HomeMy WebLinkAbout07-7311
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
BUILDING PERMIT
7311
Permit Number:
Permit Type:
Class of Work:
Proposed Use:
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
7311
SIGN
WALL SIGN
COMMERCIAL
Address: 7348 GALL BLVD
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 35-25-21-0010-08800-0000
2,000.00
12/18/2007 Name:
150.00 Address:
150.00
12/18/2007 Phone:
CHANNEL LETTERS - SIGN w/ELECTRIC
TOWNVIEW RETAIL LLC
725 CONSHOHOCKEN STATE RD
BALA CYNWYD PA 190042102
610667-5800
FINAL
REINSPECTlON FEES: Reinspection fees will comply with Florida Statute 553.80 (2)( c) when extra inspection
trips are necessary due to anyone of the following reasons: a) wrong address b) condemned work resulting
from faulty construction c) repairs or corrections not made when inspections called d) work not ready for
inspection when called e) permit not posted on job site f) plans not at job site g) work not accessible.
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."
~y~.
( ONTRACTOR SIGNATURE PERMIT OFFI
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020
City of Zephyrhills Permit Application
Building Department
Fax-813-780-0021
Date Received ...., I"" c' l::JOO 213
\ '" - &, - , Phone Contact for Permitting
#1III.m...IIIII. ml#lllmm Hm~mm
Owner's Name TOWNVIEW RETAIL LLC cia STOLTZ RE PARTNER LLC Owner Phone Number 30-544-6877
725 CONSHOHOCKEN STATE RD, BALA CYNWYD, PA 1610-667 5800 xt 122
Owner's Address 190042102 Owner Phone Number - e
Fee Simple Titleholder Name I Advance America Owner Phone Number 1888-316-4238
JOB ADDRESS
Fee Simple Titleholder Address 135 Church Street, Spartanburg, SC 29306
17348 Gall Bou1evard
IT ownview Square
LOT #
8
WORK PROPOSED
B
D
D
NEW CONSTR
INSTALL
SFR
BLOCK
I
E3
o
o
I
PARCEL 10# /35-25-21-0010-08800-0000
(OBTAINED FROM PROPERTY TAX NOTICE)
SIGN [i] MOVE D
SUBDIVISION
PROPOSED USE
TYPE OF CONSTRUCTION
ADD/AL T
REPAIR
COMM
FRAME
D
D
D
DEMOLISH
BUILDING SIZE I 2,320 sq ft SQ FOOT
...................................
o BUILDING $ 1700.00 \.
OTHER I
STEEL D
OTHER I
DESCRIPTION OF WORK
(1) 12 square foot ADVANCE AMERICA ClIpsule and (1) set of 12" CASH ADVANCE channellettel$ mounted on a raceway on the front
.
[Z] ELECTRICAL $ 300.00
0 PLUMBING $
0 MECHANICAL 1$
0 GAS D ROOFING
24.15 HEIGHT 113.67'
.....iIIIIl8i..IIII..IillIlll...U..~~.......un.II.lm...IIIIII.lIII...IIII.M...1II
VALUATION OF TOTAL CONSTRUCTION
AMP SERVICE
o
PROGRESS ENERGY
D
W.R.E.C.
I
o
SPECIALTY D OTHER
FLOOD ZONE AREA DYES
DNO
VALUATION OF MECHANICAL INSTALLATION
Address
COMPANY
REGISTERED
FINISHED FLOOR ELEVATIONS
BUILDER
SIGNATURE
\)
ELECTRICIAN
SIGNATURE
COMPANY
REGISTERED
Address
License #
PLUMBER
SIGNATURE
COMPANY
REGISTERED
Y / N
FEE CURRENT
Y/N
Address License #
MECHANICAL I COMPANY
SIGNATURE . REGISTERED Y / N FEE CURRENT Y / N
~~I ~nse#
OTHER I COMPANY
SIGNATURE REGISTERED Y / N FEE CURRENT Y / N
Address I License #
lllllll.~OOJ..m....III.~IIIIl.II..I.IIIIIIIIIIIIIIII...._IIIlIIIIIIIII.....IIII....IIIiI...................11I.11II11IIII....11.11III.............11II
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms
Minimum ten (10) working days after submittal date. Required 008ite, eonatructlon Plana, Sanitary Facilities & 1 dumpster
COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forma.
Minimum ten (10) working day. after submittal date. Required onslte, Construction Plans, Sanitary Facilities & 1 dumpster
All commercial requlrementarnust meet compliance.
SIGN PERMIT Attach (2) sets of Engineered Plans.
....PROPERTY SURVEY required for all NEW construction.
11II!llm.lllllml..llllllllmM~lllllllmMIII.II##~.~lmmllllll.1II111IIHmlllllll..lmIIIIIlIllIIIIIIIMU~H~IIIII..II#mll.lllmmmHIIIIIIIIUI.1#lIIII1II!IIIIMI.lWlmIIM.lllmll.IlIm!UIIII!III..IIIIMm.H~lmIllIlIHIII~.flm.~III~mHnl..mOOJ..lmllllllllll.IIII1MIIIIIIU.IIIIIIIIIlIfIHIIIIIIIIIIIIIIIIII
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement" required. (AlC upgrades over $5(00)
Agent (for the contractor) or Power of Attorney (for the owner) would be aomeone with not8rized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of.AppliClltion Only)
Reroofs Sewel$ Service Upg~es AlC Fences (Plot/Survey/Footage)
Driveways-Not over Counter if on public roa~ys..needs ROW
STOLTZ
725 Conshohocken State Road
Bala Cynwyd, PA 19004
610.667.5800
fax 610.664.1976
www.stoltzusa.com
IiJ
December 10, 2007
City of Zephyrhills, FL
Building Department
5335 8th Street
Zephyrhills, FL 33542
Re: Advance America # 1916
7348 Gall Boulevard
Townview Square
Zephyrhills, FL 33541
To Whom It May Concern:
This letter authorizes David Jackson of Anchor Sign, Inc., as an authorized agent of the
property owner, to obtain permits and perform Sign installations at the project address listed
above.
Thank you,
Commonwealth of (fA )
County of ( t.A.~ )
On this, the let"" day of ~ ' , 20 o~ before me a notary public, the undersigned officer, personally
appeared--r.f ....,Ic.c..,.. , known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and
acknowledged that he executed the same for the purposes therein contained.
In witness hereof, I hereunto set my hand and official seal.
~~~otaryPUbliC
o
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Sokunthea Thong, Notary Public
Upper Merion Twp.. Montgomery County
My Commission Expires Oct. 27, 2009
Member, Pennsylvan.... Association of Notaries
PHILADELPHIA
NEW YORK
CHICAGO
LAS VEGAS
WILMINGTON
~ AnchorSign@
Sign Permit Request
December 10, 2007
City of Zephyrhills, FL
Building Department
5335 8th Street
Zephyrhills, FL 33542
813-780-0020
To Whom It May Concern:
This sign permit request is in regards to:
Advance America
AD-1916
7348 Gall Boulevard
Zephyrhills, FL 33541
I have included what I believe to be the complete requirements needed to obtain this permit. If I have
failed to send any important information, please contact me as soon as possible so that I may get it to you.
Upon approval, please notify me and I will make arrangements for the permit to be paid for and picked up.
I appreciate your time and efforts. Thank you again. Please do not hesitate to call if you should have any
questions.
Sincerely,
S;~.&~
Erica Brown
Permit Coordinator
Anchor Sign, Inc.
800-213-3331 - Toll-Free
843-576-3252 - Direct
843-576-7252 - Fax
www.anchorsign.com
P.o. Box 22737 · Charleston. SC 29413
Charleston (843) 747-5901 · Toll Free (800) 213-3331 . Fax (843) 747-5907
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 misdemeanor 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 contractor(s) sign
portions of the "contractor Block" of this application for which they will be responsible. If you, as the 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 number 89-07 and
90-07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of
permitting. It is further understood tIlat Transportation Impact Fees and Resource Recovery Fees must 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. Furthermore, if Pasco County Water/Sewer Impact
fees are due, they must be paid priorto 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
will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is
hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
commenced prior to issuance of a permit and that 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. I also
certify that I understand that the regl,flations 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 Environmentally Sensitive
Lands, WaterlWastewater Treatment.
Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
Army Corps of Enginee",-Seawalls, Docks, Navigable Waterways.
Department of Health a Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks. .
US Environmental Protection Agency-Asbestos abatement.
Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:
Use of fill is not allowed 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 18 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 in the application. A
permit issued shall be construed to tie 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 tile 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.
~/{/A D. ~ (f7A/'--
Notary Public
~. 1~~7)
&67ArY1
Notary Public
Commission No.
Commission No.
Name f., p ed 4O~SEAl
ERICA 0 BROWN
Notary Public
For the State of South Carolina
My Commission Expires
April 23, 2017
S TO LT Z
725 Conshohocken State Road
Bala Cynwyd, PA 19004
610.667.5800
fax: 610.664.1976
www.stolczusa.com
(jj
December 10, 2007
City of Zephyrhills, FL
Building Department
5335 8th Street
Zephyrhills, FL 33542
Re: Advance America # 1916
7348 Gall Boulevard
T ownview Square
Zephyrhills, FL 33541
To Whom It May Concern:
This letter authorizes David Jackson of Anchor Sign, Inc., as an authorized agent of the
property owner, to obtain permits and perform Sign installations at the project address listed
above.
Th~;;f
Commonwealth of (fA )
County of( M~~ )
On this, the I~ day of ~. , 20 0-, before me a notary public, the undersigned officer, personally
appeared..,-::r' "'" Ilk.,,- , known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and
acknowledged that he executed the same for the purposes therein contained.
In witness hereof, I hereunto set my hand and official seaL
~"'--"""""~OlaryPUbliC
o
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Sokunthea Thong, Notary Public
Upper Merion Twp., Montgomery County
My Commission EXE:res Oct. 27, 2009
Member, Pennsylvan", Association of Notaries
PHILADELPHIA
NEW YORK
CHICAGO
LAS VEGAS
WILMINGTON
Basco County Parcel: 35-25-21-0010-08800-0000001
Page 1 of2
Search .Again ShowMaQ Generaliz:ed6l..1Uding Schematic EstimateTaxes Freql.Lel1tl')'AsKednQl,JestiQo_s
Other Parcel
Cards: 1 1 2 1 3 I 4 I 5 15 1 Z 1 8 1 9 1 1Q I U 1 12 1 13 ItA 1 J5 I 16 117 1 18
Other Agency Data: Tax Collector Scho_oll.3_Qard Supel"'lisoLQLElectLons
Data Current as Of:
Parcel ID
Classification
Weekly Archive - Wednesday, November 21, 2007
35-25-21-0010-08800-0000 (Card: 001 of 018
16 - Shopping Center Community
Land Detail (Card: 001 of 018)
ption Z Units I Type I P
S~;RNG 00C2 5.00 I AC 1$250,
SHg;RNG 00C2 3.98 AC $250,000.00 0.65
SHOPNG I
CTR 00C2 30,000.0 $0.01
Additional Land Information
Acres II 9.67 II Tax Area II 30:Z;H II FEMA Code leD Commeri
B!JildinsJoformat;ion - Use 16 - Shopping Center Local (Card: 001 of 018)
Year Built 1990 Stories 1.0
Exterior Wall 1 Concrete or Cinder Block Exterior Wall 2 Common Brick
Roof Structure Steel Frame or Truss Roof Cover Built-Up Tar and Gravel
Interior Wall 1 Drywall Interior Wall 2 None
Flooring 1 Carpet Flooring 2 None
Fuel Electric Heat Forced Air - Ducted
AIC Packaged Roof Top Baths 2.0
Mailing Address
TOWNVIEW RETAIL LLC
C/O STOLTZ RE PARTNER LLC
725 CONSHOHOCKEN STATE RD
BALA CYNWYD, PA 190042102
PhysJcal Address -$eeAII:l.7 ad_dresses (First Shown)
7252 GALL BLVD1
ZEPHYRHILLS, FL 33541-4306
l..egaJ__Pesc_rJptJQn (First 4 Lines)
ZEPHYRHILLS COLONY CO LANDS PB
1 PG 55 POR TRS 73 88 & 89 &
POR OF LOT 8 PASCO MEDICAL
ARTS CENTER PB 23 PG 24 BEING
1
1600
2
1600
3
1600
Line
1
2
3
Description
FST
SDA
CAN
Sq. Feet
480
2,320
320
Line
Extra Features (Card: 001 of 018)
Description Year Units
SJ>RNKfP 1990 2,800
P 1990 229,400
1990 4,353
1990 12,579
1990 6
1
2
3
4
5
DWe
LIGHTDM
Assessment (totals)
Ag Land
Land
Building
Extra Features
$0
$1,897,050
$6,545,955
$151,680
Total Assessment
Save Our Homes
$8,594,685
$0
Taxable Value
$8,594,685
V
$1,250,000
$646,750
1.00
C1
$44,554
$430,685
$17,821
Value
$4,025
$54,196
$1,535
$5 503
$5,832
http://appraiser.pascogov.com/search/parce1.aspx?sec=35&twn=25&rng=21 &sbb=OO 1 0&... 11/28/2007
Basco County Parcel: 35-25-21-0010-08800-0000001
Page 2 of2
I 6 I LIGHTSM 1990 3 $2,582
I 7 I 126W 1990 720 $1,603
I 8 I PAY CON 1990 11,200 $4,900
I 9 I SWC 1990 4,290 $1,877
I Sales History I
Previous Owner I ZEPHYRHILLS RETAIL LLC
Year Month I Book/Page I Type Amount
2007 09 7642LQ342 WO $0
2005 06 646211940 WD $0
1988 12 1765 L1282 _D " $0
Searc:b_Agai n ShQwMapGenera Ii~ed 6YJld jngSchematic:Estimat~Ia~_es EreQ!.l~lJtJy ASkE~J:L Ql.I~stiQns
Other Parcel
Cards: 1 I 2 I :3 I 4 I 5 I 6 I 7 I 8 I 9 I 1Q I :l.J. I :1.2 I D I 14 I t5 116 I 17 I 18
Other Agency Data: Ta'>LCollec:tor Sc110QIJ~QaLd SUR-ervisorQLElecJiolJS
http://appraiser.pascogov.com/searchlparce1.aspx?sec=35&twn=25&rng=21 &sbb=OO 1 0&... 11/28/2007
Pa6co County Property Appraiser - Physical Address List for: 35-25-21-0010-08800-0000 Page 1 of 1
Welcome: Records $ea_rch : Parcel Detajls : Physical Addresses
Physical Address List for Parcel: 35-25-21-0010-08800-0000
Displaying 17 record(s)
View in groups of: lQ 25 50 10_0 SQO
Street N_umber
7252
7252
7254
7300
7302
7304
7306
7320
7330
7334
7338
7340
7342
7346
7348
7352
7400
Street_NiI_me_ +
GALL BLVD
GALL BLVD
GALL BLVD
GALL BLVD
GALL BLVD
GALL BLVD
GALL BLVD
GALL BLVD
GALL BLVD
GALL BLVD
GALL BLVD
GALL BLVD
GALL BLVD
GALL BLVD
GALL BLVD
GALL BLVD
GALL BLVD
Unit
1
2
Pasco County Property Appraiser
Page Layout Modified: 10/9/20079:52:48 AM
The Local Time Is: 11/28/20078:54:34 AM
http://appraiser . pascogov .com! search/physadd.aspx?parce1 =2125350010088000000
11/28/2007
Dat~: 12/6/07 Qity..9tate:
S,Ji~nt . AmmorSign 8Y!5r~II~~ight:
sr n'~\);; ." ;',AdvahCeAmerica.VVihd.S €led .
Project Description 7348 Gall Boulevard
Height 2'-0 1/4"
ME Job: 07-11248
ANC Job: ANC 07-203
Overall Size: 2'-5" x 10'-2"
Mounting Height: 15'-0"
Mounting Style: Wall Signs Raceway and Flush Mounted to Brick Veneer
Structural Variables and Code Loading Specifications
Sign Type: Channel Letters / Wall Signs
Existing Wall Material: other
Sign Weight Per Foot: 15
Connection Design
Using ASCE 7-02 (Simplified Procedure)
Topography: Homogeneous
Exposure: C
Enclosure: Enclosed
Structure: Components and Cladding
Building: Category III
Total Load Pnet = (Iambda)*I*Pnet
Pnet= -51.48
1=
lambda =
Zone =
Effective Wind Area =
Net Wind Pressure =
PSF
Sign Loads Area Pressure (Suction)
Cash Advance Letters 0.65 FT^2 -51.48 PSF
Advance America Cabinet 8.67 FT^2 -51.48 PSF
Connection Design Connections Force Per
Total Connection
Cash Advance Raceway 5 -74 LBF
Advance America Cabinet 4 -112 LBF
Z~phyrh iIIis, FL
15',.0"
120\rn. h ..
Table of Contents
Content: Page
Design Loads. . . . . . . . . . . . . . . . . . . 1
Connection Design. . . . . . . . . . . . . . . 1
Installation Details. . . . . . . . . . . . . . . 2-3
SHEET: 1 OF 3
Sean M. McFarland; P.E.
... Code:
... Wind Spee :
... Wind Exposur :
Wind Loads Per ASCE 7-
...
w/ 2006 Sup.
...
...
1.15 (Table 6-1)
1.29 (Figure 6-3, Exp. C, height=20 ft)
5 (End-Wall - Worst Case)
10 Sq. Ft.
-34.7 (Figure 6-3)
DEe 0 6 2007
Force
-33 LBF
-446 LBF
License ExpWea FEB Z B 2009
1/2" Dia.
Sleeve Anchors
200 LBS
200 LBS
Connection Specifications
Cash Advance (Raceway)
Total connectors required = Attach Raceway with (5) 1/2" Dia. Sleeve Anchors - 1 1/2" Embedment Depth. Spaced Evenl~
Screw Trimcap @ 6" O.C. Around Letters. Attach Letter with (4) TEKS Each Thorugh 1/8" Material in Letter Cabinet
or with Plate Washers.
Advance America (Cabinet)
Total connectors required = (4) 1/2" Dia. Sleeve Anchors - 1 1/2" Embedment Depth. Spaced Evenly.
Screw Trimcap @ 6" O.C. Around Cabinet.
REVIEW DATE /2...-'3 '-eTJ
CITY OF ZEPHYRHILLS
PLAI\I~ /;:"v", "'t'\P ,'.~r~'.. Y'C
, ~~\:,.,; !"--f~,,..\rF1~e'Jt:t'~,=<",,,_~.~____
Sean M. McFarland, PE . 19526 Kuykendahl
Spring, TX 77379 . Phone (281) 813-7439
'\LL hORK SHALL CO\;Pi.'{ ALL
:."REVAJLlNG CODES. FLORIDA EUILDl';J
CODE. NATIONAL ELECTRIC CODE AN"I
C. OF Zl:.PllYRf OPDf\lANCl~
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City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
ContractorlHomeowner:
An{l~!2.. S,')n
(2-112.-10-7
.734~ (~d \ 81 uct
WQ\ ~ Sl Cj'fJ
Date Recei"'ted:
Site:
Permit Type:
Approved wino comment
Approved withe below comments: D
Denied withe below comments: D
t 180 sgJ:+
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S~rc ,/kJ.~t.
q(!Owe4
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This~mment sheet r1 e kept with the permit and/or plans.
,U ~A ~~/.J-fT)
Kalvin Switzer - ans Examiner
. Date
Contractor and/or Homeowner
(Required when comments are present)