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PERMIT APPLICATIONBP200101 CITY OF BOYNTON BEACH Application Inquiry 10/23/02 12:30:29 Application number ..... : 02 00003199 Application status, date : CERTIFICATE ISSUED Property .......... : 801 N CONGRESS AVE 483 PCN ............. : 08-43-45-19-05-015-0010 Lot Number ......... : 10/23/02 Zoning ........... : C3 COMMUNITY COMMERCIAL Application type ...... : WL WALL Application date ...... : 8/16/02 Tenant nbr, name ...... : Master plan nbr, revwd by : Estimated valuation .... : Total square footage .... : Public building ...... : NO Work description, qty . . . : Pin number ......... : 3270 FIRE WALL & DOORS JP 15000 0 Press Enter to continue. F3=Exit F5=Land inq F10=Fees F11=Receipts F7=Appl names F12=Cancel F8=Tracking inq F13=Val calcs F9=Bond inquiry F24=More keys DEPARTMENT OF DEVELOPMENT BUILDING DIVISION BUILDING PERMIT APPLICATION Original Permit # Project Name: ,,,-/-~r~. Project Address: 02- - 02-3J 99 Master Permit# Contractor's Name: A. CO,~ &~,'Z4/C/7~),~J ~Contmcter's Phone #~ Total Estimated Value of this Revision $ ~', ~)O .--- Description of Work: (Please specify in detail what is being revised from orfginal permit.) Building: r--Z~ / /?Loc/~_ ~//rz~.~-D .~cf~C4_ VaiueofWork:$ Electrical: Value of Work: $ Fire Sprinkler: Value of Work: $ Irrigation: Value of Work: $ Mechanical: Value of Work: $ Plumbing: Roofing: Value of Work: $ Value of Work: $ Sign: Value of Work: $ Site Lighting: Value of Work: $ Clearing & Grubbing: Paving/Drainage: Value of Work: $ ..... ,~ ..~ Value of Work: $ Fill/Excavation: FiLE ~,U!! ??,!~ .r)!V~.r~'.~" of Work: $ Landscaping: Value of Work: $ ,wish to revise the above referenced permit t~//~ 3rm ,he/~'~e~b~herein., certify that afl work will be constructed in conformance with all laws, codes, regulations, rules, etc. govemin~ I~ ton B,~h, ar~ I ~ that the above information is true and correct. Contractor's Signature . /f )/'~/ ~ Date: ~:L--~"~-~"~. -r^-rE f o.,o · B ,c2/ / acknowledged before me this ~ { ~:J - ........ - , __ ( ) ~~.~ MY COMMISSION # DDO46'L'v ! --.---.--...- Name of offic..er..~~c, lcl~e~nt typed~ Title or ran,,~' ~--'~¢"¢'~-~~ Application al~ed by __-- ~ Date Permit Officer '-'/ ISSUANCE OF THIS PERMIT DOES NOT AUTHORIZ~ VlQLATION OF DEED RESTRICTIONS FEES ARE NOT REFUNDABLE Original Permit # PCN (For Office Use Only) Application Accepted By: Master Permit # (Palm Beach County Property Control #) Type of Construction Occupancy Type Fence Type Roof Type Flood Zone Base Flood Elevation Finish Floor Elev. (Proposed) Number of Units Parking Spaces Required Parking Spaces Provided Area Square Feet (Gross) Area Square Feet (Net) Number of Stories Number of Bedrooms Remarks: ADDITIONAL FEE(S) BCAIF Parks Fee Penalty Fee Public Building Fee Radon Fee Road Impact Fee School Fee Sewer Fee Water Fee Fire Department Fee Overtime Fee Sub-Total SINGLE FEE Building Clearing & Grubbing Drainage Electrical Excavation Fill Fire Spdnkler Irrigation Landscaping Mechanical Paving Plumbing Roofing Sign Site Lighting Sub-Total Comp~ed by oae recor~ Dale entered into Permit log Iniaats Dale called for comments Initials Penmit # Review F H Completed by Date to P&Z records IC(3mpleled by Date records Dale entered into Permit Log ~ Initials Dale called for comments ~ Initials, Less Plan Filing Fee TOTAL AMOUNT DUE Receipt Number Date Permit Issued Pem~ # Dale Review F H Cemp~ed by , . . Date to P&Z recon~s Utilities I P°lice I P. W- Completed by Parks Forester Date records IDev, Dept Date entered into Permit Log Da~e called for comments In~a~ In~a~ DEPARTMENT OF DEVELOPMENT BUILDING DIVISION _ BUILDING PERMIT APPLiCATION 02-3!9 9 Please print. All lines MUST be completed. If not applicable, write N/A. Date: (~' ~ ~ --O ~, Master Permit # 6:2 Z ~)0~.~,/~ ~ Permit # PCN~ (Palm Beach County Prope~y Control #) Fee Simple Title Holder's Address .kv*J ~l~t~[ (If other than owner's) City/State/Zip Company Address C~/IState/Zip Job Name Job Addreee c~/stateu3p Legal Deecriplloa Bonding Company Bonding Company Address C~ylState/Z~p Architect/Engineer's Name Architect/Engineer's Address City/State/Zip Mortgage Lender's Name Mortgage Lender's Address City/Stete/Zip Peger~Fax~ .:~../- ~,- 670? (Check one below) Single Family Duplex Multi-Family Hotel Retail Office Industrial Eatlmeted Value of ConMruction $ /, ~ z AouW,'e (Check Reviewer R~quired below) Electrical ,~ Mechanical ~ Plumbing __ Structural Fire __ Other Application is hereby required to obtain a permit to do work and installations as indicated. I certify that no work or installation has commenced pdor to the iasuance of a permit and thet all work will be performed to meet the standards of all codes, laws, rules and regulations governing construction in this judediction. I underetand that a separate permit must be secured for ELECTRICAL, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONING WORK, ETC. 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 A'n'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. OWNER'S AFFIDAVIT: I certify that all the foregoing inf(xmation is accurate and that all work will be done in complia,nce with all applicable codes, laws, rules and regulatiohs governing construction and zoning. Property Owner's or Agent's Signature Date STATE OF FLORIDA, COUNTY OF PALM BEACH The foregoing instrument wes acknowledged before me this (date) by Who is personally known to me or who has produced As identification and who did (did not) take an oath. (SEAL) Signature of person taking acknowledgement Name of officer taking acknowledgement typed, printed or stamped Ti'de or rank /'"-~ ~ x _~ ~'~ Serial Number, if any / STATE OF FLORIDA, COUNTY OF PALM-B~ACH~'--"~, ~ / [ ~-- ~ The foregoing instrument was ~ ~__ ~)~ --W- [)~ [ /'"~ ~'~ J' ~"~'-~ /'~ {/'~ /~ ,,"~_ haspreducod ~,-' ,I)'"I~) ',~ ) ~'~ "l I k.-~kJ.,' ~ ident~calon and who d~ (did not) take an oath. Name of officer taking acknowledgement typed, p~ ~r-'-stamped Title or rank ' Serial u. ., a - I ~:~ - ~ ,,-, (cer~c~ of.C.Com. L~enc._l~ H_okier) ,I ~: ~. ~ co~sslo. # DD ~'.' o~ ~-~' EXPIRES February 4 2 Contractor's State Certification of Regi§tration No, ~ C. ( "~/L' ~"' "~:i~ ~ ~4'~-~ EXPIRES. February 4,2c.. Liability Insurance Expiration Date IL~) · ~ /" ~..J_~ workers' Compensath:Frr--L--XTmT~T-Da-m-------~'C'~?~::~ Application Approved by (Permit Officer) Date NOTE: This permit VOID after 180 DAYS UNLESS the work which it covers has commenced. All Contractors must have valid State Certification or County Competency plus County and City Occupational Licenses p, rior to obtaining permit. I~SUANCE ~)F THIS PERMIT DOES NOT AUTHORIZE VIOLATION OF DEED RESTRICTIONS FEES ARE NOT REFUNDABLE Fr--] (For Office Use Only) Application Accepted By: Application # Type of Construction Occupancy Type Fence Type Roof Type Flood Zone Base Flood Elevation Finish Floor Elev. (Proposed) Number of Units Parking Spaces Required Parking Spaces Provided Area Square Feet (Gross) Area Square Feet (Net) Number of Stodes Number of Bedrooms Remarks: IF THIS BOX IS NOT COMPLETED, THIS PERMIT IS SUBJECT TO A FINAL INSPECTION ONLY. AUTHORIZED for CERTIFICATE OF OCCUPANCY: Date AUTHORIZED for CERTIFICATE OF COMPLETION: Date ADDITIONAL FEE(S) BCAIF Parks Fee Penalty Fee Public Building Fee Radon Fee Road Impact Fee School Fee Sewer Fee Water Fee Fire Department Fee Overtime Fee Sub-Total SINGLE FEE Building Clearing & Grubbing Drainage Electrical Excavation Fill Fire Sprinkler [~gation Landscaping Mechanical Paving Plumbing Roofing Sign Site Lighting Sub-Total TOTAL Less Plan Filing Fee Receipt Number Check/Credit Card Number Cash Received from: Accepted by: (Initials) BALANCE DUE VALUE - FEE Receipt Number Check/Credit Card Number Cash Received from: Accepted by: (Initials) DEPARTMENT OF DEVELOPMENT I BUILDING DIVISION 0 ~ -- 3 r~ 9 9 BUILDING PERMIT APPLICATION P/ease 13tint. All lines MUST be completed. If not applicable, write N/A. Date'. ~ //~lt//~ ~ "M~ter Permit ~ ~ .... Permit (Pelm Be~h C~n~P~ Coe~l ~) Fee Simple Title HoldeCs N~me Fee Simple Title Holder's Address City/State/Zip Contractor's Company ~'~-.,,0 5 Contact person & emergency phone # Company Address City/State,Zip JOb Name Job Address City/State/Zip Legal Description Bonding Company Bonding Company Address City/State/Zip Architect/Engineer's Name Architect/Engineer's Address (If other than owner's) (If other than owner's) M~g~e LendeFs Name · ~/, kN~l _, Single Family Duplex MuEi-Famiy H~el R~m ~ O ~ce Industrial El~rica F M~hanical ___ Plumbing ~ Stm~ural ~ Fire ~ Oth~ Appl~atJon ~ hereby r~uir~ to obtain a ps. it to do wo~ and installations ~ indicate. I caddy that no work ~ i~tallation h~ c~me~c~ prior to the ~suance ~ a ~ and th~ all wo~ w~l ~ pedo~n~ to m~ the sta~ards ~ aa c~, I~, rul~ and r~ul~i~s governi~ co~[n~i~, in th~ ju~ I u~em~and ~ a s~ae ~ m~t ~ s~ f~ E~CTRICA~ PLUMBI~, SIGNS, WE~S, POOLS, FUR~CES, BOI~RS, H~TERS, TANKS and AIR CONDiTiONING ~VORK, W~NI~ TO ~NER: YOUR FNLURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING ~ICE FOR IMPROVEMENTS TO YOUR PROPERS. IF YOU IN.ND TO OBTAIN FI~NCING, CONSULT Wl~ YOUR LENDER OR AN A~ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. OWNER'S AFFIDAVIT: I ~ ~at all the forgoing info~ation is a~r~e and that all wo~ will be done in ~ian~ with all appli~ble ~es, laws, rul~ and r~ul~ion~ ~n~ng ~n~o~ ~nd zoo. Wh~a!~ kn~n t~r who W~ ~ ~~~n to ~ or who h.p~ ~ ~ , ,em~.,. a, ~o d, (d, n~) take an oath. _ S~nature~pemontakinga~n~l~ement~ ~]~ ~ ~ ~ ~{ N~e ~ ~c~ taki~ acknowl~gement typ~, p~"~ stam~ L ab ,y nsuranc. Expi~. ~F ''~ ~ ~ers' Compensation Expiration Date NOTE: Th~ ~mit VOID a~ 1~ DAYS UNLESS ~e w~ ~h it ~ ~a ~men~. ~1 C~ must have valid S~ Ce~ff~ ~ ~n~ Com~t~ ~us Coun~ a~ Ci~ O~u~t~nal Li~ses prior to ob~ini~ ~rmit. ISSUA~E OF THIS PE~IT ~ES NOT AUTHOR=E VIOLATION OF DEED ~ESTSICTIONS FEES A~E NOT REFUNDABLE FF-] Application Accepted By: (For Office Use Only) Application # Type of Construction Occupancy Type Fence Type Roof Type Flood Zone Base Flood Elevation Finish Floor Elev. (Proposed) Number of Units Parking Spaces Required Parking Spaces Provided Area Square Feet (Gross) Area Square Feat (Net) Number of Stories Number of Bedrooms Remarks: IF THIS BOX IS NOT COMPLETED, THIS PERMIT IS SUBJECT TO A FINAL INSPECTION ONLY. AUTI-IDRI~ED~for CERTIFICATE OF OCCUPANCY: ]A~THO~IZE'D for Date ADDITIONAL FEE(S) BCAIF Parks Fee Penalty Fee Public Building Fee Radon Fee Road Impact Fee School Fee Sewer Fee Water Fee Fire Department Fee Overtime Fee Sub-Total SINGLE FEE Building Cleadng & Grubbing Drainage Electrical Excavation Fill Fire Sprinkler Irrigation Landscaping Mechanical Paving Plumbing Roofing Sign Site Lighting Sub-Total TOTAL Less Plan Filing Fee Receipt Number Check/Credit Card Number Cash Received from: Accepted by: (Initials) BALANCE DUE Receipt Number Check/Credit Card Number Cash Received from: .VALUE Accepted by: (Initials) DEPARTMENT OF DEVELOPMENT BUILDING DIVISION MEMORANDUM NO. 02-197 02-3!99 TO: FROM: DATE: SUBJECT: Diane Reese, Finance Director Don Johnson, Building Official~] September 16, 2'002 CASH BOND -- CHARTER SCHOOLS OF BOYNTON BEACH 801 N. CONGRESS AVENUE, SUITE 483 Attached is a Cashier's check fbr $2,200.00 from Charter Schools of Boynton Beach. This is a cash surety for the Charter Schools of Boynton Beach and is to be held until all outstanding issues of their temporary Certificate of Occupancy are completed. This should occur within 30 days. Upon completion of the deficiencies of the permit and the issuance of the final Certificate of Occupancy, the surety will be returned. DJ:rs Attachments/letter from Jose A. Obeso and check XC: Timothy K. Large, Building Code Administrator Permit File # 02-3199 S:\DevelopmentkBUILDING~Building DivkDocumentsLMemos in Word\Cash Bonds - 2002\Cash Bond - Charter Schools of Boyton Bch.dot 0 2..3 _99*, 6240921 Rev.2 01/00 M 58517-J ' " 'R~ER' ' "'' ' ; ': ' ' OR~ER · ; : ' '" -'.~ '~ ., , Wells Far o Bank Ltd N A Los Angeles CA ' " ' lssuedBylntqrat~ Y . , ;-? :..., '~ : ",'. ':. ;;-';' '-' '... .,; '~' .' ::~.~. .~' CITY OF BOYNTON BEACH Boynton Beach, Florida DEPARTMENT -25350 DATE ~ r~'. / 6 ~o_O_~_ I DOLLARS Date: To: September 16, 2002 City of Boynton Beach Bldg. Dpt. 100 E. Boynton Beach Blvd. Boynton Beach, Florida 33425 0g ~[RCHITECTS & PLANNERS Re; Chatter School of Boynton Beach Boynton Be:ach Mall 801 N. Congress Suite 483 Boynton Beach, Florida 33435 Permit No. To whom it may concem: Based on the total estimate to complete the work for the Chatter School of Boynton Beach of $8, 192.00 per visual inspection approximately 80% of the work is completed so the remaining mount pending shall be $2,000.00 which is to complete the electrical (which should be completed by 9-17-02) doors panic hardware installation, close holes in pantry and computer walls and install 1 ½" Fire rated door Sincerely, J  seA. Obeso, Architect JAO/ao 3100 N.W. 2nd Ave. (561) 391-4115 Suite 314 BocaRaton, Florida 33431 PREPARED 8/16/02, 14:22:18 PAYMENTS DUE RECEIPT CITY OF BOYNTON BEACH PROGRAM BP820L APPLICATION NUMBER: 02--00003199 801 N CONGRESS AVE 483 FEE DESCRIPTION AMOUNT DUE 0 Z ' ~ ! 9 9 FIRE AND LIFE SAFETY FEES BUILDING PERMIT TOTAL DUE 35.00 168.00 Please present this receipt to the cashier with full payment. Opez: Date.' 8/19/8~ M Total tendered Total p~uent Receipt no: 3S1531 PREPARED 8/27/02, 11:11:17 PAYMENTS DUE RECEIPT CITY OF BOYNTON BEACH PROGRAM BP820L APPLICATION NUMBER: 02--00003199 801 N CONGRESS AVE 483 FEE DESCRIPTION AMOUNT DUE PLAN CHECK FEE 83.20 TOTAL DUE 83.20 Please present this receipt to the cashier with full payment. 0per: ALLEH] Date: 8/27/i~ Total tendered Total payment Recei~tno: $~3.~ PREPARED 8/16/02, 9:28:04 PAYMENTS DUE RECEIPT CITY OF BOYNTON BEACH PROGRAM BP820L APPI~ICATION NUMBER: 02--00003199 801 N CONGRESS AVE 483 FEE DESCRIPTION AMOUNT DUE ..~ .............................................................. 0-2-~-319-9 PLAN CHECK FEE 72. TOTAL DUE Please present this receipt to the cashier with full payment. S~EET OF ?ER~iT SET DO NOT RE~O~/E ope~: t~LLEILT Date: 8/16/B~ Total tendered Total pa)~ent Receipt no: TO: FROM: DATE: RE: 'DEPARTMENT OF DEVELOPMENT BUILDING DIVISION MEMORANDUM NO. 02-288 December 12, 2002 SCANNED DE~ 2 7 7002 BUILDING DIVISION RETURN OF CASH BOND - CHARTER SCHOOLS OF BOYNTON BEACH 801 N. CONGRESS AVE., STORE 483 On September 16, 2002, we sent you a memo (copy attached) regarding a cash bond of $2,200.00 for the completion of the permitted work at the above address. The work has been completed and the final Certificate of Occupancy has been issued. Therefore, please return the bond to the Charter Schools of Boynton Beach. Attached are a Direct Payment Requisition and an Agenda Item Request form. DJ:rs Attachments XC: Timothy K. Large, Building Code Administrator Permit File # 02-3199 S:~Development~BUILDINGXBuilding Div',DocumentsXMemos in Word\Cash Bonds - 2002LRetum of Cash Bond - Charter School 02-3199.doc DIRECT PAYMENT REQUISITION PLEASE RETURN CHECK TO RUTH IN THE BUILDING DIV. Please issue a check in the amount of $ 2,200.00 SCANNED To: Charter Schools of Boynton Beach DEC 2 7 ZOOZ 801 N. Congress Ave., Store 483 Boynton Beach, FL 33426 .... .t.-z~tj IJl V LOlUJX] For: Return of cash bond for the completion of permitted work at the Charter Schools of Boynton Beach located at 801 N. Congress Avenue. Requested by Department of Development Date December 12. 2002 Approvals: Section Admin. Finance Dept. City Manager '5on J oh r~,,.~o n 001 0000 220 99 00 2,200.00 2,200.00 rs Attachments\Memo # 02-197, 02-288 and Agenda Item Request Form XC: Permit File # 02-3199 S:\Development\BUILDIN(ABuilding Div\Oocuments\121 Forms\Cash Bond Return-Charter School.doc Requested City Commission Meeting Date~; [] December 3, 2002 [] December 17, 2002 [] January7,2003 [] January 21,2003 CITY OF BOYNTON BEACH AGENDA ITEM REQUEST FORM Date Final Form Must be Turned in to CRv Clerk'~ Office November 18, 2002 (Noon) December 2, 2002 (Noon) December 16, 2002 (Noon) January 6, 2003 (Noon.) Requested City Commission Meetinu Dates [] February 4, 2003 [] February 18,2003 [] March 4,2003 [] March 18.2003 SCANNED BUILDING DIVISION Date Final Form Must be Turned in to City Clerk'~ Office January 21,2003 (Noon) February 3, 2003 (Noon) February I 8, 2003 (Noon) March 3, 2003 (Noon) NATURE OF AGENDA ITEM [] Administrative [] Development Plans [] Consent Agenda [] New Business [] Public Hearing [] Legal [] Bids [] Unfinished Business [] Announcement [] Presentation [] City Manager's Report RECOMMENDATION: Resolution authorizing the release of a cash bond of $2,200.00 to Charter Schools of Boynton Beach for the project known as the. Charter Schools of Boynton Beach. EXPLANATION: On September 16, 2002, the Building Division sent to the Finance Department a cash bond of $2,200.00 for the completion of the pemfitted work at the Charter Schools of Boynton Beach (801 N. Congress Avenue). The work has been completed and the Certificate of Occupancy has been issued. PROGRAM IMPACT: None FISCAL IMPACT: None ALTERNATIVES: None Qui/m~ ~. Gr~en~, D~velopment Director City Manager's Signature Development Department DeparUnent Name City Attorney / Finance / Human Resources S:kBULLETIN~ORMSLatGENDA iTEM REQUEST FORM.DOC CHARTER SCHOOLS OF BOYNTON BEACH, INC. Specializing in Technology, Foreign Languages, and Cultural Studies www.csbb.org ~ November 25, 2002 Mr. Don Johnson, Director Building Division- City of Boynton Beach 100 E. Boynton Beach Blvd. Boynton Beach 33425-0310 SCANNED BUILDING DIVISION Re: Cash Surety for permit 02-3199 Dear Mr. Don Johnson: Pursuant to the rules for cash surety for ceH;r, cate of completion, the Charter School of Boynton Beach requests a refund of the deposit of $2,200.00 paid September 16, 2002. Sincerely, / Pamela Owens, M.P.A. / Principal IBV,2 7 2OO2 801 N. Congress Avenue, Store 483 Boynton Beach, FL 33426 Tel.: 561.738-2380 TO: FROM: DATE: SUBJECT: DEPARTMENT OF DEVELOPMENT BUILDING DIVISION MEMORANDUM NO. 02-197 Diane Reese, Finance Director Don Johnson, Building Officia September 16, 2002 SCANNEr) O~C 2 7 ZOOI BUiLDING DIVISION CASH BOND - CHARTER SCHOOLS OF BOYNTON BEACH 801 N. CONGRESS AVENUE, SUITE 483 Attached is a Cashier's check for $2,200.00 from Charter Schools ofBoynton B~ach. This is a cash surety for the Charter Schools of Boynton Beach and is to be held until all outstanding issues of their temporary Certificate of Occupancy are completed. This should occur with/n 30 days. Upon completion of the deficiencies of the permit and the issuance of the final Certificate of Occupancy, the surety will be returned. DJ:rs Attachments/letter from Jose A. Obeso and check XC: Timothy K. Large, Building Code Administrator Permit File # 02-3199 S:kDevel°pment~BuILDlNGkBuilding EHv~Docum~tskMemos fn Word, Cash Bonds - 200~\Cash Bond -Charter Schools ofBoyton Bch.dot EXHIBIT "B" OFFICIAL CHECK '*,,.,Sill *- i,..,..SS',...' h.,~:*': *-~.S':'i.. ~', i~! i:. *i' .~"* *~. ;' ', ' .*.:,./!- 2 :; .> *: ./.'. '~. =6 TO*'* .... f~ ORDER Sys[eml Inc,, E~lewo~, Colo~o Wells Fargo tank Ltd. N,A,, Lol Angeles, CA GNATURE 'F? ~ " . Cl~ OF BOYNTON BEACH ,. ~ · BUILDING - - DEPARTMENT ~J. .:~~ ~ /5 2o~ EXHIBIT "C" EXHIBIT "D" 3100 N.W. 2nd Ave. (561) 391-4115 Suite 314 Boca Raton, Flor/da 33431