HomeMy WebLinkAbout19-20863 CITY OF ZEPHYRHILLS
5335-8TH STREET
(813)780-0020 863
PLUMBING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit#:20863 Issued: 2/22/2019 Address: 4932 GALL BLVD
Permit Type: PLUMBING ZEPHYRHILLS, FL.
Class of Work: PLUMBING RENOVATIONS Township: Range:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Sq. Feet: Est. Value: Book: Page:
Cost: 2,000.00 Total Fees: 75.00 Subdivision: CITY OF ZEPHYRHILLS
Amount Paid: 75.00 Date Paid: 2/22/2019 Parcel Number: 14-26-21-0010-00800-0120
CONTRACTOR INFORMATION OWNER INFORMATION
Name: OWNER Name: HERNANDEZ VINCENT & EMINA
Addr: Address: 26652 SHOREGRASS DR
WESLEY CHAPEL FL 33544-7728
Phone: Lic: Phone: (813)610-7181
Work Desc: INSTALL INTERCEPTOR , TOILET, SINK& PIPES FOR CLEANER MACHINES
APPLICATION FEES
PLUMBING FEE 75.00
INSPECTIONS TIONS REQUIRED
1ST ROUGH PLUMB
2ND ROUGH PLUMB
SEWER `
WATER
FINAL
Lk i
2'
REINSPECTION FEES:(c)With respect to Reinspection f es 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 may be 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.
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
"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 and Fee Must Accompany Application. All work shall be performed in accordance with City
Codes and Ordinances.
Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City
Codes and Ordinances.
CONTRACTOR PER OFFI
PERMIT EXPIRE I 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Date Received Phone Contact for Permitting d IS
Owner's Name �ecnaaje-T Owner Phone:Number
Owner's Address hQ.- r Owner Phone Number
oez le'l Owner Phone Number
JOB ADDRESS Blvd LOT#
SUBDIVISION PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED NEW CONSTR B ADD/ALT = SIGN = = DEMOLISH
E� INSTALL REPAIR
PROPOSED USE = SFR Q COMM = OTHER
TYPE OF CONSTRUCTION Q ii BLOCK Q FRAME = STEEL =
DESCRIPTION.OF WORK I 4 r �)t? v- I pl- /
BUILDING SIZE SO FOOTAGE=. HEIGHT.
=BUILDING $ VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL $ AMP SERVICE = DUKE ENERGY 0 W.R.E.C.
=PLUMBING $ L n wo.
=MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
=GAS = ROOFING Q SPECIALTY OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE'AREA =YES NO
BUILDER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN
Address I License#
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N_J FEE CURREN
Address License#
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREN .. Y/N
Address License#
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N' FEE CURREN
Address License#
OTHER COMPANY
SIGNATURE REGISTERED N FEE CURREN
Address 2-4450 s5kc')rP T W esk a License#
RESIDENTIAL Attach`(2).Plot'P.lans;(2)sets of Building,Plans;.(1)sets of..Energy Forms;R-O-W Permit for new construction,.
Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects
COMMERCIAL Attach(2)complete sets of Building Plans-plus.a Life Safety Page;(1)set of Energy_Forms.R-O-W Permit for new construction.
Minimum ten(10)working days after-submittal'date. Reyuired-onsite,Construction Plans,.Stormwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster.Site Work Permit for.all new projects.All commercial.requirements must meet compliance
SIGN PERMIT Attach(2)'sets of Engineered Plans:
""PROPERTY SURVEY required for all NEW construction.
Directions: z
Fill out application completely.
Owner&Contractor sign back of application;notarized
If over$2500,a Notice of Commencement is 4equlred: .•(A/C upgrades'dver$7500)
Agent(for the contractor)or Power of Attomey(for•,the,owner)would be someone with notarized letter from.owner:authodiing same
OVER THE COUNTER PERMITTING, co :q )
I ( py.of•contract re uired - 1
Reroofs if shingles Sewers �'Setvice;Upgra&s-A/C Fences(Plot/Survey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW 4 er :' = '
i
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed"restrictions"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: 'If the owner has hired--a-contractor or
contractors to undertake work, they may be-required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misIdemeanor violation
under.state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work, they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847-
8009. Furthermore, if the owner has:hired a contractor or contractors, he is advised to have the contractors) sign
portions of the "contractor Block" of this application for which they will be responsible. If you, as'theli owner sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may.apply to-the construction of new.buildings, change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance inumber 89-07 and
90-07, as amended. The undersigned also understands, thatsuch fees, as may be due, will be identified at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees mt lust be paid prior to
receiving a "certificate of occupancy" or.final power release. If the project does not involve a certificate of occupancy.or
final.power release,.the fees must be paid prior to permit issuance: Furthenihore, if Pasco County Water/Sewer Impact
fees-are due,.they..must.be..paid prior to permit issuance'in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN-LAW(Chapter 713, Florida Statutes,as amended): If valuation of work is $2,500.00 or more, I
certify that I,-the'"applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than'the-"owner"; I certify that I have obtained a copy of the above described document and promise in good faith to
!' deliver it to the"owner"prior to commencement.
CONTRACTOR'S/OWNER'S.AFFIDAVIT:: I certify that all the information in this application is accurate and that all work
i will be done in compliance with all applicable laws regulating construction, zoning and.:larid development. Application is
hereby made to obtain a permit to do work and installation as indicated. I certify that no work for installation has
commenced prior.to issuance of a permit and that all work will be performed to meet standards of fall laws regulating
construction, County and City coddes;=zoning regulations,,,and land development regulations in the'jurisdiction. I also
certify that I 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 limited to:-
Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environimentally 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, Wast water Treatment,
Septic Tanks.
US Environmental Protection Agency-Asbestos abatement.
Federal Aviation Authority-Runways.
1,understand that the following_restrictions apply to the use of fill:
Use of fill is not allowed"in Flood Zone W"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 certifythat'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 affect adjacent properties, the owner may be cited for violating
the conditions of the building permit issued under the attached permit 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, I promise in good faith to inform the owner of the permitting.conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air.conditioning, gas, or other installations not specifically-included ih'.the.application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
set aside any provisions of the'technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if,work authorized by
the permit is suspended-or abandoned.for a period of six(6)months 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 (90) 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 FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FdWIMPROVEMENTS TO;YOUR PROPERTY. -IF YOU INTEND TO?OBTAIN FINANCING;CONSULT
WITH YOUR LENDEWOR AN ATTORNEY-BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT(F.S.117.03)
NEkt MAGEN;=—- ' CONTBRC TAR` it4 ,-_� -
Subscnbed nd sworn or affi ed befor me this K "'Subscnbed and swom_to �r affi e�)_ ef re. 3his �Z
_A_ayt
Who is/ person Ily known tome or has/have produced Who is/are perso to me or has/have produced
as identification. as identification.
Notary Public 04� Notary Public
Co si o. 9 QI/
'lr:: All `' x I rlileoi�a G®Bi
f Notary PGG27Bg
ed
��sd?hro57 anlesdraep
Name o �01
Deer 12,2 3
iM cembYFell InauraR
�SlOf9
ALL WORK SHALL COMPLY WITH PREVAILING
CODES FLORIDA BUILDING CODE,
~� E NATIONAL ELECTRIC CODE,
AND THE CITY OF ZEPHYRHILLS
ql,
ORDINANCES
r
s
EVq DATE
CITY OF ZEP
PANS EXA�n,IN�FR
F
1 J 4 `V ; 3� I •
L
r0+ �-►_
- d
ALWAYS QUEOFF THE TOP
ALWAYS CDAI£OFF Gf TrE A-N HEADER FGR
TH£TO?OF Al? UNES TO PRESSES
P+T AUR.FORSECOWSTIARY
�1, RCOK DL�T£5 \ /
1 AFTERCCOl.fR Y
I
AER COA r�Rf SSOR
TD PRESS ✓
r ar
-P)Tra Amr�ac�R�,
CRA{Y J FUIRY 3 SECUNTARY \-VOSTURE SEPARATOR
TO PRESS ALSSaYS CUE OFF TF I/2"PPE WITH AUTO D?A':
BOTTOM Cf TK AIR "K
TO PRESS HEADERFOR K PAN
1 PRESS
�t0`PRESS
SLOE VALVE
PFE iNON
—FS TER RECIRATOR ASS'Y r� cc
R)TH aUTO ORAS'
(SUPPLIED bTTH VAC>f}�} t U 9U U!>✓W NJ
NiP LEG `TD`PRESS
1rHDRan LYMULLI Y IOU,MOPES
i
TYPICAL TYPICAL
STEAM RETURN STEADA SUPPLY
ASSEMBLY ASSf�+BLY
CHECK VALVE CUT—CFI VALVE 1
PIPE UNION �—PIPE UNION
`�--INVERTED BUCKET TRAP �Et�?OF THE
STRAINER i LINE TRAP
PIPE UNION
ENO OF THE
LINE TRAP
l'NSULATE ALL
�``�,,, `` • STEAM PIPING
ALWAYS DROP `- ` `:.•
DO`;t..TO TRAP � �'� '"�' �STEMMA SUPPL t
STEAD RETURN
INSTALL TRAP AS—
Low AS POSSIBLE
i 2;633
ALWAYS USE AN MEN E " v
ENO OF THE LiR�TRAP J !a1 ,,fl (D �Ivt(j N Q
T4 PROVIDE CONTMIAL !!' U L
CIRCULATION U M E L M E
Prod action(1 +Pperator) 75 shirts pe(huur
Productio-h-Q.Operator) 90 shuts per hour
Steam:Pressure.Supply 100- 125 psi 7-_9:bar
Steam.Consumption 3412,.bhp .55.k�lhr.
Air.Pressure_Supply S5= 125 psi 6 9 bar.
Airbonsumplion 75dhr 9.1 Cfm 257 Unin
Air.Consumption @.901hr. 160.cfrn. .309,LfMin
Electrical Supply fC0ntf.0Is):. 1 i.5/1160 24011/50
Eledtical; (bler}
.Supply o1.w 200 23013160" '380-415f315a
-
,Electrical Consumption (,3.phase), I.2 9 amps' 230 6.7.amps @ 400
FloorSpace 1. 85 sn:f. 7.9 sq rn
a
9': 6 8'-i 1".
[29001 [27201
Two Operator Double Buck Unit
TD2 - Double Buck, ABS - Sleever and Two 3TZ - Collar & Cuff Presses
MINIMUM MAICLEARANNTENANCECE,
'/-AJFR INLET I—
Is TYP i ISVII PHOO HZ lt2 NPT li
t HZ 2S2XV13 P�10
3 CONNECTION
14
g 3-1 17-112 L
MIN
20 31.11t2 35 34 MAX
ig
1 4
J-J SOOYSUCKOIMENSIQNS
L
93 RIB 4-V4
STEAM OUT-/ 102 NPT
irl NPT
45 VIEW A
REQUIREMENTS
m
WEIGHT OF PRESS:2,400 LOS
AIR SUPPLY,SS PSI
ELECTRICAL PRESS,115110
ELECTRICAL SLOWEft 20=30
-L F CUBIC FEET:165
- -- I - I,-
�64 PC—: :-:�Ji
STEAM:28HP
23 23.!716
ELECTRICAL.-PRESS-1 AMP 115 VOLT
ELECTRICAL'aLOWERS-123AjoP@mVOLT
llSVPOWERJ
ON 14-118 1--
CONNECTI
`SEE ENLARGED VIEW A
ucol:-
44017-DC
4334------.._...;
ct13tr9t4f'
iI EFttti(I(lEFFIII; 41a . ,'" 32.00
' 2r,00 ;�ttCftttt[UEtIllF �.F`�. `
DIMENSIONS '
Lin
-AIR INLET 318 NPT 1 ' AIRBAG•\
2@.IXT
i I
SUPPLY .EMENTS__
i2E0U1R
YlE40HT OF PRESS:850 LSS
I �', AIR SUPPLY:65 PSI
STEAM SUPPLY-.1*125 LOS
ELECTRlC41.:115Y11 PWSOHZ
83�12
1 EXPORT CUSSCFEESiBS
_ _:, `' _CON_SU_MPTION$
Isis '•S4` o AIR:f,0 CUSIC FEET1CYClE
1 STEAM:314 SHP
{ y� 25�{13 yts .- _ ELECTRICAL:12 AMP—_, _...----..-----
tjt i r j P'' =
ii,S6 'j). _1`, t�.-:_.._:'-"^1-.., 'M m.u�.•,. "aK.�..z.•� j
l�B.OD�+1\'TEAM OUT 1.56- !, ••P0(II511ERR�C»NECt14N
IN
-ter t0.00 i+ iR NPT FOOTSATCH•' !"ivir',-:,`-. •", t 3:32 30QC}C'1aNC I
0
a
a '
ELECTRICAL I ��I'•.` I�.•;^?'1.,1.�+.� �.J_3_.e{'`��1
44.00
I i i" j i
CQNNECTION —�1 y ; .11.00
B'13PROHGI,_ IL, '
ELECTWCCAALL CORCC ---'- --
;..^ r LL--- .;_.;
T 50.13 STEAM IN
NPT-
t I AIR CONNECTION r,�;I�""-L--- iI "`-STEAM OUT
318 NPT-�, �r; rl�_.-•.__I �; 3M NPT
23.50j tf 26.75
I-_ 15.63
(---- ___ —._.__.�_ _l.L!.F1`_'.C-,•. ,.1311801`MOUNTING
—_22.75----'{�I-'-1.68 I - �^-9.50
35.25- ------""'_- I i -19.00-----..r
BUCK DIMENSIONS SUPPLY REQUIREMENTS
i 1, WEIGHTOF PRESS'850 LES
y AIR SUPPLY:85 PSI
3, STEAM SUPPLY:100.125PSI
-- 700 9.00 ! 4. ELECTRM'120MOV,1P,H,
' I ...�___�_ 5W Hz,112 AMP
-19.69 CONSUMPTION ,;,hs;.
1. AIR:1314 CU.FT.f CYCLE ,1✓• jRT.S;�
2. STEAM:314 BOILER HP I .,}.` r. 1 W ROUGHING
R1125 ;s+y,I�h� ROUGHING ItC
A '- isB 42 473•DC I A
m.i,:w -: r
7
SHIRT UNIT SPECIFICATIONS
Steam Steam Steam Steam Air Air Operating Air Volume Electrical Shipping
Model Supply Inlet Outlet Usage Supply Inlet Air Press. Per Cycle Supply Amps Weight
PSI NPT NPT BPH PSI NPT PSI CU.FT. LBS
TS1 100-125 (1)1/2" (2)1/2" 1.5 85-125 .1/2" 80 3.6 115/1/60 1 2550
230/3/60 12.9
'iD 100-125 (1)1/2" (2)1/2" 2.0 85-125 1/2" 80 3.6 115/1/60 1 2720
230/3/60 12.9
HS 100-125 (1)1-1/4" (5)1/2" 2:5 85-125 1/2" 80 3.5 115/1/60 1 2850
230/3/60 17.7
115/1/60 1
HS1 100-125 (1)1-1/4" (5)1/2" 3.25 85-125 1/2" 80 4.5 230/3/60 17.7 3865
HSZ 100-125 (1)1-1/4" see note 3.5 85-125 1/2" 80 3.0 115/1/60 1 3600
below 230/3/60 17.7
ABS 100-125 (1)1/2" (1)1/2" 0.75 85-125 3/8" 75 1.9 115/1/60 1/2 1150
F3T 100-125 (1)3/8" (2)3/8" 0.5 85-125 3/8" 75 1.0 115/1/60 1/2 795
F3TB 100-125 (1)3/8" (2)3/8" 0.5 85-125 3/8" 75 1.0 115/1/60 1/2 795
3TZ, 100-125 (1)3/8" (2)3/8" 0.75 85-125 3/8" 75 1.75 115/1/60 1/2 1020
WCZ 100-125 (1)3/8" (2)3/8" 1.0 85-125 3/8" 75 1.75 115/1/60 1/2 1020
Q4T 100-125 (1)1/2" (2)1/2" 1.25 85-125 1/2" 60 2.0 115/1/60 1 1445
Note: (1)1"with internal traps supplied
(5)1/2"without internal traps supplied
-----------------
n�
25 0.25
ELECTRICAL-,,
CONNECTION
ONG)ELECTRIMICOR
50.13 STEAM OUT.
318 NPT
STEAM IN
318 NPT
26W 318 NPT AIRCONNECTION-' I
23.50 FrTl
15:63
23 81
13116 DIA MOUNTING
22.75 In I i 8.00
HOLES(4)
37,50
SUCK DIMENSIONS SUPPLY REQUIREMENTS
WEIGHT OF PRESS;1080 LOS
AIR SUPPLY;85 PSI
STEAM SUPPLY,.IDD-125 PSI MIN
ELECTRICAL'120f2JOV.IPH,
50,60 Hz.112 AMP t
24;m
CONSUMPTION
f*Z'r'(ta'!-ijf RIGUGHIKG]R--�
AIR:1414 CU,FT.FREE AIR.,CYCLE
1-Tia
1 STEAM:W4 BOILER HP
A:;
ne 29908-DC
7
"
�
'.
r— '-- ---'--'-- ---'------'-------- ---'--- — - --' '-- -- ' ---
` ^
' / ^
i
� .
. .
i
`
!
ELECTRICAL
CONNECTION 1147-:
�
� LRONG
ELECTURRAP
STEAM~���
|
! 27 AIR /
� �""
/ 14 w
| � !
� � !
� ",03116 MOUNTING
mo
xmESw !
'
. SUCK DIMENSIONS SUPPLY REQUIREMENTS
' i
� � �
SWHzmAMP .
!
m,,r � | -------'
^--_~^_--
. w9*l CONSUMPTION / i�� ---------
------------.
' ���` � ���J����c�� ROUGHING 114'�
-- / | �
KIT � � �� �A �
�
�
�
~
�
:A
LAUNDRY PRESS SPECIFICATIONS
Steam Steam Steam Steam Air Air Operating Air Shipping
Model Supply Inlet Outlet Usage Supply Inlet Air Volume Electrical Amps Weight
PSI NPT NPT BHP PSI NPT Pressure /Cycle SupplyLBS
PSI CU.FT.
100-125 (1)3/8" (1)3/8" 0.75 85-125 3/8" 75 1.75 115/1/60 1/2 1215
DTZ 100-125 (1)3/8" (1)3/8" 0.75 85-125 3/8" 75 1.75 115/1/60 1/2 995
SLZ 100-125 (1)3/8" (1)3/8" 0.75 85-125 3/8" 75 1.75 115/1/60 1/2 1095
WAZ 100-125 (1)3/8" (1)3/8" 0.75 85-125 3/8" 75 1.75 115/1/60 1/2 1050
LPZ 100-125 (1)3/8" (1)3/8" 0.75 85-125 3/8" 75 1.75 115/1/60 1/2 1195
ESLZ 85-125 3/8" 75 1.75 115/1/60 1/2 1015
230/1/60 21.1
=. 100-125 (1)3/8" (1)3/8" 0.25 85-125 3/8" 75 1.0 115/1/60 1/2 580
FB 100-125 (1)3/8" (1)3/8" 0.5 85-125 3/8" 75 1.0 115/1/60 1/2 670
EFB 85-125 3/8" 75 1.0 115/1/60 1/2 670
230/1/60 16.5
4
City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner:
Date Received: 5-19
Site:
Permit Type: /G�'1�J ��� ✓ �
Approved w/no comments. Approved w/the below comments: ❑ Denied w/the below comments: ❑
This comment sheet s be kept with the permit and/or plans.
FEB 2 `0 2019
Kalvin Swi er lans Examiner Date Contractor and/or Homeowner
(Required when comments are present)