PERMIT APPLICATIONBP200101
CITY OF BOYNTON BEACH
Application Inquiry
9/27/01
14:31:30
Application number ..... : 01 00002298
Application status, date : FINALED
Property ......... : 141 COMMERCE RD
PCN ............. : 08-43-45-09-21-002-0060
Lot Number ......... :
6/13/01
Zoning ........... : PID PLANNED INDUSTRIAL DEV.
Application type ...... : IG IRRIGATION SYSTEM
Application date ...... : 6/05/01
Tenant nbr, name ...... :
Master plan nbr, revwd by :
Estimated valuation .... :
Total square footage .... :
Public building ...... : NO
Work description, qty . . . :
Pin number ......... : 2289
PUMP & WELL EXISTING
WE
1850
0
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BUILDING DIVISION
BUILDING PERMIT APPLICATION
(Please Print)
Permit #
(FOI{ SUB PERMITS ONLY)
(, ,.,Ira Beach County PropeMy Control #)
Owner's Name r~f6. c_,~s' (3' ~lapJw owner's Phone #
Owner's A~dress /~ ]' ~O~~~ ~
City -~~ ~~ -'~ State ~b~ Zip
Fee Smmpl~ ~'~ '~ol~er's ~a~n~ ~ ~ (If other than owner's)
Fee Simple Title Holder's Address (l~olher than owner's)
Conlraclor'sName ~ ~o,~o ~. Contractor's Phone ~ ~~
Project Manager and em~ergency ph~e ~ ~ ~ (~ {~ ~
Contractor's Address ~ ~ [~ ~ ~o~ Beeper/Fax~" _ ......
City ~~ ~~- _ - --~ '-[ State ~_ Zip ~y~ .
Job Name ' ( .... ~. (~- h. ~(~' __ '~ --
JobAddress /~i- ~~q_c~ ~ ~~ -~
Bonding Company . . , ~ ,-,....,.~
Bonding Co, Address City ~~ ~ate
ArchitecUEngineer's Name
Architec~engineer's Address HOTEL
Mortgage Lender's Name
Mo~gage Lender's Address
SINGLE F~ILY DUPLEX MULTI-FAMILY
o..)
DE~RIPTION OF WORK:
A~plication ~ here~y required t~bt~in~ Permi~to do work and installations as indicated. I.ce~i~ that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all codes, laws, rules and
regulations governing construction in this jurisdiction. I understand that a sepa[ale permit must be secured for ELECTRICAL, PLUMBING,
SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEArERS, TANKS AND AIR CONDITIONING WORK, ETC.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
codes, laws, rules and regulations governing construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A ~TICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING ~ICE FOR IMPROVEMENTS TO YOU~P~IF YOU INTEND TO OBTAIN FINANCING, CONSULT
Prope.y Owner's or Agent's Signature/']~'~ ~~~ Dale
STATE OF FLORIDA, COUNTY OF PALM BEACil
'Hm foregoing i,,s~,,,e,R ~s acknowledged belbre ,nc this ~u~ ~ ~ ~ 0o ~ (,mate) hy ~ k r ;S
who is ~~''a~--~=~=-~d ...... ~ as idenfilicalion ~d who did (did not)
lake asa~ TOM DELLS
'SEAL) ~ l~ EXPfRES MAY 06, 2~3 ~ ,
~. I . ~ ~?~/ BONDED THROUGH U ~ ~ ~ '
5~gnatureofpcr~~k.n.~~8~ E ~ {~ ~ Name of officer faking acknowledgement - typ¢~
pnnted or ~ampcd To ~ ~3~ ...... ~an~ ~ .... ~ Serial Number, if any
Contractor's Signature ~~~~ Date
STATE OF FLO~DA, COUNT LM BEACi I
Thc foregoing ~stmlnent was ac~owlcdgcd before me this ~o ~ q'~ Z~ (date) by ~~
WhO Is ~llall~ a~to m= or wnu nas Drounccu ~ as identificalioa and who did (did no~
~ ~i?~L~~ ~x~s ~AX 0~. 2~ ~
{SEAL) ~ ~) BONDtD THROUGH
~gnalureo~ per~~-~--~-~ ........ ~ ~ ~ Nnmc or o[ficer hiking acknowl~genmnt - type(
printed or stamped ~ ~[ Tillc or rank ~~ Scrim Number, ffany
(Cedificate of Competency Holder)
Contractor's State Ce~iScation of Registration No.
Liability Insurance Expiration Date .~~..~
Workers' Compensation Expiration ~at~
Application Approved By ~ ~~ "~it Of~cer Date: ~/~/~
Any change in building plans or specifications must be recorded with this office. Any work not covered above must have a valid permit prior
to sta~ing. In consideration of granting this permit, the owner and builder agree to erect this structure in full compliance with the Building
and Zoning Codes of the City of Boynton Beach.
NOTE: This permit VOID after 180 DAYS UNLESS the work which it covers has commenced. All Contractors must have
valid State Ce~ification or County Compelency plus County and City Occupational Licenses prior lo obtaining pe~it.
ISSUANCE OF THIS PERMIT DOES NOT AUTHORIZE VIOLATION OF DEED RESTRICTIONS
FEES ARE NOT REFUNDABLE
",".liT ,',1'1'1 I('A'I
Application #
Master Plan #
SETBACKS:
ZONE:
LEFT
RIGHT
APPLICATION DATE:
RECEIVED BY:
FRONT
REAR
TYPE OF CONSTRUCTION
OCCUPANCY TYPE
ROOF TYPE
F ,ENCE TYPE
AREA SQUARE FEET
FLOOD ZONE
BASE FLOOD ELEVATION
FINISH FLOOR ELEVATION
NUMBER OF STORIES
NUMBER OF UNITS
PARKING SPACES REQUIRED
PARKING SPACES .~ROVIDED
# OF BEDROOMS
# OF BATHROOM~"
ROAD IMPACT FEE
SEWER FEE
WATER FEE
PARKS FEE
SCHOOL FEE
PUBLIC BLDG. FEE
LAW ENFORCEMENT FEE
RADON FEE
BCAIF
ADDITIONAl. FEE
PENALTY FEE
SUB-TOI'AL
REMARKS:
REQUIREMENTS for
CERTIFICATE OF OCCUPANCY
CERTIFICATE OF COMPLETION
FINALS:
SITE SIGN
FIRE FENCE/BUFFER WALL
DRAINAGE
PAVING OTHER
SITE LIGHTING OTHER
AUTHORIZATION for CERTIFICATE OF OCCUPANCY:
Date
AUTHORIZATION for CERTIFICATE OF COMPLETION:
Date
SINGLE FEE
Site Improve.
Building
Electrical
Mechanical
"~ Plumbing
Roofing
Drainage
Excavation
Landscaping
Paving
Sign
Sewer
SUBTOTAL
VALUATION
TOTAL
LESS PLAN FILING FEE
TOTAL AMOUNT DUE
DATE ISSUED
INTERIM SERVICES FEE CALCULATIONS:
Residential:
X =
# of Unils Applicable
Monlhly Fee
Commercial:
# of Sq. Ft
Base Sq. FI
FEE
Interim
Services Fee
Divided by 1,000 =
(rounded to Base Sq, Ft
Nearest tenth) Rale
X
Applicable Interim
Monthly Fee Services Fee
Revised 6/18/97, $114197