:, _(copy of contract:required)
:Reroofs if:shiingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
Diribeways-Not over Counter if on public raadway9'.needs ROW
' .-, '�i (�U,i..^!i li4Yj :!;%f>i�ii ?,S .I�`S fiA^• e,,a.
,. •- ;li,l:�4iFi:��faf;rClvJlfi!'i9f:+.'r `.,;.
<A•c?FXsk�.R�S�?a''sc'°��'Dsefii°:.ti;......- -.... --
NOTICE..OF DEED RESTRICTIONS: The undersigned:.under.stands;that;this,,permit;ma ;be;subect:to!.!, ed!;restrld"I`;
vrhich,;may::be more,resfiic#ive Coon ::ce`"lotions:-`Theirtderst°ned assumes rs o slbtti ,forfcam``lance'with;:an""tY 9 .9. p .n . t3!. p Y.. .
applicable:.deed restrictions.
UNLIiCENSE0;-:CONTRACTORS' AND'CONTRACTOR RI SPONSlBILITIES ``If the owner has=-,tiired=`a°:contractor or
co itractors to undertake work,,they may be:,required"to beaicensed in accordance With state,and=local;r,,egulationsw If,the
contractor.'is=not;licensed.as:required:'by law;botl;the ov+mer and*.contractor=i� ayztie cited forts:misdemeanor:-violatian: _
under state law. if the owner or,intended-,contractor are,uncertain as-to what,ticensing�requirements,i,n:ayr'apply>afor�ti e.
intended work,•ahey.aie advised ti contacf"'the`Pasca,County'BuildiriT ;lns .ection D v s on Licensin .Section at:727-84°7-'
8009: 'Furthermore; 'if the owner has`°liireci'a ct tttractor.or contractors, he is advised td- have-the,99ntractor(s,)sign
;..
- portions of the con#ractor'Block'of this application for which'ahey..will.be-responsible,- if you, as;tf e:, r-sign.a§,,,,:e� - � :,�
contractor.; that may be an indication:-that"he;is•not properly licensed and;is not er titied`to permitting privlleges in�Paseg,
~stars
County. : ....,r,
TRANSPORTATION'IMPACT/.UTILITIES:IMPACT AND RESOURCE RECOVERY'FEES: The undersi' ned.under ,.ds
that Transportation Impact Fees and Recourse Recovery Fees=may apply to',the construction-of new,:bulidings,.chat gesof}-
use in existing'buildings;-or expansion:>of:existing buildings, as specified in Pasco County Ordinance number:89=07'and :
90-07, as amended. The underslgnedalso understands, thatsuch.fees, as"may;-(e:due;:will-t%e iden#ifed-lat fhe=tirrie3_of' K
permitting. At is further understood that' Impact Fees°and Resource'rRecovery.Fees'must be paid pr.'ior:to
receiving a-"certificate ofoccupancy" or final..power release. If thepraject does nat:tnvolve:a certificate of occupancy o `i, ;A
final-:power release,'th-O fees•'must be._paid prior to,permit issuance..:.Furthermore,•if•.Pasco.County WaterlSewer-Impact;=:
fees are due;,they,.mustbe:,paid,prior to permit issuance in�accordance with'applicable.Fasco:Countyordinances.
CONSTRUCTt4N•I IEN L. (Chapter713,Florida Statutes,as amended): If valuation of work is$2,500:0;0,or,moee;l r
certify that I, the-applicant,,have been..provided with a ,copy:.of:.the "Florida'-Construction`1,len Law—Homeoviiner's
Protection Guide" prepared•by"the�Florlda Department of Agriculture and Consumer-Affairs. *if the applicant is.,someone;,.,
other than the owner",,i cerfify..that-(.:have obtain_ ed a copy of the above'described`'doculrient�and:prom'ise:in'good.;faith;fo,'..,.,.
deliver:it hei"'priorao=commencement.
CONTRACTORVOWNER'S AFFiDAVIT:,a;certify_that all the information in this application is accurate and"that all'work
will be done in compliance with all applicabk laws regulating construction, zoning-and land-development. Application is
hereby.-made to.obtain-a:,permit:to Ao-Work-and, installation as indicated: I certify that no work or°.'Ins#aliatioii`h has
commenced prior to issuance of'a permit and- at all work will be performed to meet-standards-of all laws regulating.
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. T(also:
certify that t understand that the regulations of other government agencies may apply to the intended work, and that it is
my responsibility to identify what actions I must,take to be in compliance. Such agencies include.but�are not limitedao: i
Department of Envirorimental'tiProtection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands,WaterMastewater'Treatment.
- Southwest-- Florida Water Management District-Wells; Cypress .Bayheads, Wetland Areas, Altering
Watercourses. . `
- - Army Corps of Engineers=Seawalls, Docks', Navigable Waterways.
Department.of.Health,,&.Rehabilitative.-Services/Environmental',.Health, Unit-Wells,:Wastewater.Treatment,
Septl&Tanks.
US Environmental Protection Agency-Asbestos abatement.
Federal•Aviation;Authority-Runways.
I understand that-ihe foi fowl ng'.rdsfrictions apply to-the use of fill:
Use of fill is.notallowed in Flood Zone"V"unless expressly permitted.....
If the fill:material is to be used in Flood Zone "A", it is understood that a-drainage plan addressing.a
"compensating volume" will be submitted at time.of permitting which'is prepared by a professional engineer
licensed by-the:State''of Florida. ..
If the fill-material is.to be used-in Flood Zone "A" in connection with a permitted building using stem Wall.
construction, I certify that fill will be used only to fill the area within the stem wall.
If fill material is-to-be used in -any area, I certify that use of such-fill will not adversely affect adjacent
properties. If use of fill•is found to adversely affectadjacent properties, the owner maybe cited for violating.
the conditions-of4he build ing;perm It.issued under the attached.perm it.,application, for.lots•less:than one (1)
acre which are elevated by fill,an engineered drainage plan is required.
If I am.the AGENT FOR.THE:OWNER-1I prom Ise in-good faith.to inform.the owner,ofahe-permitting-conditions set forth in
this affdavit prior to con mencirig-construction; .l understand that„a.sepatate permit may be required for electrical.work,.
plumbing, signs, wells,,;pools,.;air,•,conditioning,::gas,.:or.othd�lfhstallations not specifically included in the application.
permit issued shallT:be':•construed to 6e a licerise'''to.proceei withal e work:and not as authority#o violate, cancel, alter,}or
set aside any provisions-of`tle technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction:of:errors':in_pians construction,or:violations"of°anycodes:-' EVery-permit issued shall-become invalid
uniess-the work-authorized-by such-permit-is-commenced withinrsix months of.permit issuance,-or.if-work authorize0 by . ^i
the permit is,suspended-or abandoned for -period�of'six'(6);rrionths.after the time the work is commenced, An extension
may be requested, in.writing,`from.the Building~Official for a period.not to exceed-ninety(00)`days and will demonstrate
justifiable cause for.the extension..,If,work ceases for ninety(90)consecutive days,the job Is.considered abandoned. ? ,
WARNiNG'TO OWNER:_ YOUR:jAiLUREtTtJ.RECtRDA NOTiCEtOF C.QI�IMENCEMENT MAY RESULT IN YOUR
PAYING.TWICE,`FORj:1tVIpRQNt M NTS,TO:YO,iJR<PROPERTY:;.IF YOVJNTEND�-TO+O13T%IN:FiNANCiNG;;OONSULT
WITH YOUR"LENDER O ATTORNEY BEFORE•RECORDING,,YOUR=NOTICE-OF`COMMENICEMV.NT
FLORIDA JURAT,(F.S.117.03)
oto
OWNER OR AGENT CONTRACTOR
Subscribed and'swo or a rrned).befare me this Subscribed and swom to(or affrmed)beforwme this
by 57 Ajijon, Rr' ,by
Who Is/are person
jffy known to me o0fasthAve.produced Who[stare personally known to me•or hasthave produced.
L.tG as Identification. as Identification.
KG Notary• Public Notary Public
Commission No. Commission No.
.. .. F E
Name of n tiiRedsttts of Florida Name of Notary typed,printed or stamped
commission I FF 909855
My CoMm.fxpirsi Aug 18.2019
�'••,,°,uli��•+`� 'BQI11{IdthOli l l}&SIT.
Jacqueline Boges
From: Gail Hamilton
Sent: Monday, May 14, 2018 10:25 AM
To: Jacqueline Boges
Subject: RE: 6142 16th st
Jackie
They need to provide a readable plan for the conversion....) can't make out what is what,windows, doors, need window
and door type as well.
Gail K Hamilton
Director
Community Redevelopment Agency
City of Zephyrhills
5335 8th Street
Zephyrhills, Florida 33542
Direct 813-780-0202
ghamilton(a�-ci.zephyrhil Is.fl.us
--AC,OMMUNITIES
EK
MCI PM
RKS
PROTECT OUR CRAs
From:Jacqueline Boges -_----------_---------------- ----------- ------ ----------
Sent: Friday, May 11,2018 3:11 PM
To:Gail Hamilton<GHamilton@ci.zephyrhills.fl.us>
/ Subject: 6142 16th st
Hello Gail,
See the attached drawing this is for a garage convert to livable space. 6142 16th st
daekie Boges
813-780--0020 ext 351,3
1
Jacqueline Boees
From: Rodney Corriveau
Sent: Friday, May 11, 2018 4:26 PM
To: Gail Hamilton
Cc: Jacqueline Boges; Todd Vandeberg
Subject: RE: 6142 16th st
This is not in the CRA.
Planning is generally ok with this. The plan is illegible however.
Rod
C�
,Zephyrhills
01%
V 030
co
ZEPHYRHILLS-HOMETOWN AMERICA IN THE HEART OF TAMPA BAY!
Rodney V. Corriveau, AICP
Assistant Planner
Physical/Mailing Address:
City of Zephyrhills Planning Department
Historic Captain Jeffries House
38537 51h Ave.
Zephyrhills, FL 33542
Phone: 813.780.0201
Fax: 813.780-0005
Under Florida law,e-mail addresses are public records. If you do not want your e-mail address released in response to a
public records request,do not send electronic mail to this office.
From:Gail Hamilton
Sent: Friday, May 11,2018 4:03 PM
To: Rodney Corriveau<RCorriveau@ci.zephyrhills.fl.us>
Subject: Fwd:6142 16th st
FYI.....convert space to ADU?Can you please review.
Thanks!1
Gail K Hamilton
City of Zephyrhills
CRA Director
(813)780-0202
DISCLOSURE STATEMENT FOR OWNER'
CITY OF ZEPHYRHILLS BUILDING DEPARTMENT
I, S_aL 2qj have read and fully understand and
agree to the provisiond of this instrument.
The undersigned states and affirms that he or she is desirous of constructing,
renovating, adding to or reroofing his r er own domicile, that he or she
actually occupies, or will occupy by S / le said domicile, and same is not for
rent, lease or sale. That he or she Aalf comply with the following conditions:
1. That the owner and he or she alone shall act as the builder for all phases of
construction.
2. That the owner will comply with all provisions of the City of Zephyrhills
ordinances and codes pertinent to the building.
3. That in the event various phases of construction are subcontracted, he will
engage only properly licensed subcontractors and will personally supervise
such work. 1
4. That in the event the Building Inspector shall require corrections to be made,
the owner will assume full responsibility to insure they are made, and upon
completion will call for a reinspection before proceeding with the building.
5. That the owner shall assume full responsibility for the construction and will
not expect supervision of his work from the City of Zephyrhills Building
Department.
6. That prior to final inspection any additional fees, including reinspection
fees, must be paid in full. A written request from this office shall
constitute an official notice to pay additional fees.
7. That the owner shall comply with all City, State and Federal laws in regard to
social security, workman's compensation, lien laws, etc. , where applicable.
8. That the owner shall comply with all the safety codes issued by the Florida
Industrial Commission.
9. State law requires construction to be done by licensed contractors. You have
applied for a permit under an exemption to that law. The exemption allows
you, as the owner of your property, to act as your own contractor with certain
restrictions even though you do not have a license. You must provide direct
onsite supervision of the construction yourself. You may build or improve a
one-family or two-family residence or a farm outbuilding. You may also build
or improve a commercial building, provided your costs do not exceed $75,000.
The building or residence must be for your own use or occupancy. It may not
be built or substantially improved for sale or lease. if you sell or lease a
building you have built or substantially improved yourself within 1 year after
the construction is complete, the law,will presume that you built or
substantially improved 'if_for sale or.jease, which is a violation of this
exemption. You may "not hire an unlicensed person to act as your contractor or
to supervise people working on your building. It is your responsibility to
make sure that people employed by you have licenses required by state law and
by county or municipal licensing ordinances. You may not delegate the
responsibility for supervising work to a licensed contractor who is not
licensed to perform the work being done. Any person working on your building
who is not licensed must work under your direct supervision and must be
employed by you, which means that you must deduct F.I.C.A. and withholding tax
and provide workers' compensation for that employee, all as prescribed by law.
Your construction must compl with all applicable laws, ordinances, building
codes, and zoning regulati
OWNER'S SIGNATURE DATE
ADDRESS
PHONE
WITNESS PERMIT #
.nmr CINDA,FyFE
�`: Notary PuW1u.Stafe e1 Florida
Com...fee n
%F yr Ft�p°•• MY Coinm.Expins Aug 16,2 19
"���mmo k ary As
Rated In accordance withAAMAIVYOMAICSA
lal/I.S-PJA440-05(HUD U1111 111).
PWG Testing vvitneswed bjr an independent
159 00002 00001
AAMA accredithad fabonstowV-
NF PWG M-
Aluminum Frame H—LC591219X2134(4BX8Q—(OP+W-60
,LovsE—Cftw,Air Structural Rating: DP +501-6
Daidile Gliamm
&A Hit,oars GA
National Fenestration Tested in accordance with ASTM E90/41311332 for
I Rating Council® Vertical Slider amousbcal performance:
�351� I STC:
ENERGY PERFORMANCE RATINGS Meets or exceeds ASTM E130D requirements.
U
LI-Factor Sol Heat Gain Cbe"cient 3f,42 Annealed I W32 Annealed
W4 OA IGU
0.5A4 3.10 0.31
410FL Series (U.S./I-P) (Metric/Sl)
ADDITIONAL PERFORMANCE RATINGS rMift Approval liondw: 141W
Visible Transmittance Air Leakage Tex=Depwinind of Imitninoe: VON—1W6
0.57 < 0.3
RUntifiettuer stipulates that these ratings conftan to awticable NFRC pmcadu�for deteminingwhole
imoduatpeffanname.KTRC rwdngs we determined forafted setotenvimrimental wncWons and a specific
productsize.14MC does not reewnthend any product and does not wamftthesuftabifiV of wq product for
Uyspectficuse.Consult Inanufactureft IdAwift"for other prodwatperfasmance lrfannadw.
wvvw.nfrc.org 2231502-3-1 325516
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18.00'
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14.00'
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12.00' 12.00'
SCREEN PORCH
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24.00'
GARAGE 28 001 j
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36.00'
14.00'
16TH ST
Jacqueline Boges
From: Jacqueline Boges
Sent: Friday, May 11, 2018 3:11 PM
To: Gail Hamilton
Subject: 6142 16th st
Attachments: 6142 16th st.pdf
Hello Gail,
See the attached drawing this is for a garage convert to livable space. 6142 16th St
tl._ fr
dackic Boges ':�:"`
81J-780-0020 cxt J513
"A rule I have had for years is:to treat the Lord Jesus Christ as a personal friend. His is not a creed,a mere doctrine, but it is He
Himself we have."Dwight L. Moody
Florida has a very broad public records law. Electronic communications regarding most City
of Zephyrhills business are public records and available upon request. Your e-mail
communications may therefore be subject to public disclosure. If you received this message in
error, please do not read, forward, copy, etc. and delete immediately.
1
TOP .WORK .
By order of the Building Official: Wiffam-A. (Burgess
All Building, plumbing, electrical and mechanical work
shall cease at the below mentioned property.
Address: io
®ate:
Code Enforcement Officer:
Contact the
Zephyrhills Building Department
5335 - Sth Street
813-780-0020
a o PA-
City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
i
J-J
Contractor/Homeowner: �nf�4 "Gt` 1 I
Date Received: '_
Site: 2
Permit Type: Gh, /s 0-N
Approved w/no comments:❑ Approved w/the below comment
s: V Denied w/the below comments: LF
-:�l At/4,ilq W,(Hdal J&01
&I of It g LAJI to r yr .PJJ
s) oj"r�j10 /doz)k, AZY;a)"11
This comment sheet shall be kept with the permit and/or plans
6 qd�,
Ka witzer— o Plans Examiner Date actor and/or Homeowner
��' LIMequired.when comments are present)
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