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PERMIT APPLICATIONBP200101 CITY OF BOYNTON BF2%CH 8/24/01 Application Inquiry 11:12:56 Application number ..... : 98 00002352 Application status, date : APPROVED 5/29/98 Property .......... : 2301 NW 2ND ST PCN ............. : 08-43-45-16-01-021-0410 Lot Number ......... : Zoning ........... : RI SINGLE FAMILY (7.26) Application type ...... : PD PAVING Application date ...... : 5/29/98 Tenant nbr, name ...... : WIDEN DRIVEWAY Master plan nbr, revwd by : LAH Estimated valuation .... : 1440 Total square footage .... : 0 Public building ...... : NO Work description, qty . . . : Pin number ......... : 6899 Press Enter to continue. F3=Exit F5=Land inq F7=Appl names F8=Tracking inq F9=Bond inquiry F10=Fees F11=Receipts F12=Cancel F13=Val calcs F24=More keys  D~P;~'~{ ~ C.F D]~-~,-]~LOp~~I'~ BUIT.~-)I~--(~ DIVISION BUI~ING P~T ~PLI~TION (Please Print) Pe~it ~ (FOR ~ P~ITS O~Y) PCN % (Palm Beach Cou~ Pro~y Con~1%) o~er's N~e (~~ ~~~',~ O~er's Phone % O~er'~address ~]/ ~; ~~ City ~/~)~J ~~ - - State / ~ C - Zip. Fee Simple Titleholder's N~e (If other than o~er) Fee Simple Titleholder's Address~ , ~~/~ ~~o~e than o Contractor's N~e /' ~~ 's ontractor Phone Contractor's Address ~~ ~/~ ~ ' Job Name ~ .: Job Addre City. Legal Desc .ption "-- Bonding Company. ~" Bonding Co. Address City. Architect/Engineer' s N~e Architect/Engineer' s Address Mortgage Lender' s N~e Mortgage Lender ' s Address SINGLE F~ILY:__ DUPLEX: ~LTI-F~ILY:__ HOTEL: ~TAIL: OFFICE:__ I~USTRI~: (check one) DESCRiPTiON OF WO~: ~' ~~. Application is hereby made to obtain a pe~it to do the work and installations as indicated. I certify that no work or installation has co~enced prior to the issu~ce of a pe~it and that all work will be perfo~ed to meet the standards of all laws re~latin~ construction in this jurisdiction. I underst~d that a separate pe~it must be secured for ELECTRIC~ WORK, PL~BING, SIGNS, ~LLS, POOLS, FU~ACES, BOILERS, H~TERS, T~S, ~d AIR CO~ITIONERS, ETC. O~ER'S AFFIDAVIT: I certify that all the fore~oin~ info~tion is accurate ~d that all' work will be done in compliance with all applicable laws re~latin~ construction and zoning. W~ING ~ O~: YO~ FAIL~ ~ ~CO~ A N~ICE OF CO~C~ ~Y ~T IN YO~ PAYING ~CE FOR I~RO~S ~ YO~ PROP~. IF YOU ~ ~ OBT~ F~C~, CON~T ~ YO~ L~ OR ~ A~~ B~O~ ~CO~G YO~ N~ICE OF CO~C~. Property ~er' s or ~t's Si~t~e Date STATE OF FLORIDA, CO~ OF P~ B~CH The fore~oin~ instr~ent was ac~owled~ed before me this (date) by , who is personally ~o~ to me or who has produced (t~e of identification) as identification ~d who did (did not) take an oath. (S~n) Signature of person takin~ ac~owled~ent N~e of officer takin~ ac~owled~ement--t~ed, printed or st~ed Title or rank _ _ __ ~; ~Se~al~er, if any . D~g~ ,' ~rm~Qin~jn~r~ent' was ac~oW%edged before me this ~ ~ /~ (date) by ;~/~.//~~ ~ , wh~is persona~ly ~o~ to me or ~o has produced - ~t~>, ~om%~o~9~m~dentificati~) as identifi~tion and wh~ ~t) take an oath. ,~~ .~c · - ,7 ~7 // /~ //' Signature son taking ac~owled~emen~)~ ~ Name of officer taking ac~owledgement--t~d, printed or st~ed ( ~/~ ~ Title or rank Serial n~er, if any , (Certificate of Competency Ho~de~)/ %' ~. Contractor s State Certification or Registration No. (~~ %~ cOntractor's Certificate of Competency No/ ~O~ ~ wo~m~s' CO~mNS~W~ON ZX~W~ON O~W~: ~/~7 ~ ~ APPLICATION APPROVED B~f~.g~.',---//~J~ Permit Officer '~ate: .~' ~y change in building plans or specifications must be recorded wi~ this office. ~y work not covered above must have a valid pe~it prior to starting. In consideration of the granting of this pe~it, the o~e= and builder agree to erect this structure in full compliance with the Building and Zoning Codes of the City of Boston Beach. NOTE: This permit VOID after 180 DAYS ~LESS the work which it covers has been co~enced. All Contractors must have valid State Certification or County Competency plus County ~d City Occupational Licenses prior to obtaining pe~it. ISSU~CE OF THIS PE~IT DOES NOT AUTHORIZE VIOLATION OF DEED RESTRICTIONS THIS PE~IT OR P~S FILING FEE IS NOT ~F~LE (THIS SIDE FOR OFFICE USE ONLY) Application # Master Plan $ APPLICATION DATE: RECEIVED BY: SETBACKS: LEFT RIGHT FRONT REAR ZONE: ROAD IMPACT FEE TYPE OF CONSTRUCTION SEWER FEE OCCUPANCY TYPE WATER FEE ROOF TYPE .PARKS FEE FENCE TYPE SCHOOL FEE AREA SQUARE FEET PUBLIC BLDG. FEE FLOOD ZONE LAW ENFORCEMENT FEE BASE FLOOD ELEVATION RADON FEE FINISH FLOOR ELEVATION BCAIF NUMBER OF STORIES ADDITIONAL FEE NUMBER OF UNITS PENALTY FEE PARKING SPACES.REQUIRED PARKING SPACES PROVIDED. SUB-TOTAL # OF BEDROOMS # OF BATHROOMS SINGLE FEE __Site Impr. __Building __Electrical __~echanical __Plumbing REMARKS: Roofing Drainage __.Excavation __.Landscaping Paving Sign Sewer SUB-TOTAL LESS PLAN FILING FEE REOUIREMENTS FOR CERTIFICATE OF OCCUPANC~ TOTAL AMOUNT DUE -~-/ CERTIFICATE OF COMPLETION__ RECEIPT NUMBER I~(~~ __.SITE FINAL ,SIGN FINAL DATE PERMIT ISSUED __FIRE FINAL OTHER INTERIM SERVICES FEE CALCULATIQ~$ __PAVING FINAL ,OTHER Residential: X = __DRAINAGE FINAL # of units applicable Interim monthly fee Services Fee __?ENCE/BUFFER WALL FINAL Commercial: __.SITE LIGHTING FINAL .divided by 1,000 = # of sq.ft. (rounded to base sq. nearest tenth) ft. rate C.O. OR C.C. AUTHORIZATION X = base sq.ft, applicable Interim Signature Date rate monthly fee Services Fee A:PE~/~lTAP.WPL-2/92, rev.7/93, 4/95-bh