HomeMy WebLinkAbout11-12518 CITY OF ZEPHYRHILLS /
' S335 - 8TH STREET �,/
• (sis)�so-oo20 12518
BUILDING PERMIT
Permit Number: 12518/12582 Address: 7800 GALL BLVD
Permit Type: SIGN ZEPHYRHILLS, FL.
Class of Work: MONUMENT SIGN Township: Range: Book:
Proposed Use: NOT APPLICABLE Lot(s): Block: Section:
Square Feet: Subdivision: ZEPHYR COMMONS
Est. Value: Parcel Number: 35-25-21-0130-00000-0050
Improv. Cost: 10,700.00
Date Issued: 12/13/2011 Name: SF ZEPHYR COMMONS LP
Total Fees: 187.50 Address: 2851 JOHN ST STE 1
Amount Paid: 187.50 MARKHAM ON CANADA L3R 5R7
Date Paid: 12/13/2011 Phone:
Work Desc: INSTALL 1 ILLUMINATED MONUMENT AND 2 WALL SIGN
NW SIGN INDUSTRIES
V�
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Z ,��l
ELECTRICAL ROUGH
FINAL '
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REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection
trips are necessary due to any one of the following reasons: a) wrong address b) condemned work resuldng
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 � pians 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.
"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 pertormed in accordance with
Ci C and Ordinances. NO OCCUPANCY BEFO C.O.
CONT TO NATURE PERMIT OFFI R
MIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
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City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: �/(� ��( �
-� ..��'�.���.
Date Received: _ �Q— Z�—� f
Site: �� �� �� /��v/�
�
Permit Type: ���� /'� � C f `' / Z J j� Sr U -
Approved w/no comments: Approved w/the below comments: ❑ Denied w/the below comments: ❑
[��� `�' i � �f �(C �� � [ �-�` , , � , C .
�
This comment sheet shall be kept with the permit and/or plans.
� / _
, � �- e
Kalv Switze, — Plans Examiner Date Contractor d/or Ho eowner
� (Require wh omments are present)
813-780-0020 � � � I � �
City of Zephyrhills Permit Application Fax-813-780-0021 � 7
Building Department J
Date Received i?j' Phone Contact for Permittin V� 5' ' �
TTfTf --
Owner's Name Z Owner Phone Number — `�5 —�
Ownsr's Address � wner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS � O�.+LJ C� L V LOT # �
SUBDIVISION PARCEL IDN J� Z 5 Z I� 0( 30 � Q ��Q � �,�V
(OBTAINED FROM PROPER7V 7A% NO710E)
WORK PROPOSEO e NEW CONS7R B ADD/ALT Q SIGN � Q DEMOLISH
INSTALL REPAIR
PROPOSED USE � SFR � COMM Q OTHER
TYPE OF CONSTRUCTION � BLOCK � FRAME � STEEL �
DESCRIPTION OP WORK 2 �
BUILDING SIZE �� S� FOOTAGE � HEIGHT �
�BUILDING $ � E +. VALUATION OF TOTAL CONSTRUCTION
�ELECTRICAL $ ,� ��� AMP SERVICE Q PROGRESS ENERGY � W.R.E C.
QPLUMBING $
�MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
QGAS � ROOFING a SPECIALTY � OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO
BUILDER `" „(� � COMPANY 1 � ►
SIGNATURE � �a r � REGISTERED Y/ N FEE CURREN Y/ N
Address Z License # ES Q
ELECTRICIAN C� COMPANY �
SIGNATURE � O � � REGISTEREO Y/ N ' FEE CURRE� Y/ N
Address License #
PLUMBER COMPANY
SIGNATURE REGISTERED Y 1 N FEE CURREA Y/ N
Address License #
MECHANICAL COMPANY
SIGNATURE REGISTERED Y( N FEE CURRE� Y J N
Address License #
OTHER COMPANY
SIGNA7URE REGISTERED Y/ N FEE CURRE� Y 1 N
Address License #
111111111111111111111111 1111111111111111111111111111111111111111111
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Fortns; R-0-W Pertnit for new construction,
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & t dumpster, Site Work Permit for subdivisions/large projects
COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Fortns. R-0-W Pertnit for new construction.
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stortnwater Plans w/ Siit Fence installed,
Sanrtary Facdities 8 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
••••• ' 1 1 L 1 1 1 1 1'
D�rections: •
Fdl out applicahon completely
Owner & Contraaor sign back of application, notarized
If over 52500, a Notice of Commencement is required. (A/C upgrades over 57500)
" Agent Ifor the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authonzing same
OVER THE COUNTER PERMITTiNG (Front of Application Only)
Reroofs rf shingles Sewers Service Upgrades A/C Fences (PIOUSurvey/Footage)
Drivaways-Not over Counter if on public roadways..needs ROW
� 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
po�tions 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 indicatio� 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 WaterlSewer 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 "owne�' 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, Water/Wastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls, Docks, Navigable Watervvays.
- 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 O�cial 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 wiil 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 YOUR NOTICE OF COMMENCEMENT
FLORIDA JURAT (F S. 1 .
OWNER OR AGENT CONTRACTOR
� ubscribed and swor o( re me t i� __/_l Subscribed and sworn o e re me t�s
of�i! by f/r!F/ 10 by
Who is/are personally known to me or has/have produced i� nall nye or haslhave produced
as identification. as identification.
ary Public Notary Public
mmission No. — I C mission No. I� Oa
.�enn� r L. o h rL�n � J enrt; �e r L-�.��c�Y�
Name of Notary typed, printed or stamped Name of Notary typed, prmted or stamped
ar r� O �pAY PUB�/ �EMNI�ER L JOHNSON
? o�? ... �.�, JENNIFER L JOHNSON 2' �' `' MY COMMISSION # EE 1310Q4
MY COMMISSION # EE 1310Y4
* * EXPIRES: October 2, 2015 * * EXPIRES. October 2, 2015
`�'� �`O� Bonded Thru Bud9e1 Nota!' S�vites � ft�`O' Bonded Thru Budpe! Notary Services
FOF F��
NW 1 N DUSTRI ES
BETTER FASTER SMARTER
2416 Sand Lake Road Orlando, FL 32809 Phone (407) 251-931 I Fax (407) 25 I-935 I
www.nws ign i nd ustries.com
POWER OF ATTORNEY
�
Dat : � 2� l l
I hereby name and appoint ��'�'����` � Z�(� ��\ �� 2—
`.
of �� ��CIC1 �1�CtlaS�"'C�1 � to be my lawful attorney-m-fact to act for
me and apply to the � I�.'� � r L__s:_ � �`L{ ��� 1� 5 for a Lj 1 l� 11 I �1E�:� �� I V�C 1�
permit for work to be performe d at a location described as: � � J
'���� C�r�-l� �lv�
(Property Address)
(Owner of Property)
(Street Address)
and to sign my name and do all things necessary to this appointment.
��<c� ��d�� E5� 2oc�2.2�-
(Contractor N )(Type or Print) (Contractor's License Number)
(Contractor Si
The •egoin�� stru acknowledged before me this � day f f 20�
bY �„ .t�Q
�ho i�}�e_rs�_ nally n to me or who produced
as identification and who did not take an oath.
t '` ' 1
f - � ' .. . , °
ary Pub�yc rmt � ���""Y•��°�.�, JF�.NN�FERLJOH
, " MY COMMISSION � EE 13tGea
� � Seal * * EXPIRES: October 2, 2015
� otary Pu ic (Signa e) '" ga�dTn,uBuaye�►+otanse�v�ces
• 2851 John Street, Suite One, Markham, Ontario L3R 5R7
Main 905.477.9200 Fax 905.477.7390
SF ZEPHYR COMMONS GP LLC
October 7, 2011
City of Zephyrhills
Building Dept.
5335 8 St
Zephyrhill, FL 33542
Re: Sign Permit for Chase Bank — Zephyrhills Kossik — NBD # 22501
To Whom It May Concern:
This letter shall serve as authorization for NW Sign Industries to sign any necessary documents
for permit obtainment and also to fabricate and install signage for Chase Bank located at 7800
Gall Blvd., Zephyrhill, FL 33542 per attached plans.
Sin e ly,
Robe . Green
Manager
�
Sworn to an su scribed before me this �� day of C�C�p�' , 20�, personally
appeared for me who is personally known / produced a
valid dri ers' cense as identification.
Notary Pu lic (Seal)
My commission expires: � � �
sisaso-oo2o City of Zephyrhilis Permit Application Fax-813-780-0021
Building Department
Date Received phone Contact for Permittin ' 3�
Owner's Name �� �` ��`',�� r� ���J �L Owner Phone Number !� S�` � 7 �
Owner's Address �" � � a�'► b Sr(� 1/� C t�hA.�-,� �'• E�Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS ��D � � � I �� v�' LOT # �
SUBDIVISION , PARCEL ID# ;� ' a� �"�� 3 � " d O v G O S O
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED e NEW CONSTR 8 ADDIALT � SIGN Q Q DEMOLISH
INSTALL REPAIR
PROPOSED USE Q SFR Q COMM Q OTHER
TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q
DESCRIPTION OF WORK
BUILDING SIZE SQ FOOTAGE� HEIGHT
0 BUILDING $ VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
�PLUMBING $
[�MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � � � S �` (� �
QGAS Q ROOFING Q SPECIALTY Q OTHER � � I�/�
�P���''f
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO � ����� �
�� `� � -il
�
BUILDER � COMPANY �l S /.� G{�
SIGNATURE REGISTERED Y/ N FEE RRE� Y/ N
Address ' License #
ELECTRICIAN COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
Address License # � -�
PLUMBER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
Add�ess License #
MECHANICAL � COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N
Address License #
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREA Y/ N
Address License #
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 onslte, Construcbon Plans, Stormwate� Plans w/ Silt Fence installed,
Sanitary Facilities 8 1 dumpster; Site Work Permit for subdivisions/large projects
COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new construcdon.
Minimum ten (10) working days after submittal date. Required onsite, Constructlon Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster. Site Work Permit for all new proJects. Ail commercial requirements must meet compltance
SIGN PERMIT Attach (2) sets of Engineered Plans.
*'*`PROPERTY SURVEY required for all NEW constructlon.
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement is required. (A/C upgrades over 57500)
'* 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 if shingles Sewers Service Upgrades AIC Fences (PIoUSurvey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
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 rest�ictions.
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 locai 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, ff the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the Ncontractor 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 properiy licensed and is not entitled to permitting privileges in Pasco
Counry.
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"cert�cate 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 ail the information in this appiication 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, Water/Wastewater 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, 1 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
prope�ties. tf 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 specificatly 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. (f 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 YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 117.03)
OWNER OR AGENT CONTRACTOR
Subscrlbed and swom to (or affirmed) before me this Subscribed and swom to (or afflrmed) before me this
by b Y
Who is/are personally known to me or has/have produced Who lslare personally known to me or has/have produced
as Identtflcadon. as identification.
Notary Publlc Notary Public
Commission No. Commission No.
Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped
/�L�
�
u�,v +M.�„ '�,2�R
�k eE_
*�.b,
City of Zephyrhills �
BUILDING PLAN REVIEW COMMENTS I 2� J�
�� �
Contractor/Homeowner: /� �� � �y� � � -�-, ��
Date Received: / f — 2 % —��
Site: 7�vC� �p� �� f"5 � l�
Permit Type: �`� ��! S i(�Yl GtJCf �� cs'f .�.��1
Approved w/no comments: Approved w/the below comments: O Denied w/the below comments: ❑
This comment sheet shall be kept with the permit and/or plans.
�U
Kalv' r— Plans Examiner Date Contractor and/or Homeowner
(Required when comments are present)
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