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HomeMy WebLinkAbout08-8157 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 8157 Permit Number: Permit Type: Class of Work: Proposed Use: Square Feet: Est. Value: Improv. Cost: 4,745.00 Date Issued: 8/07/2008 Total Fees: 117.50 Amount Paid: 117.50 Date Paid: 8/07/2008 Phone: Work Desc: INSTALL WALL SIGN W/ ELECTRIC EXIST 8157 SIGN WALL SIGN COMMERCIAL Address: 7400 GA L BL V ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 35-25-21-0010-08800-0000 TOWN V W RETAIL LLC 725 CONSHOHOCKEN STATE RD BALA CYNWYD, PA 190042102 R ELECTRICAL ROUGH 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: Yo r failure to record a notice of commencement may result in your paying twice for im vements to your perty. If you intend to obtain financing, consult with your lender or an attorney recording your n tice of commencement. II PERMIT OFF I IT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 11111111111111I1111I11111111111111111111111111111111 11111111 2008115763 . . Rcpt: 1196624 DS: 0.00 08/07/08 Rec: 18.50 IT: 0.00 Dpty Clerk ~' ~ Permit No. NOTICE OF COMMENCEMENT JED PITTMANA fASCO COUNTY CLERK 08/07/08 0~: 4am 1 of 2 OR BK 7900 PG 975 Property Identification No.35-25-21-0010-07200-0011/35-25-21-001O-08800-0000 /35-25-21-0010-05600-0000 THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Section 7]3.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. 1. Description of property (legal description :) See attached a) Street Address: 7252- 7400 Gall Boulevard. zeOhvrhills;L 33545 2. Genera] description of improvements: New signage - ,-l u av...o... 0... .5 ~c. JS- ; u..J p J- ~ R" e... ~ IE 3. Owner Information: Townview Retail, L.L.C. c/o Stoltz Management of DE, Inc. a) Name and address: 725 Conshohocken State Road. Bala Cynwvd. PA 19004 b) Name and address offee simple titleholder (if other than owner) N/A c) Interest in property 0 w t\.~.r- 4. ContractorInformation hdeln'lo../'O'Y1a...f )'(q",\ tD€>s)CJ~ eoV'!\. (VC(? ( (It\...~C\.\ <;1. (o..."""CJ F..... ~s)) '? a) Name and address: j;;iU'" v Dr~H 1 QRJ 1 Carlal ShGet. ~@lRi:RQII: FL'DR7 b) Te]ephone No.: (727) 545-9785 x1309/ (727) 4105128 Fax No. (Opt.) 5. Surety Information I a) Name and address: " Q.... b) Amount of Bond: c) Te]ephone No.: Fax No. (Opt.) 6. Lender a) Name and address: Bear Stems Commercial Mortg.age. Inc. Servicer: Wells Fargo 1320 Willow Pass Road. Suite 210 Concord. CA 94520 Phone No. 800-986-9711 7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served: N/A a) Name and address: b) Telephone No.: Fax No. (Opt.) 8. In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713. ]3(1) (b), Florida Statutes: N/A a) Name and address: b) Telephone No.: Fax No. (Opt.) 9. Expiration date of Notice of Commencement (the expiration date is one year from the date of recording unless a different date is Specified): WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMEN EMENT. STATE OF FLORIDA COUNTY OF PASCO The foregoing instrument was acknowle~ed before me this L day of :::ft,,/y ,20H, by -r \T' JI-'l; I J~ as t'r"t>~ ~M4'~ (type of authority, e.g. officer, trustee, attorney in fact) for ""'OI.O"'W~ <UA.) k~; I . . (nam of party on behalf of whom instrument was executed). Personally Known ../ OR Produced Identification _ Notary Signature ~ ' ~ Type of Identification Produced Name (print) 6()~n\-k<4 ~O!1j Verification pursuant to Section 92.525, Florida Statutes. Under penalties ofperj ry, I declare that I have read the foregoing and that the facts stated in it are true to the best of my knowledge and belief. ~ COMMONWEALTH OF PENNSYLVANIA Notarial Seal Sokunthea Thong, Notaty Public Upper Mer~n Twp., Montgomety County My Commission Expires Oct. 27, 2009 lv1embef, Pennsylvania Association of Notaries FORMS/NOC,rvsd2007 OR BK 7900 PG 976 2 of 2 OR 8K 7642' PI 344 3 or 3 LEGAL DESCRIPTION EXHIBIT "A" A portion of the W 1/2 of the W 1/2 of the SW 114 of SectIon 35, Township 25 South, Range 21 East, being also a portion of Tracts 72, 73, 88 and 89 of ZEPHYRHILLS COLONY COMPANY LANDS SUBDIVISION, as recorded In Plat Book 1, Page 55, public records of Pasco County, Florida, being also a portion of Lot 8, PASCO MEDICAL ARTS CENTER, ,is recorded In Plat Book 23, Page 24, public records of Pasco County, FlorIda, being more parttularly described as follows: Commence at the Northwest corner of the SW 1/4 of said Section 35, thence along the North line of said SW 1/4, S. 89 degrees 51'40" E., 663.35 feet to the East Ihe of the W 1/2 of the W 1/2 of the SW 1/4 of said Section 35, thence along said line and along.;he East line of Tracts 72, 73, BB and 89, S. 00 degrees 09~03" W., 25'.00 feet to the South r1glt-of-way line of Pretty Pond Road, for a point of beginning; thence continue S. 00 degrees at'03" w., 1004.84 feet, thence leaving said line N. B9 degrees 55'34" W., 50.00 feet, thence S 00 l;fegrees 09'03" W., 117.00 feet, thence N. 89 degrees 55'34" W., 200.00 feet, thence S.OO degrees 09'03" W., 109.00 feet, thence N. 89 degrees 55'34" W., 259.00 feet, thence S 00 degrees 09'03" w., 205.36 feet, to the North' right-of-way line of North Medical Avenue, the1ce along said line N. 89 degrees 56'33" w., 133:84 feet, to the East right-of-way line of U.S. HtJhway 301, thence along said line and along a curve concave to the West with a radius of 57395.BO feet, chord bearing N. 00 degrees 04'19" W., 747.11 feet. thence leaving said right-of-way lin~ S. 89 degrees 50'57" E., 171.18 feet, thence N. 00 degrees 09'03" E.. 197.00 feet. thence I,J, 89 degrees 50'57" W., 173.54 fe'et, to the West line of Tract 73. thence along the West line::lf Tracts 72 and 73,' N. 00 degrees 0'7'20" E., 332.86 feet, thence leaving saId line S. 89 degr~es 51'40" E., 200.00 feet, thence N. 00 degrees 07'20" E., 160.00 feet to the South right-of-way line of Pretty Pond Road, thence along said line S. 89 degrees 51'40. E., 448.35 feet to the POII,JT OF BEGINNING. AND RETENTION POND: The North 290.0 feet of the South 515.0 feet of the East 150.0 feet of the SW 1/4 of the SW 1/4 of the NW 1/4 of Section 35, Township 25 South, Range 21 East; being a 'portion of Tracts 56 and 57, ZEPHYRHILLS COLONY COMPANY LANDS SUBDIVISION, as recorded in Plat Book 1, Page 55, public records of Pasco County, Florida. TOGETHER WITH an easement for ingress and egress and drainage purposes over the South 225.0 feet of the West 30.0 feet of the East 100.0 feet of the SW 1/4 of the SW 1/4 of the NW 1/4 of Section 35, Township 25 South, Range 21 East, Pasco County, Florida, LESS the South 15.0 feet. AND TOGETHER WITH the irrevocable right and easements as set forth In the Reciprocal Easement Declaration recorded in Official Records Book 1801, Page 974, as amended In the First Amendment to Reciprocal Easement Declaration, recorded in Official Records Book 1929, Page 576, Public Records of Pasco County, Florida. AND TOGETHER WITH that certain perpetual non-exclusive egress and Ingress easement as set forth in Exhibit "0" to that certain Easements and Maintenance Agreement entered into by and between Zephyrhills Retail LLC, a Delaware limited liability company and Concire, Inc., a Florida corporation recorded In Official Records Book 7159, Page 758, of the Public Records of Pasco County, Florida. , STATE OF FLORIDA COUNTY OF PASCO . THIS IS TO CERTIFY THA T THE FOREGOING IS A TRUE AND CORRECT COpy OF THE DOCUMENT ON FilE OR OF PUBLIC RECORD IN THIS OF2E.WITNESS MY HAND AND OF~ICIA4 THIS '(h. DAY OF ~~.. 2 00 ~~D PI ~MA lERK OF qRCiJii'COURT ~ 'L.,/~ DEPUTY CLERK 813-780-0020 City of Zephyrhills Permit Application Jt' B (S 1 Building Department - 11 Fax-813-780-0021 Date Received ItIlllllllllllllttl!lllllllll Owner's Name Owner Phone Number Owner Phone Number I Owner Phone Number I Fee Simple Titleholder Address I \ IZ.hr/IS' "L.3 g540 LOH I PARCELID#135-25-2/- (){)/o-offctJ- 00 (OBTAINED FROM PROPERTY TAX NOTICE) SUBDIVISION JOB ADDRESS WORK PROPOSED NEW CONSTR INSTALL SFR B ~ ~ SIGN D MOVE D DEMOLISH PROPOSED USE TYPE OF CONSTRUCTION g D D BLOCK D SlzLP I One.. ~ AD DIAL T REPAIR COMM FRAME DESCRIPTION OF WORK ~_J~~-~ D BUILDING ~ 145". <.JQ I VALUATION OF TOTAL CONSTRUCTION OTHER STEEL I D .-l-o .e>li OTHER I D ELECTRICAL 1$ D PLUMBING 1$ D MECHANICAL 1$ D GAS D ROOFING AMP SERVICE D PROGRESS ENERGY D WR.E,C, I I I D I VALUATION OF MECHANICAL INSTALLATION Address SPECIALTY D OTHER FLOOD ZONE AREA DYES DNO ~IltlllI!IIIIIIIIIIIHII~IIIllIHII__..~__lltlllI!IIIIlltlllI!IIIImlI\llllIlltlllI!IIIIl!IlllllIItrl!!lllll ~f~-+t~~R~W'f y~~N License # l-p OOCOtY)"2J I ';~~~:R~~ ~~i~R~ I~Y~~ FINISHED FLOOR ELEVATIONS I 1MI1llllllIm1ltllll!llll1ltllll!llll1lllllllm1ltllll!llll_IltlllI!IIIIUlllIIIHlllIlIlllIRI__ BUILDER SIGNATURE Address ELECTRICIAN SIGNATURE Y I N FEE CURRENT U;:5(X)mn:Q I I I I I I I Y/N License # PLUMBER SIGNATURE COMPANY REGISTERED Y I N FEE CURRENT Address License # MECHANICAL SIGNATURE COMPANY REGISTERED Y/N FEE CURRENT Y/N Address License # COMPANY REGISTERED OTHER SIGNATURE Y/N Address License # llIlIflllllll!lll..........-;.__ 1lIlIII!Ill1lllllllllll1llllll!lll1lllllllllll1lllllllllll1llllll!lll1lllllllllll1llllll!lll1lllllllllll1lllllllllll__IlIlIII!IllIlllllllllll_-- 1lIlIII!Ill1lllllllllll__ RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, Minimum ten (10) working days after submittal date, Required onsite. Construction Plans, Stormwater Plans wi Silt Fence installed. Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge projects Attach (3) 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, Required onsite. Construction Plans, Stormwater Plans wi Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance Attach (2) sets of Engineered Plans, ....PROPERTY SURVEY required for all NEW construction. IIIIlIIlI COMMERCIAL SIGN PERMIT mm~~!lIDIIlIDI~mmmm:mHR-WflillllllllimllllODllllllll~mD.IIm.mm!lllfili~~mDJl~mJlIftJ.IImI~lRmHIAlR:JIHR1JRmIIIlmmllllll:~rm-JHJJHrRmHrJHJrRlHrAlfJHHHHATmIIII~ Directions: Fill out application completely, Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement is required. (AlC upgrades over $5000) Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades AlC Driveways-Not over Counter if on public roadways..needs ROW Fences (PloUSurvey/Footage) 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 that 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 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 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 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 Environmentally Sensitive Lands, WaterlWastewater 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, 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 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 in 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 FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YO R TICE OF COM NC ENT, FLORIDA JURAT (F,S, 117,03) , CONTRACTO Subscribed and sworn to (0 by Who is/are personally known to me or has/have produced as identification, OWNER OR AGENT Subscribed and sworn to (or affirmed) before me this by Who is/are personally known to me or has/have produced as identification, Notary Public Notary Public Commission No, Commission No, Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped .1 L\tr.. \.J~...."....,.A. ~'~V/~VVV ~,~~ rl'~ L.' vvv TO:Unknown COMPANY:SIGN XPRESS c;UI'PLlER SIGN XPRESS 10821 CANAL STREET LARGO, FL 33777 United States Purchase Order . PURCHASE ORDER NO r~~SION I PAG; 743315 THIS PURCHASE ORDER NUMBER MUST APPEAR ON ALL INVOICES. PACKING LISTS. CARTONS AND CORRESPONDENCE RELATED TO THIS ORDER SHIP TO See Line Item (s) Below for Actual Ship To Location BILL TO Humana Inc Accounts Pa~able Deport PO Box 7400 3 Louisville,KY 40201 United States HUMANA@ G~idance when you need it most 500 West Main Street Louisville, KY 40202 502-580-8880 CUSTOMER ACCT NO I SUfOlOR9908 DATE OF ORDERI8UYER REVISED DATElTIME 10-APR-08 C Brandenbur F'AYMENT TERMS SHIP ~A DELIVERY TERMS Net 45 UPS FOB Destination FREI GHT TERMS REQUESTOR/DELIVER TO CONFIRM TOrrElEPHOr--l: Prepaid and Add Johnson, Ms. Donna C DEROSE (727) 545-9785 ITEM PART NUMBER/DESCRIPTION DELIVERY DATE QUANTITY UNIT UNIT PRICE EXTENSION This Purchase Order is issued for the est i me ted ollar Amoun for Goods or Services (GIS), and Hun ana does nc t commit 1 o pa the stated amount except as hereinafter set for h . Paymen (s) will ~ e re eased only e s GIS are provided and correctly submitted nvo ices bE come payable. A ter all anticipated invoices he ve been rec eived and baid against thi:~ PO, it will be closed and any Dollar ~ mount rema ning will e c ncelled wi t no further obligation by Humana. All prices and amounts on this or er are eXI= "'essc d in US de llar Please formally accept this order by: 1 NEEDED: 4 , 745 . 00 N 11-APR-08 Zephyrhills new sign for front of building Invoice #2255 o SHIP TO: 5401 W Kenned~ Blvd ~ 161 Tampa,FL 3360 United States Total 4 ,745 . 00 THIS ORDER EXPRESSLY LIMITS ACCEPTANCE TO THIS FORM. THE ATTACHED TERMS AND CONDITIONS. AND ANY OTHER Ths Ptrchase Order has been electronically approved by: HUMANA DOCUMENT YOU SIGN ANY ADDITIONAL TERMS SET FORTH IN ANY SUPPLIER COMMUNICATION ARE HEREBY REJECTED ~~~.~ Chief Proct.rement Officer 'STOLTZ 725 Conshohocken State Road Bala cynwyd, PA i9004 610.667.5800 fax 610.664.1976 www.stoltzusa.com fiI July 18, 2008 TO WHOM IT MAY CONCERN: This letter authorizes INTERNATIONAL SIGN & DESIGN CORPORATION To manufacture and install sign(s) and/or awnings at the following location: Townview Retail, L.L.c. Humana Medical 7400 Gall Boulevard Zephyrhills, FL 33541 INTERNA TIONAL SIGN & DESIGN CORPORATION is authorized to secure Permits required by the local governing body. Sincerely, SWORN TO AND SUBSCRIBED before me this J g#t day of ~, 2008 by who is as identification 1""0" / personally known to me OR ~; \ k.f" produced ~iC~ (NOTARY PUBLIC SEAL) My Commission Expires: It>/~7 /1>9 I . COMMONWEALTH OF PENNSYLVANIA Notarial Seal Sokunthea Thong, Notary Public Upper Merion Twp., Montgomery County My CommiSSion Expires Oct. 27, 2009 Member, Pennsylvania ASSOCiation of Notaries PHILADELPHIA NEW YORK CHICAGO LAS VEGAS WILMINGTON City of Zephyrhi1ls BUILDING PLAN REVIEW, COMMENTS .', Qy-..'lBI--f/<. *~ ,,'.. .,.~ ~ ;.- ;,- e.,;.,~ " --:: -...- l /' ...:::-/' ,. '..,"..1/ 1'1 I \~ \ ~';:~~.:., Site: --r. 3 ,n 7-,3/-05 7cJob ((;1+(I,b/fib /A)tf.Q) J&- / w/''j (" ;., cc/r(~ ContractorlHomeowner: Date Received: Permit Type: Approved wino comments~ Approved wIthe below cOIDnlents: 0 Denied wIthe below comments: 0 ."~- s all be kept with the permit and/or plans. ~w Contractor ,and/or Homeowner (Required when comments are present) Kal Date