HomeMy WebLinkAbout12-13625 . . CITY OF ZEPHYRHILLS
5335-8th Street �''
(813)780-0020 �3625
ELECTRICAL PERMIT
Permit#:13625 Issued: 11/20/2012 Address: 39254 SOUTH AVE
Permit Type: ELECTRICAL MISC ZEPHYRHILLS, FL.
Class of Work: ELECTRIC SERVICE/NEW Township: Range:
Proposed Use: NOT APPLICABLE Lot(s): Block: Se�tion:
Sq. Feet: Est. Value: Book: Page:
Cost: 199.00 Total Fees: 60.00 Subdivision: CITY OF ZEPHYRHILLS
Amount Paid: 60.00 Date Paid: 11/20/2012 Parcel Number: 13-26-21-0010-00000-0010
Name: ADT LLC Name: BOLENDER INVESTMENTS
Addr: 5471 W. WATERS AVE STE 1000 Address: 39254 SOUTH AVE
TAMPA, FL. 33634 ZEPHYRHILLS, FL. 33542
Phone: 813 806-7000 Lic: Phone:
Work Desc: LOW VOLTAGE BURGLAR ALARM SYSTEM
ELECTRICAL FEE 60.00
ROUGH ELECTRIC
CONSTRUCTION POLE
PRE-METER ��
FINAL -( - "
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REINSPECTlON FEES: Reinspection fees will comply with Florida Statute 553.80(2)(c)when extra inspection
trips are neoessary due to any one of the following reasons: a)wrong address b)wndemned work resulting
from faulty construction c) repairs or aorrections not made when inspection called d)work not ready for
inspection when called e) permit not posted on job site t) 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.
"Warning to owner: Your failure to record a notioe of commencement may result in your paying twiae for
improvements to your property. If you intend to obtain financing,wnsult with your lender or an attorney
before reoording your notice of commenoement."
Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City
Codes and Ordinances.
CONTRACTOR PER OF I
PERMIT EXPIRES IN 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 ConWct for Pertnittin 813 806 7040
�rr_�rr- --
Owners Name Bolender Investments Inc Owner Phone Number
Owners Address 38461 County Road 54,Zephyrhills 33542 Owner Phone Number —�
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS 39254 South Avenue,Zephyrhdls 33542 ��T� �
SUBDIVISION PARCEL ID# �3-26-21-0010-00000-0010
(OBTAINED FROM PROPER7Y 7AX NO710E)
WORK PROPOSED B NEW CoN57R 8 ADD/ALT � SIGN Q Q DEMOLISH
� INSTALL REPAIR
PROPOSED USE Q SFR Q COMM � OTHER
NPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q —1,.
DESCRIPTION OF WORK Install low voltage burglar alarm secunty system
BUILDING SIZE SQ FOOTAGE� HEIGHT �
1'T''r�r'r-'r`T'r r''r''r r r r r r'r�r'r'1''r'�''1''r'r T
�BUILDING $ VALUATION OF TOTAL CONSTRUCTION
�ELECTRICAL $199 pp AMP SERVICE � PROGRESS ENERGY � W.R E.0
�PLUMBING $
�MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
�GAS 0 ROOFING Q SPECIALTY � OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO
• 1-i-�.-I.-R-�.d-i-
BUILDER COMPANY
SIGNATURE REG�STERED Y/ N FEE CURRE� Y/N
Address License#
E TRICIAN COMPANY ADAMS,KEVIN DBA ADT LLC
GNATURE R eISTERED Y/ N FEE CURRE� Y/N
Address 71 W WATERS AVE,TAMPA 33634(SUITE 1000) License# EF20001034
PLUMBER COMPANY �
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# �—�
MECHANICAL COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREf. Y!N
Address License#
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License#
IIIIIIIi1111111111111111111111111111111111111111111111111111111111I
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,Stortnwater Plans w/Silt Fence installed,
Sanitary Facilities&1 dumpster;Site Work Permit for subdrvisions/large projects
COMMERCIAI Attach(3)complete sets of 8uilding 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 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:• ��^
Fill out application completely
Owner&Contractor sign back of application,notanzed
If over 52500,a Notice of Commencement is required. (AIC upgredes over 57500)
" Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMIITING (Front of Application Only)
Reroofs if shingles Sewers Service Upgrades A/C 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 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 certiTy 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,Water/Wastewater Treatment.
- Southwest Florida Water Management District-Welis, Cypress Bayheads, Wetland Areas, Altering
Watercourses
- Army Corps of Engineers-Seawalls,Docks,Navigable Waterways.
- Department of Health & Rehabilitative ServiceslEnvironmental Heaith 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 wiil not adversely affect adjacent
properties. If use of fili 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: ILURE TO RECORD A NOTICE EMENT MAY RESULT IN YOUR
PAYING TWICE PROVEMEN O YOUR PROPERTY OU INTEND TO O AIN FINANCING,CONSULT
WITH YOU NDER AN ATTORN BEFORE REC ING YOUR NOT E OF C MENCEMENT.
FLORIDA T(F.S.117.0
OWN ORAGENT CONTRACTOR
Subs ' a affirmed)b re e this wor or affirmed)before me lhis
� i k � b
Wh is/a rsonal know o me or has/have produced Wh is! re pe y now o me or has ave produced
as identification. as identification
Notary Public Vl 0��J�.(J1 1���`w�X�c 7 Notary Public
Commission No. Commission No
Na Name of N
REBECCA ALDRIDGE �;��'P�,, REBECCA ALDRIDGE
``^PY'vV�i
`�•'� �'°` MY COMMISSION k EE 189904 °�'� �'= MY CDMMISSION 4 EE i89904
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= �r,s EXPIRES.April 16.2016 "„•,�,;o: EXPIRES:Apfil 16.2016
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e��-�eaoo2o City of Zephyfiills Permit Application he���-�'�t
Bulltllnp DeperlmeM
Dato Roeolvod 815 lSOB yDbo
_,_��, Phon�Con4e!fa P�rmltllno_
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Owno�s Namo 8obr�dor Invoatmonb Inc p�ri�or Phono Numbor
Owna�s/wtlross 38hbt CouMy Road 54,Zaphyrhilis 39542 ownor Pnona Numbor �� .
Foo Slmple T�tiahn�dsr Fpmy qwnsr Pf�On�NwnU�Y �
Fee slMpi�Tltlehold9r Atlaws6
.1oe ADDRESS 39�`�4 SOUth Avanua,Y�phyrhllle 39342 LOT M �
SUBONIStON PAItC8L1!!IF 13'Ze"z1�0010•00000-0Q10
toerNHeo Frtor�oram r�x Nor+oa
wORK PRpPOSEO NEw CONSfR AOD/AlT Q SIGN Q Q DEMOLISH
� INSTAl4 REPAIR
PROPO&80 USE [] SFR [] COMM � O�R
7YPE OF CONSYRUC710N � BLOCK � FRqM& 0 STEE� [] • �
DESCWPTION OF WORK Ins18U iow voll3go Ourglar alerm aacurlry sys�em
BUII.DIaG S�� � _ _ SQ FOQTA6E� HEIGH7 �
08UILDING i y,q�,U,qT10N Of'�OTAL CON�TRUCTION
[f]E6ECTRICA� S 199� AMp SE�tVICE [� PROGR68S 6NFRGY �f w.R.e.c.
QPLUM6ING S / 3�jZ �
Q�CMIANICAL f VALUATION OF MECHANI�AL INSTALLATION � (
QGAS Q ROOFINC, ['� SPECIALTY 0 QTHER
FIWISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO
BUILDER COMPANY
SIGNATURE Eoierertm Y/N PEE CURRE� Y 1 N
Addross Llcan:o f
E �Ak ��pp�� ARAMS,KEVIN DBn nOT LlC
Nq1'URg �<''c'r�r� Y!N �cuaRan Y/N
r„� Y1 w WATERB AVE,TAMPA 33634(SUIT61000) ��ge� EF20pp1D34
PLUMBER COMPANY
SIGNA7URE r+oo�nrWetlD Y/N Fee cuart�n /N
Addross IJCanas 1�
�cNaNicu c�Pan�r
SIGNATURB qEWB7EJaED Y! N M�ECIIRRE� fN
Addroae ucanao/ �
OTMER � COMpANY
$IGNATURE NEOaTE1tEO Y/ N FEE CupRE� Y/N
At10na UCenee�
iiii � � ii � i � � � r � � � � i � � iii � i � � � iii � ii � � ii � � � � � ii � < < � � � � � � � � � � t � tr � � � i
RESIpENTAL Attad�(nl PIa Pluns;(2?s��Ot Bufltlinp Plan�;(7�iet of Enorpy Fams;R•GW Prmilt Tor n�w conNructbn,
Mlnlmum tsn(10)worklrq daya aMr�u1�MN tlMa. Reqdnd onskn.Consaudlon PIb�6,Slormweler Pun�w!BIN Fonca Instullvd,
S+mUery FaoMUe�6 7 aiwnp�t�r;6ho Wo�C PwrMt fo�supdiN�lonwryo pro�acts
CpMMERCIAI. Putuch(3)canq�W wts o►BulWlnq Plans p�r�l.ik Safety P�pr;(7)est a Enarpy f ams.R-O-W Purtnll for new conswdlon.
Mlnknum ta�(10)waklnp deys rltar tuomNUl dMe. Roq�drod onsilr.Conawcuon Plant,3tomm�wtor Pkrm vrl SIN Furae Inetallea,
S�nNry FadMdea b 1�npn�ar.�Ite Work Parmlt for oll new v�ol����narclal nqukomonts muml m�x+t canpNaneo
SIGN PERMIT Anech(2►seu o(En0lneerod Plans,
•`•�PROPeRYY SuRVfY requlred tor all NEW constructlon.
olroctlons:� -- -
f1A aA:wPNrxlion o0mp�y
Ownar 6 Conuaclor�lOn baek of eppll�auon,nMarizod
if ovrr Sx600,a Nonce w'Commoncvmrnt ir reqWwd. (AIC upprados ovo�S�50o)
'" Ayunt(tor me contr�cta)w Pw�r of AlWrnay(�ar Ine owner�would be somcona wNh notarizatl lauer hom ohner aukhokciMl wme
OVflR THE COUNTER PERMIITING 1Front oi ApplMaUon Only)
Raroofi If aMnOM�s Sdw+►s Servia Uppr�des PJC Fencee fploU6urveylfool�fge)
Drw�w�yallot over Cnuntew Ii o�pubtic�oadways.,nurds ROW
60/Z0 3�Jdd 3�IIIa3S hlIafl�3S 1Qti 6S0L-908—ET8 bT�Ot ZZOZ/bT/Zi
NOTICE OF O��D I2ES7R1CTIONS; The und9rslgned understands that thib permlt may be subject to"deed"I'B&trlCtlons"
which may be more restrictive tha�Counry regulaUons. The undersigned as9umes r6spansihility for compllence wlth any
applicabi6 de9d ra�trieti�ons.
UNLICLNSLD CONTRACTORS AND CONYRAC7p�t RE3PONSIBiLITIES: If the owner has hired a contraCtor or
contracEors to undertBKe woMc,thdy rr►ay be requir�ed to be Iicens9d In accordancx with state and IoCal reg►�IaUons. If the
conUactor ie not licenced��requlred by law, both the owner and contractor may be cited for e misdemeanor violation
under state law. If Ihe owner or IMended contr�clor drb uneenaln as to what lioeneing rBqWPemerns may apply for the
ir�tended work,Ihey are advised to c�ntACt the Paseo County Bullding Inspection Givi�ion—Llr�nsing Section at 727-847-
8009, FuAhermore, if tfle oHmer has hired a conl�acbor or COntraCtocs, he is advised to Rave the eontrador(s) sign
portions af the"coMreCtO�91oCk"ot this application for whidt lhey will be responsible, If you, as the owner sign as the
Contractor,that may be an(ndiCdtlon that he is not properly Ncensed and IS not er�tlUed to permi�ing p�vllages in Pasco
County,
7RANSPORTATION IMPAC7/U7ILITIES IMPACT I0.ND RE50URCE RECOVERY FEES. The Undersigned understands
that TranapoRation Impact pees and Recourse Recovery F9es may apply to the wn�tnaction ot naw bulldinys,change of
use in axf��ng bulldings,or expar�sion of axfsdng bulldfngs,as specified i�P�sCO County Ordinance numbe�89-07�nd
90-07,as amendgd. 7h�undersigned alsfl�mde�sti�flds,ihat Such fees,es may be due,wlll be ideMified at the C�1e o(
permitting, It IS turlher understoad that TtanBportaUon Impact Fees a�d Rosouroo Ra�overy Fees must be paid prlpr to
rece�vinp a"certlAcate oi occupancy"or fln81 power release, If the pro�eCt doea not involve a certificate of occupancy or
finel pow9r release.the fees muut be pald prlpr tp permK issuanoe, PWthem�ore,if Pasco County WateNSower Impad
rees aro due,they musl be paid pAOr to permit lasuana in accord8nC9 with applicable Pasco Counyr ordlnarxxs.
CONSYRUCTION L.IEN I,AW(Chapter 7'1 g,Florlda Sbtutss,as amanded): If valuaGon Of w0�1c Ia 32,500.00 or more,I
cartffy that I, the applkBrN, h8vs bxn provided with a Copy of the "Floride CarutruCUOn Llen Law�Homeonmer's
Pratecli�Guide"pr�9pered by the Florida Department of P�gricullure and Consum�Af(81rs. I(the applicant i6 some�one
other than the"owno�',I CArtlfy that I have obteined e copy of the above desaibed doCUment and promise in good faiG1 to
deliver it to the"owner'prlOr to comme�cemer�t.
CONTRACTOR'S/OWNER'S ARFlDAVIT: I Gertlfy that all the intortnation in dtls appliCBtion is accurate and that�II work
wlll he da�e in compllanee wlth aN applicable law�regUleltr►p construction,zoning and land development Apppceqon Is
hereby made to obtaln a permit to do work antl In6taMaUdn as indicated, i eertlfy that no work or inst8118t1on h�
commenCed p�or to issuance ot a permit and that all work will be partomie�d to meet standaMs of all laws regulating
construcdon, County and Cily oodea, zoning r�gulauons, and land dbvebpment repulations in the Jurlsdlctlon. I also
certity dtat I understand that the regul�UOns of other govemment agenClez may apply to the iMended work,and that it ie
rtry responslbllhy to identiry what actions I must take to be in compllanee. Such ayenaes includ�but are not limited to:
- Departmer�of Environm�'►tal Protedion-Cypfess 62yheada,WcGand Areas 8nd EnvironmentaNy Sensltiv9
Lands,WetsrNV2stewater Treffimem,
- Southweat Florlda Water Management plsl��Ct Wells, Cypress 8ayneads, Wetland l�keab, Allering
Wstercoutses,
- Army Cofps of�nglneers•Seawa�ls,Dodcs,Navlgable Waterways.
- Departmer�t vf Health & Rehabilitative SeNlCesl�nvlronmeMal Heallh Unit-Wells, Wastewat�r Treatment,
Septic Tanks.
• US EnvirOnmental Protection AgerlCy-ASbestos abatement.
- Federal AvidGOn Authority-Runuvays.
I understand that th6 fONOwing resUictione apply lo tha use af fiIL•
• Use Cf RII IS not allowed in Flood XOne"V"unless expressiy parmltted,
• If the �1) matsrial is to be used In Flood Zorie "A", it IS understood that a tlPalnage plan eddresbing a
"epmpensatlnp volume"wiN b6 SUbmltted at time of pertnitting which is prepared by a professional enginebr
lioensed by the SteEe of Florlda.
- If the fill material is l0 bb used in Flood l.o�e"A"In connection with a permltteci building ubing stem w811
construclion,I caRify tllat flll wNl be used only to�II the aroa wdhin the etem wall.
- If fill materiel is to be used in any area, I oertMy that use af such Ap will not adversely attect �dJacern
properties, N use of 11�fs found to adversseiy af66d adjacent propeRles,ihe awr�er may be ated for vlolatlng
the conditions of G1e bulld�ng permit issued under the attached pertnit appllC2tfon,tor lots less than one(1}
acro which aro 9�evad3d by fill,an engineered dr�lnaga plan is roquired.
If I am the ACENT FOR Tti�OWNER,I promise In go0d falth to iMorm the owner of the per�tting c�ndfllOns Set forth in
thls�davit prior to Commendng construction, I understend that a separate pormit may be required for ebCWe�l work,
plumbing,signs,welis, pools, sir conditioni�, gas, or other installaiions not SpGcifically included I�the appllcatlon. A
permd iCSUba shall be canstrued to be a Ucense to proceed with the work and not as authority to vlpleee,cancel,alter,or
set aBide any provisions oi the tecftntCOl cOdes,nor shall issuan08 ot a permit provent the Bullding OTficlal fram thereafter
requktn8 a conection oi errors in plans,construction or violetions of�ny codes. Evary pem�lt Issued ahsq become i�valitl
unleSS the wotk authoriud by BuCh permit is commenced wi1nM s!x manths of permit i�6UanCe.or If wwk authorized by
th�pertnit is suspended Cf ab8ndoned for a period of blx(9)months after the Gme tMe work is commenced. An exp�nslon
may be requested, in wrlUng,from the 8uildir�g Otficidl(or a p�rlod nat ta excxed ninibry(9Q)days and wiN tlemonatrate
juSlMable cause ior the axtenSlOn. If wark ceases for nin8ty{90}cansecutive daye,!ne JOb Is considered abendoned.
WARNtNC�TO OWN�R: ILURE TO RECOIRD A N0710E ENT MAY li�$ULT IN YOUR
PAYING TWIC ROVEME O YOUR P�tOPERTY OU INY'L�N TO N FINANCING,CONSULT
VY Y AN TT B � RE R� IN YOUR N R �N EM T,
L . .11>.0'
owN OR AGfiNT ON7RACTOR
g � �thl� b w a �Q b�toro 1Ms
I m�or num.w produood d m�a n aw aoduoud
a�Wentlllcatlon. �s IduMIAckYen.
nb�ry auw�c ,,,�,�ft.e �4 nlo�on P�w��
Cuerve��a+No. Commissbn No,
� NphiB 01 N
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City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: �'�
Date Received: �l - ��� Z
Site: �39Z5 � S�t� �
-T—
Permit Type: �� v� '��.
Approved w/no comments: Approved w/the below comments: ❑ Denied w/the below comments: ❑
This comment sheet shall be kept with the permit and/or plans.
� �
alvin zer-Plans Examiner Date Contractor and/or Homeowner
(Required when comments are present)
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