HomeMy WebLinkAbout13-14532 , ' CITY OF ZEPHYRHILLS
5335-8TH STREET ��
�si3)�so-oo20 �4532
BUILDING PERMIT
Permit Number: 14532 Address: 5747 6TH ST
Permit Type: COMMERCIAL ZEPHYRHILLS, FL.
Class of Work: ADD/ALT COMMERCIAL Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number: 11-26-21-0010-01100-0110
Improv. Cost: 1,750.00
Date Issued: 9/11/2013 Name: MILLER LEE WILLIAM III& ERICA
Total Fees: 152.50 Address: 5747 6TH ST
Amount Paid: 152.50 ZEPHYRHILLS, F'L. 33542
Date Paid: 9/11/2013 Phone: 813-997-3872
Work Desc: RENOVATION INTERIOR ONLY FOR HAIR SALON
7.5 . .
CARLYLE ELECTRIC FIRE PLAN REVIEW FEES 25.00
I
�n
,� 0 l
� ' ��
--,
� � ¢��o�
�
FOOTER BOND DUCTS INSULATED SEWER MISC._
ROUGH ELECTRIC LINTEL MISC MISC.
1ST ROUGH PLUMB PRE-METER INSULATION WALL MISC.
DUCTS INSTALLED WATER MISC DRIVEWAY
PRE-SLAB SHEATHING MISC. MISC.
CONSTRUCTION POLE FRAME MISC. MISC.
REINSPECTION �EES: 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 resulting
from faulty construction c) repairs or corrections not made when inspections called d)work not ready for
inspection when called �) permit not posted on job site� 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 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 Acxompany Application.All work shall be performed in accordance with
Ci Codes and Ordinances. NO OCCUPANCY BEFO C.O.
' � „
�
ONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
C�TY OF / / / / BUILDINa
ZEPNYRHILLS �EPARTMENT
OF ADDITION OR CORRECTION
� • • - •
ADDRESS ��� DATE PERMIT,�,
� �—� � �T- ��z� 'L�t� � `f;3�z
THIS JOB HAS NOT BEEN COMPLETED. The following additions or corrections shall be made before the iob
will be occepted.
, L��-- ►� �' , -_, �� -� � c� N�T � IJ J�-pr�-�--
�.,��N, = �v�,,��;�.J�
� ��� (L � C n � j'L� �1� o c 'C't�l t��1 (.21�T�'`P �j '�T.�WI .
� � �� = GTt� C'� �r�(r r, � �' h, t=�
� ��J � �� 5 � ���z�
It is unlawful tor any Carpenter,co�c�aa,s���de�,or other persons,co AFTER CORRECTIONS ARE MADE CALL
cover or cause to be covered,any part of the wotk with flooring,�ath,earth 780-0 0 FOR RE-INSPECTION
or other material,until the proper inspector has had ample time to approve
the installation. f ,��,
lJ
OFFICE HOURS 7 30AM-4 30 PM MON-FRI INSPECTOR
813-/tlU-UULU C;iry ot Zephyrhilis Permit Application Fax-813-780-0021
Building Department
Date Received — / 3 Phone Contact for Pennittin --
Owner's Name ����,�\�� L. '(1i1� �`-E'(^ '�"t�-:r 1��t. Owner Phone Number "- �"'
Owner's Address � � � (
�1 1 rt�c� Owner Phon ber '� ��`���(p�
Fee Stmple Titleholder Name Owner one Nu ---``
Fee Simple Titleholder Addreaa
JOB ADDRESS ��LI�� �� ��C���' ] LOT# ��
SUBDIVISION PARCEL ID# � I —o� (�-�N ""(�Q�}�—C����L�l
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED B NEW CONSTR 8 ADD/ALT [� SIGN Q [� DEMOLISH
INSTALL REPAIR
IPROPOSED USE Q SFR Q COMM Q OTHER �
TYPE OF CONSTRUCTION Q BLOCK Q FRAME � ST�EL Q
DESCRIPTION OF WORK �� �IQ � (�1 1 ��O'� �� �
BUILDING SIZE 3Q FOOTAGE C� HEIGHT ��
QBUILDING 3 � VALUATION OF TOTAL CONSTRUCTION
QELECTRICAL $ ��U_ AMP SERVICE �] PROGRESS ENERGY Q W.R.E.C.
QPLUMBING $ �
�.� - ► �"l�c��c��
QMECHANICAL $ �_ VALUATiON OF MECHANICAL INSTALLATION ���?,"1/
�I !
QGAS Q ROOFING Q SPECIALTY Q OTHER � '
FINISHED FLOOR ELEVATIONS FL O ZONE AREA QYES �(�� � �
�__
BUILDER � OMPANY (,�✓���
SIGNATURE REGISTERED Y/ N PEE CURRE� Y/N
Address �' License# C —�
ELECTRICIAN � COMPANY �CGC�
SIGNATURE • REGISTERED Y/ FEE CURRE� Y/N
Address • License# C �
PLUMBER COMPANY �
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# C
MECHANICAL � COMPANY
SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
Address License# C
OTHER COMPANY
SIGNATURE REGISTERED Y/ N FEE CURREP Y/N
Address License# C
RESIDENTIAL Attach(2)Plot Plans;{2)sets of Building Pians;(1)set of Energy Fortns;R-O-W Permit for new construction,
Minimum ten(10)working days aRer submittal date. Requfred onsite,Construction Plans.Stormwater Plans w/Silt Fence installed,
Sanitary Fadlitles 8 1 dumpster;Site Work Permit for subdivisionsAarge pro)ects
COMMERCIAL Attach(3)complete sets of Buflding Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new constructfon.
Minimum ten(10)working days aiter submittal date. Required onsite,Construction Pians,Stormwater Plans w/Silt Fence installed,
Sanitary Facilities 8�1 dumpster.Site Work Permit for all new projects.AII commercial requirements must meet compliance
SIGN PERMIT Attach(2)sets of Engineered Plans.
""PROPERTY SURVEY requlred for all NEW construction.
Directions:
Fill out application compietely.
Owner R Contractor sign back o(appHcation,notarized
If over 52500,a Notice oi Commencement is required. (A/C upgradea 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 AppUcatlon 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 A►ND 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 wili 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 buildi�gs, 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 unde�stood that Transportation �mpact Fees and Resource Recovery Fees must be paid prior to
receiving a "ce�tificate of occupancy" or final power release. If the project does not invoive 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.
CONSTRUCTtON 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 constructio�, 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 timited to:
- Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, WaterNVastewater Treatment.
- Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
- Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
- Department of Health 8 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 expressty 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
prope�ties. If use of�II is found to adversely affect adjacent prope�ties, 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 j
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 invatid
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 IIV YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN INANCING, CONSUL7
WI7H YO R LEND R AN ATT NEY BEFORE RECORDING YOU OTIC F E Y.
FLORIDA JURAT(F.S,_1,7.@3) �' �_ ! .i
. � � , '.
OWNER OR AGEN �� CONTRACTOR ' � �
�ubsc�ibed and swo (o ed) for me this S bscr�i4ed and � n t or�flirmed)b for m�h is� I
-y-l_3 by ' Y-/� by �\ ( Vl( 1'F'
�islare personally known to me or ave produced Who Is/are per�na own to me or h ave produced
/, �r,l.e.r L-�CI�-- as IdenBfication. i�L L�r�v��� :�[���-- as identlfication.
�� � '� ,
,' ��� � `' � Notary Public
Notary Public
r :;. �QUELIN @p� '= �,�
Com I • ' �� � Comm ssi ,
�a1t�� •�an�n,r�er'emb��2,201 kJ '-�` �"' �ssiWl#EE ES
Name of Notary type , �•��'�. Name of d, �m��2,20i4
�oo-aasao�s
A. U.S.DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT � B. T'YPE OF LOAN
SETTLEMENT STATEMENT
Sunstate Title Agency�jllC. 1 �FHA 2 [JFMHA 3 �X�CONV UNWS
13937 7th Street a. �vn s �coNV iNs
Dade City,Florida 33525 _ __ __
352-567-1141 fax:352-567-3830 6 FdeNumbv i�o,�Numx�
S-29661
6 Mongege Ins Cau 40 '--- - ---- --
C NOTE. Thes jorm is jurnished to give you a statement oJactua/settlement costs.Amountr paid to and 6y the sert/ement agent are sl�own /tems marked
(poc)were paid outside the clasing. They are shown here jor injormaaonal purposes and are not inclu<fed in�he totals
D Borrower WILLIAM LEE MII.LER,III and ERICA J MILLER
E.Seller PETER JOHN PiJLEO,Individually and as Sole Trustee of the PLJLEO FAMILY REVOCABLE LIVING
TRUST,dated July 4,2003,as amended on August 7,2007,and as amended on March 24,2010
SAN ANTONIO CITIZENS FEDERAL CREDIT iTNION
F Lender 7301 GALL BOULEVARD
ZEPHYRHII,LS,Florida 33541
5747 6th St.
G Property� Zephyrhills,Pasco Counry,Florida 33542
Section 11,Township 26,Range 21,Lot 11&12,B►ock 11,CITY OF"I.EPHYRHILLS(formerly Town of
Zephyrhills),Book 1,Page 54,Pasco Counry,Florida
H.Settlement Agent: Sunstate Title Agency,Inc.
Place of Settlement: 13937 7th Street,Dade City,Florida 33525 Pasco County
I.Settlement Date: July 31,2013
J. Summary of Borrower's Transaction K. Summary of Seller's Transaction
100.Gross Amount Due From Barrower: 400.Gross Amount Due'Y'o Seller:
101 Contract Sales Price 97,500.00 401 Contract Sales Price 97,SOOAO
]02. Personal Property 402. Personal Pro erty _________
103. Settlement Charges to Borrower(line 1400) 4,636.06 403 _ _ _
104. 404
105 405
Ad'ustments for Items Paid b Seller in Advance: Ad'ustments for Items Paid by Seller in Advance:
106. City/Town Taxes 406. City/Town Taxes ____ _ _ __
107 County/Parish Ta�ces 407 Coun /Parish Taxes __ _
108. Assessments 408. Assessments
109 409
--- ----- -- — - --- ---- -
110. 410.
120. Gross Amount Due from Borrower: 102,136.06 420. Gross Amount Due to 5eller: __ _ _ 97,500.00
200. Amounts Paid b or in Behalf ot Borrawer: 500. Reductions in Amonnt Due to Seller:
201 Deposit/Eamest Money 1,000.00 501 Excess De osit(see instructions) _
202. Principal Amount of New Loan 78,000.00 502. Settlement Cha es to Seller(Line 1400) _ 7,503 13
203 Existing Loan(s) 503 Existin Loan(s) _ __
204 Appraisal Credit 1,250.00 504 Pa off of First Mortgage _ __ _ ___ _
205 505 Payoff of Second Mortgage _ ____ ___ _
206. 506. Purchase Mone MoRgage _ _ _
Adjustments for Items Un aid b Seller: Ad'ustments for Iteros Unpaid by Seller: _
210 City/Town Taxes 510. City/Town Ta�ces __
21� Counry/Parish Taxes Jan 1,2013 thru Jul 30, �qZ,55 511 County/Parish Taxes Jan l,2013 thru Jul 30, �g2.55
2013 2013 ---__——--__ __-
212. Assessments 512. Assessments
213. Credit to Buyer for Closing Costs 5,000.00 513. Credit to Bu er for Closing Costs _ _ _5,000.00_
214 514
220. Total Paid b /for Borrower: 86 042.55 520. Total Reductions in Amount Due Seller: 13,295.68
300. Cash at Settlement from/to Borrower: 600. Cash at Settlement to/from Seller:
301 Gross Amount due from Borrower(line 120) 102,136.06 601 Gross Amount due to Seller(line 420) _____ 97,500 00
302. Less Amount Paid by/for Borrower(line 220) 86,042.55 602. �O�Reductions Amount due Seller(►ine L 3,295.68
303. Cash From Borrower: $16,093.51 603. Cash To Seller: 584,204.32
HUD-1 May 2007 OMB No.2502-0265
July 31,2013 12:10 PM RESPA handbook 4305.2
Settlement Date:July 31,2013 File Number S-29667
L• Settlement Charges -
700. Total Sales/Broker's Commission: Paid from Paid from
Based on Price $97,500.00 @ 6.00% _ $5,850.00 Borrower's Seller's
Division of Commission as follows Funds at Funds at
701. 2,925.00 to COLDWELL BANKER/PENCY OWENS REALTY SetUement Settlement
702. 2,925.00 to PRUDENTIAL TROPICAL REALT'Y
703 Commission Paid at SetUement 5,850.00
704 Transact�on Fee to PRUDENTIAL TROPICAL REALTY 325.00
800. Items Payable in ConnecHon with Loan:
801. Loan Fee to SAN ANTONIO CITIZENS FEDERAL CREDIT iJNION 750.00
802. Doc Prep Fee to SAN ANTOHIO CITIZENS FEDERAL CREDIT iJNION 350.00
803. Appraisal Fee to PRICE APPRAISAL GROUP 1,250.00
804. Env�ronmental Fee to SAN ANI'ONIO CTTIZENS FEDERAL CREDIT iJNION 150.00
805 Flood Cert Fee to SAN ANTONIO CITIZENS FEDERAL CREDTT iINION 18.00
806.
807.
900. Items Required by Lender to be Paid in Advance:
901 Daily interest-NONE
902. MoRgage Insurance Premium
903. Hazard Insurance Premium
904. Flood Insurance Premium
905 Winstorm Insutance
1000. Reserves Deposited with Lender:
1001 Hazard Insurance
1002. Mortgage Insurance
1003 City Property Taxes
1004. County Property Taxes
1005 Annual Assessmenu
1006. Flood Insurance
1007. Windstorm Insurance
1100. Title Charges:
1101 Settlement or Closing Fee to Sunstate Title Agency Inc. 425.00 400.00
1102. Abstract or Title Search
1103 Title Examinarion
1104 Title Insurance Binder
1105 Document Prepararion
1106. Notary Fees
1107 Attorney Fees
(includes above item numbers:
1108. Title Insurance to Sunstate Tide Agency,Inc. 25.00 560.63
(includes above item numbers:
1109 Lende�'s 7g,000.00 Risk Rate Premium: $25.00
Coverage
1110. �er's 97,500.00 Risk Rate Premium: $560.63
Coverage
1111 Endorsement 6(RR$25) 35.00
1112. Endorsement 8.1(RR$25) 35.00
1 I 13 Endorsement FL Form 9 58.56
1200. Government Recordin�and Transfer Charges:
1201 Recording Fees: Deed 18.50 Mortgage 86.50 Releases 0.00 105.00
1202. City/County Tax/Stamps: Deed 0.00 Mortgage 0.00
1203 State Taac/Stamps: Deed 682.50 Mortgage 2'73.00 273.00 682.50
1204 Intangible Tax to Clerk of the Circuit Court
1205 Record Assignment of Rents to Clerk of the Circuit Court 86.50
1206. Record Trust Affidavit to Clerk of the Circuit Court 10.00
1300. Additional SetUement Charges:
1301 Survey to AFN Consulting,Inc. 400.00
1302. Pest Inspection to Boltin Pest Conuol 65.00
1303 Home Inspection to Accucheck Home Inspecrion Service 285.00
1400. Total Settlement Charges(Enter on line 103,Section J and line 502,Section I� $4,636.06 $7,503.13
I have carefully reviewed the FICTD-1 Settlement Statement and to tite bes[of my Imowledge and belief,it is a trve and accurate statement of all receipts and
disbursements made on my account or by me in this transa�I further ceRify that I have received a co Of HL1L)-1 Settlement Statement.
/ � / �
�
Borrower: � � � l - Seller: ` '�` �6�
IAM LEE MILLE III PETER JOHN P E
.
Borro er: "
J .LER
The HU ement Statement wtu I nve repared is a We and accura[e accoun[of this transactioa I have caused or will cause the funds to be disbursed in
accordance wi[h[his s[atement.
Settlement Agenr. Date: July 31,2013
SUNSTATE TITLE
WARNING: It is a crime to]mowingly make false sta[emenis[o the United S[ates on this or any other similar fortn.Penalhes upon convicfion can include a fine or
imprisonment For details see:Title 18 U.S.Code Section]001 and Section 1010.
HUD-1 May 2007 OMB No.2502-0265
July 31,2013 12:10 PM RESPA handbook 4305.2
-�
�
�. .a.a.� -. _ � ' , �
I
, � ;�-�----`—_
�- �
�
, � �. -- �
�
� .
�
si�JL�fvcl7 iL.�r f�t_A!'tii(S) �AVL di:El4 ��_r,f..ti.� , ;
'�< �" � f-3YRHILLS FtRE��IA.RS!-IAL 5 f"�FFIC�� t {
vZ .- -
1 c
�)�tP�' '.l�t__ -----�— i . . --
�!"`MrPFVK _�.__ �..�.v_�� ----- - - � .
i
i �
! � �,
1
- �-� d ��t�
` � 4 ,` -- . �,�,.i i
�
s
r �
t ' �, � —-- �
`
\` � ,��w�:.:.w___ �2,f
� �'4 --- - -- -- -' ' - -�.. ...>_._A
Gf
� ?� - i
r
w �f "'�=���&��'1-fi._j �` �
�`3 ) ;1 f`}'`��i{ ���� ,l(� '`
� �` f y� �d'i:.i.� _1 7 �.,
j � � ��.i <<
� t 1 � � - '4,' t i� f
�� ��'_��i�-`'J_
a . _ . .._ ._ _' _ ,�..,.e—..,
� •t' -•
I j
�.. R ` �
_� �. �{
�� , ` r�,
� �+'ii.\t ;�lllci�l � I ;ii;��.i(�c;�. .;( , ,
C��\1':1QO � �12?I.1,_. '� +.�.J� . ,
� ���'�(11I , L� f� '�I)l.[`, `� _? 1
� t ll�lii c . i'�i�� � �� � �11�,j �
1 � 1 'ti�����t,; ;?\11I, 1�i.'
� i`� '; , i�; ,l; , 1 n )i: � �i I '';'
� �
l � �
� , , �,
�-- i
L.!� '
, ' �,,�.
� � S;
;
f.
�
` '� � .'�
City of Zephyrhills
BUILDING PLAN REVIEW COMMENTS
Contractor/Homeowner: }�`�� ` l� �� � �r-+ �-�' �� I ��£'r
Date Received: C� -- � -°- � <�j
Site: "� �S �
Permit Type: C�--�'1't�rti G T �'E�"��CC� ,
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.
�"�,�-'�1
Kalv� Switze lans Examiner Date Contractor and/ar Homeowner
(Required when comments are present)