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PERMIT APPLICATION
BP200101 CITY OF BOYNTON BEACH Application Inquiry i0/24/02 11:17:08 Application number ..... : 01 00004235 Application status, date : FINALED Property .......... : 301 N CONGRESS AVE PCN ............. : 08-43-45-30-01-001-0012 Lot Number ......... : 7/03/02 Zoning ........... : C3 COMMUNITY COMMERCIAL Application type ...... : MS MISCELLANEOUS STRUCTURE Application date ...... : 10/24/01 Tenant nbr, name ...... : Master plan nbr, revwd by : Estimated valuation .... : Total square footage .... : Public building ...... : NO Work description, qty . . . : Pin number ......... : 9681 REPLACE CANOPY BD 72000 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 B0 L NO0Y O 4 2 3 5 BUILDING PERMIT APPLICATION (Please Print) COMPLETE EACH BOXED ENTRY PCN# 0~- {/~-~[5-30-01-001 -00/9 Owner's Name{ ~o 1L;¢ 0~ Er~./flh'se% Owner's Address~ IV o/~A ]~o ta ~_~ Fee Simple Title Holder's Name Fee Simple Title Holder's Address Rec. # Permit # (FOR SUB PERMITS ONLY) (Palm Beach County Property Control #) ~3wner's Phone~ (_ctStlj .3 q6'q T~ C[ State 7"¢ Zip 7706 7 (If other than owner's) (If other than owner's) ontractor's Company~ ~+ ~ Co~5+ro,cf;orl t~ · T.,T.~ ICompa'ny Phone ~ (~qJ qd 7-~0~ ontact person and emergency phone ~ CompanyAddress IY[~ 5~ ~q~ ~v~ Pager/Fax~ (qS~ City Dee~ ~'eld ~e~C ~ State [c[ Zip ~-- rrT? ,'.-~', ;'-, [~ \\ ~ t~ ~tl Job Address~ ~01 ~/'/ (ot~'eS<; lI,~,\ t~~ t~. t~ ; ','_..~-~-.!! ;// gegaIOescription/ P~.lm ,~,ch F~-,',~s cO Pi[t,~~'~,lqOF~,~ E ~3~ L T~ ~ "~-'- -~ ~-8 '~/)i [::~J]~ Zoned .ondin~Company ~/~ ~.~ ~' &" ~' ~ Bonding Co. Address c,y ' } .- State Architect--s Name ~,'c~a / d ~, ~a rr/s ~~xnglON ~chitecUEngineer's Address /V/~ S ~ ~ ?+~ ~ ,~U~~ .~' ' ~ ~' ~/ ~~ Mortgage Lender's Name Mortgage Lender's Address SINGLE FAMILY__ DUPLEX __ MULTI-FAMILY ~ HOTEL__ RETAIL ,/~ OFFICE _ INDUSTRIAL (check one) ESTIMATED VALUE OF CONSTRUCTION CHEcKDETAILED 'DESCRIPTION OF WORK:IREVIEWER REQUIRED: Tear ~ ~ ~ ~STRUC'I1 IFIRE~ ~OTHEI~ Application is hereby required to obtain a permit to do work and installations as indicated. I certify 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 separate permit must be secured for ELECTRICAL; PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, 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 NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR~r'~PERTY. IF/Y~U INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LE.,NDER ORtN ATTORNEY B._~,~, ,~)/~I~)~UR..~CE OF COMMENCEMENT. Owner s or~ Signature~/ ~ --~ Date ~--O [ Property STATE OF FLOP, JDA, COUNTY OF PALM BEACH ~~ The foregoing instrument was acknowledged before me this (date) by as identification a~d who did (~ who is .personally known to m~ or who has produced take an oath..,~. ]moa ~ (SEAL) !~.~o,..~ May 22, 2005 -,~ Signature of P~'/~:~akir/~tq~l~l~lg "c ~ Name of officer taking acknowledgement - typed, printed or stamped ~~ /' .~~0~/4'~ Title~, rani( Serial Number, if a~y __ Contractor's Signature _ Date ST^T OF FLORIDA, COUNTY OF PALM BE^C. The foregoing instrument was acknowledged before me this (date) by who~ or who has produced as ider~ification and who did L~d not~ take an oath. (SEAL) // - ,'/,,.~. S .a.. eorpe.ont,, m acknowled ement ¢" _/ Name of o .c. acknow|ed eme.t- , ed. printed or stamped ,~ ~[t~, :~1~ Titlejzfrank__ Serial Number, if any Contractor's State Cort,~;~ Re~-~a~7~.~0~:~l~e('°, 2r~'et?~ Holder) Liability Insurance Expiration Date 1~.- 3/- 0/ Workers' Compensation Expiraticg~ Date I ~. - ~! - O! 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 ~nsideration of gran~ng this permit, the owner and builder agree to erect this structure in full ~mpliance with the Building and Zoning Codes of the Ci~ of ~ynton Beach. NOTE: This permit VOID after 180 DAYS UNLESS the work which it covers has commenced. Ail Contractors must have valid State Cedification or County Competency plus~ounty and City Occupational Licenses prior to obtaining permit. ISSUANCE OF THIS PERMIT DOES NOT AUTHORIZE VIOLATION OF DEED RESTRICTIONS FEES ARE NOT REFUNDABLE S:~DEVELOPMEN%FORMS.DOC~PERMIT APPLICATION MOD.A.DOC- Revised 6/18/97, 11/4/97, 1~98, 6/99, 8/99, 5/00, ~00, 9/25/2000 (THIS SIDE FOR OFFICE USE ONLY) APPLICATION # APPLICATION DATE: SETBACKS: LEFT RIGHT MASTER PERMIT # APPLICATION ACCEPTED BY: FRONT REAR ZONE: 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 # OF STORIES # OF BEDROOMS ADDITIONAL FEE BCAIF PARKS FEE PENALTY FEE PUBLIC BLDG, FEE RADON FEE ROAD IMPACT FEE SCHOOL FEE SEWER FEE WATER FEE FIRE DEPT. FEE OVERTIME FEE SUB-TOTAL 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 SINGLE FEE Building Cleadng & Grubbing Drainage Electdcal Excavation Fill Fire Alarm Fire Sprinkler Irrigation Landscaping Mechanical Paving Paving/Drainage Plumbing 'Roofing Sign Site Lighting VALUATION '~-, ~oo 'SUB TOyA~L TOTAL FEE LESS PLAN FILING FEE //I,~__..//// ,,,~ ., 1 Accepted by: (Initials) ' 8A NCE DUE Recpt # CK # Cash Rec'd from: Accepted by: (Initials) S:\DEVELOPMENT~FORMS.DOC\PERMIT APPLICATION MOD.A.DOC - Revised 6/18/97, 11/4/97, 12/98, 6/99, 8/99, 5/00, 8/00.9/25/2000 BUILDING DMSION DEPARTMENT OF DEVELOPMENT BUILDING DIVISION BUILDING PERMIT APPLICATION Date: PCN# Fee Simple Title Holder's Name Fee Simple Title Holder's Address City/State/Zip Company Address City/State/Zip Master Permit # 01-q3.35 Permit # (Palm Beach County Property Control #) Tx (If other than owner's) (If other than owner's) +wi ,~ 7- 3o 76 Pager/Fax~ Zoned Bonding Company Bonding Company Address City/State/Zip Architect/Engineer's Name Architect/Engineer's Address City/State/Zip l) e ~. r ~C[ ~ l A ~o~gage Lenders Name Mortgage Lender's Address City/State/Zip (Check one below) Single Family Duplex Multi-Family Retail X Office Industrial Hotel (Check Reviewer Req~ Electrical ' ~l-e-chanical ~......_~.~lumbing ~ 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 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 separate permit must be secured for, ELECTRICAL, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONING WORK, ETC. OWNER'S AFFIDAVIT: I certify that all the applicable codes, laws, rules and regulations Property Owner's or Agent's Signature STATE OF FLORIDA, COUNTY OF PALM BEACH The foregoing instrument was acknowledged before me this I Who is personally known l;ome ,or who has proa-~cea ' ~//.'~ (SEAL) Signature of person taking acknowledgement Name of officer taking acknowledgement typed, printed or stam~c:f' Title or rank STATE OF F~ORIDA, COUNTY OF PALM BEACH lhe foregoing instrument was Who is ~e,~onalht known to me or who has produced , ' -- (SEAL) Signature of person taking acknowledgement Name et officer taking acknowledgement typed, printe~l~r stamped Title or rank anc~ that all work will be done in compliance with all Contractor's State Certification of Registration No. Liabilibj Insurance Expiration Date Application Approved by Any change in building plans or speoficatio~s must be recorded with Ibis office. Any wod( not covered above must have a valid permit pdor to starting, In consideration of grants this pen~t, the owner and building agree to erect this structure in full comptiance with the euilding and Zoning Codes of the City of Boynlon Beach. 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 pdor to obtaining permit, ISSUANCE OF THIS PERMIT DOES NOT AUTHORIZE VIOLATION OF DEED RESTRICTIONS FEES ARE NOT REFUNDABLE (date) by As identification and who did (did not) take an oath. ~ '~ ~ co~,s~o,, ~s ~ Sedal Number, if a-fl~''"~' ................. ~ Date 0 ~/ ~/0 ~ (date)by Bobbu L ~oore O~ ~ idepfifi~fi~ and ~o did (did not) ~ke an ~. - - ~ ~.~fg; M~ 2[ 2005 S~Hal Numar, if a'~ ,~''' ........ (Ce~fi~te of Compemncy Holder) Pcc- OSS~g6 Wo~em' Compensation Expiration Date (Pe~it Officer) Date S:\DEVELOPMENT~FORMS&TEMPLATES\BUILDING PERMIT APPLICATION-IQI. Rev 6/18/97.11/4/97, 12/98.6/99.8/99. 5/00.8/00. 9/00, 10/01 Application Accepted By: Application # Type of Construction Occupancy Type Fence Type Roof Type Flood Zone Base Flood Elevation Finish Floor Elev. (Propcsed) Number of Units Parking Spaces Required Parking Spaces Provided Area Square Feet (Gross) Area Square Feet (Net) Number of Stories Number of Bedrooms 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 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 SINGLE FEE Building Clearing & 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 -'~ "~ Cl,~'~Cte(/~t~sa'ra humber · '-'~ Cash Received from: 'Accepted by: (Initials) BALANCE DUE t r Check/'~;;re~card Number ~:;-t,.'.*i %, Cash Received from: Accepted by: (Initials) VALUE FEE S:\DEVELOPMEN~FORMS&TEMPLATES\BUILDING PERMIT APPLICATION-Igl, Rev 6/18/97, 11/4/97, 12/98, 6/99, 8/99, 5/00, 8/00, 9/00, 10/01 BUILDING DWISION DEPARTMENT OF DEVELOPMENT BUILDING DIVISION BUILDING PERMIT APPLICATION 01-4235 Please Print Date: (~/~7/0..~_ Original Permit # (~ l' q~,- ~5 Master Permit # ProjectName: ~et[ C~ ~ ~ /~C~ ~~ Project Address: 30,1 N~ o~~ ~ City/State/Zip: ~o~. ~ ~~. ~ Total fistimat~d Valu~ of this ~vi~ion $ 1000. oo ~oscription of Work: (Plooso specify in ~oto[l w3ot is boin~ roviso~ ~rom oriqin~l pormit.) Building: Valuo o[ Work: $ Electrical: Value of Work: $ Fire Sprinkler: Value of Work: $ Irrigation: Value of Work: $ Mechanical: ,~_~B/~.C~' Pl',%Og'PS~°/', ~Z), ,~OXc"'$ Value of Work: $ /~l~O.~ Plumbing: Value of Work: $ Roofing: Sign: Site Lighting: MAR 2 7 ~e of Work: $ Clearing & Grubbing: Paving/Drainage: F illlExcavation: BUILrJII~!~ O~:,L~t~f Work: $ Value of Work: $ Value of Work: $ Value of Work: $ Landscaping: Value of Work: $ I wish to revise the above referenced permit to perform the work described herein. I certify that all work will be constructed in conformance with all laws, codes, regulations, rules, etc. goveming Boynton Be~ach, and_l certify that the_ above information is true and correct. Contractor s Signature' ~~ ~ ~7~.0 ..~/~ j Date: ~/~/~ STATE OF FLORIDA. COUNTY-OF PAL~M BEACH --~'' ~ ' Who is personally known to m~or who has produced As identification and who did (did not) take an oath. Signature of person taking acknowledgement ~'~ -=*: ;*~ Name of officer taking acknowledgement typed~inted or stamped ~'~'~:" Title or rank Serial Number. if any Application approved by _..~,~ c.c~ '~ Date Permit Officer / / ISSUANCE OF THIS PERMIT DOES NOT AUTHORIZE VIOLATION OF DEED RESTRICTIONS FEES ARE NOT REFUNDABLE MY COMMISSION # DD02822~ Mmy 22, 2005 ~O~D ~O ~OY F~N ~ S:\DEVELOPMENT~ORMS&TEMPLATES'~BUILDING PERMIT APPLICATION REVISION-IgI-Rcv. 12/98, 6/99, 8/00, 10/01, l l/0l (For Office Use Only) Original Permit # PCN 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: Permit# ~----~/--~ t Review O H Completed by ~._~ Date to P&Z records , ,"22'-('~¢-~ ~~' Utilities Police I P.W. Completed by ~ Parks I Forester Dev Dept Date entered into Permit Log Initials Date called for comments Initials Permit # Review F H s,ruc, P&Z I Eng'l Fire Completed by Date to P&Z records Utilities I Police Parks Forester Dev Dept Completed by Date records Date entered into Permit Log Date called for comments Initials Initials 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 VALUE FEE Building Clearing & Grubbing Drainage Electrical Excavation Fill Fire Sprinkler Irrigation Landscaping Mechanical Paving Plumbing Roofing Sign Site Lighting Sub-Total Less Plan Filing Fee TOTAL AMOUNT DUE Receipt Number /(~] Date Permit Issued Permit # Review F H Submittal Acceptance Date Elec. Mech. Plumbin1 Structura P&Z Eng. Fire Completed by Date to P&Z records Utilities Police P.W. Parks Completed by Date records IForester Dev. Dept Date entered into Permit Log Date called for comments Initials · Initials S:\DEVELOPMENTkFORMS&TEMPLATES'~BUILDING PERMIT APPLICATION REVIS1ON-IgI-Rev.12198, 6/99, 8/00, I0/01, I Il01 I)it'.,PAR'I'MIt;N'I' O1,' i)EV I!;L, Oi'MI,;N'I' BUILDIN(; I)IVISION BUILDING PERMIT APPLICATION (Please Print) Permit # 0/--/-'t/,~ 3 ~ (I,'OR SI III I'EI,thll'l'S ()NI,Y) PCN# ......... (Palm Beach County Property Control #) Owner's Name ,~tb'~~, V/¥ .~_...,,.,..,~ p.~'L.,r ~{ ...................... Owner's Phone Owner's Address .~ ~ ~~~.__~tu~___~._~ ........ ' City ~~~_ ~p~.~ .................... Stat~-' . .... ~/ Zip Fee Simple Title Holder's Name ....... (If other tit~R owner's) Fee Simple Title tlolder's Address (11 other th~n owner's) Conlraclor's Company ~=~ ~ ~L~~~~ ~,npany Phone ~ Contact person and emergency phone ~ ~~ __~-~__~_~_~.~! ~ ~G Company Address ~ P[~ ~L~_~_~ ............. Pager/Fax~ City ~ ~ ~ ....... Stme ....~[ Zip Job Name ~L% ~ Job Address ~ ~ cO~~ ~ Legal Description Bonding Company Bonding Co. Address ArchiteclJEngineer's Name City .___ State 5 Architect/Engineer's Address ............... Mortgage Lender's Name Mortgage Lender's Address SINGLF, FAMILY I)UPI.E× MULTI-FAMII.Y I1() HLI. (check one) ESTIMATED VALUE OF CONSTRUCTION $ ..... DETAILED DESCRIPTION OF WORK: __~__~.~"_ts~,.. RI!TAlL J)~ OFFICE INI)USTRIAL Application is hereby required to obtain a permit to do work and installations as indicated. I cedify that no work or installation has commenced prior to the issuance of a permit and that all work will be t)eHormed to mc;et lbo standards of all codes, laws, rules and regulations governing construction in this jurisdiction. I underst;md Ihat a sepm ale i).rmit must be secured for ELECTRICAl, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, It[~A-I EllS, 't ANK.% AND AIl~. C(')NI.qTIONING WORK, ETC. OWNER'S AFFIDAVIT: I codify that all the foregoing inlomudi(m is accumh., ami th,~[ all wink 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 NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR~ROPERT~ IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LEN, DER OR A,N ATTORNEY BEFOI~y~ORI~I~_YOUR NOTICE OF COMMENCEMENT. ~"y Owners or Agents Sig.atur. ~~ ~ _ Date STATE OF FI.ORll)A, ('()UNTY OF PALM BEACII ~ Thc Ibrcgo~trumenl was acknowledged before me this _ ~ ,~ (date) by ~DED THRU a~ t~.~-NOT~I who is pc~ ~o mc or who has produced ......... as idemificalion a.d who did {did no0 lake a. oalh. (SEAL) ~.,~~ Signature of person taking acknowledgement ~ Contractor's Signature" STATE OF FLORH)A, COUNTY OF PALM B~ACI[ Thc foregoing instrument was acknowledged before mc this who is ~n to me or who has produced take an oa~: ~ Name of officer taking ackm)wlcdgcmcnl - typed, __ Serial Number, il'any ~ I / (dale) by as idcntilicatitm and who did (did not) (SEAL) ('~' Signature ofperso,, lakiQg, acknowledgement ~<-.._T .>L.._ ~-LT( Name of oflicer ~~~F~ t~d, (Certificate of Competon(:y Hohl~r) ~RUA~ I~OT~I Contractor's State Ce~ification of Registration No. Liabili~ Insurance Expiration Date ............. Workers' Compensation Expiration Date Application Approved By ,( Any change in building plans or specifications musl be recorded with this offic.. Any work not covered above must have a vali~ permi~ prior to sla~ing. In consideration of granting this permit, Ihe owner and builder agree Io umct Ibis structure in full compliance wilh lhe Building and Zoning Codes el the City el Boynton Beach, NOTE: This permit VOID after 180 DAYS UNLESS lite work whit:Is it t:.ve~s has commenced. All Contractors n~ust have valid State Certification or County Competency plus County and City ©CCUl)ational Licenses prior to obtaining pe~ mit. ISSUANCE OF THIS PERMITDOES _N~I__A_I,~_I-I~).R!~zE .V_JgL_A_TJQN OF DEED RESTRIC_T_ION_S FEES ARE NOT REFUHD__AB_~=.E_ APPLICATION # APPLICATION DATE: SETBACKS; LEFT ZONE: {THIS SIDE FOR OFFICE USE ONLY) MASTER PLAN # RECEIVED BY: RIGHT FRONT 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) # OF STORIES # OF BEDROOMS REMARKS: ADDI1 IONAL FEE BCAIF PARKS FEE PENALTY FEE PUBLIC BLDG. FEE RADON FEE ROAD IMPACT FEE SCHOOL FEE SEWFH FF_~E WATER FEE FIRE DEPT. FEE SUB-TOTAL SINGLE FEE Building Clearing & Grubbing Drainage Electrical Excavation Fill Fire Sprinkler Irrigation Landscaping Mechanical ......... Paving Paving/Drainage Plumbing Roofing Sign Site Lighting SUB-TOTAL VALUATION REAR FEE 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 TOTAL LESS PLAN FILING FEE TOTAL AMOUNT DUE RECEIPTNUMBER DATEISSUED fi, of Units Commercial: INTERIM SERVICES FEE CALCULATIONS: Residential: X = Applicable Monthly Fee # of Sq. FI Divided by 1,000 (rounded to Nearest tenth) --Applicable Monthly Fee Interim Services Fee Base Sq. FI Rate Interirn Services Fee BUILDING DIVISION DEPARTMENT OF DEVELOPMENT 0 1 - 4 2 3 5 , BUILDING DIVISION , , BUILDING PERMIT APPLICATION Rec. # (Please Print) '-- COMPLETE EACH BOXED ENTRY Permit # O I ' ~f9~ 3 ~ (FOR SUB PERM]TS ONLY) PCN# (Palm Beach County Property Control #) ~wner's Addres~ ~ ~ 70~ '~~t~g bor~ h ~ ~ ' ' ~ity ~ ~o ~_S ~ ~ S~ate rff zip 7 ~ P Fee Simple Title Holder's Name ~/~ (If other than owder's) Fee Simple,Title Holder's Address , , [~f other than owneA's) ContractorsCompan~ ~o~]~C P l~ t~ ~CompanyPhone~ (S0 7 ) -97 q ~Contact person and emergency phone ~ ~ ~ _ Company~ddr~ss . ~[~ ~ ~ f~ ~ - '' Pager/Fax$ City ~ff t~,~ ~ e~ ~, - State ~ :~ Zip ~ ~ff ~obAddres~ ' - ~ O I ~/ ~4req 5 J~egal Description~ ~ · Zoned Bonding Company /~ Bonding Co. Address , , .... City , .' State Architect/Engineer's Name J~, ~ J~ ~/~r .~ /t~ o,r,¥,t $ .... Architect/Engineer's Address Iql~... Mortgage Lender's Name N/~:~ - Mortgage Lender's Address _! SINGLE FAMILY DUPLEX__ MULTI-FAMILY__ HOTEL__ RETAIL ._~ OFFICE INDUSTRIAL (check one) -- 4~1 .,,~ O0 -- -- ESTIMATED VALUE OF CONSTRUCTIONI $ ~'~(JO ,~ . , IDETAILED DESCRIPTION OF WORK~] CHECK REVIEWER REQUIRED: ~ ~ ~ ~TRUCl1 IFIRI~ ~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 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 separate permit must be secured for ELECTRICAL; PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, 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 RECOR~ A NOTICE OF C~)~MMENCEMENT MAY RESULT IN YOUR TO PAYING TWICE FOR IMPROVEMENTS YOU.~,,PR~DPERT~,Y~IF Y~QO.,JNTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN A~ORNE~T. Prope~y Owner's or Agent's Signature~ ~ ~ ~- O~ STATE OF FLO~DA, CO~TY OF PALM BEACH The foregoing ins~ment w~ ac~owledged before me this O~ (date)by ~e~ ~a ~~d~~/~ who is ~e or who h~ pr~uccd fi t~on take an oath. (SEAL) ~&~ . ~ ~2, ?oos . Signature of person t~i.g ac~owledg~men, ff~~ 7~~ame of printed or stamped d~ O n ~ (tV~; Title or ;~ Serial Nmber, if ~y STATE OF FLORIDA, COUNTY OF PALM BEACH The foregoing instrument was acknowledged before me this who is personally kno~wn to me. or who has produced take an Oath. - (SEAL) ' Signature of person taking acknowledgement ,~f.4..~.~ printed or stamped ,,]a. 5o~a /ae/-/,-pe ~V - - (date) by Title or rj~ as identification and wh~did (did not) of officer taking acknowledgement - typed, Serial Number, if any (Certificate of Competency Holder) Contractor's State Certification of Registration No. ~ ftc O ~-~¢'~7 :~'~ Liability Insurance Expiration Date Workers' Compensation Expiration Date /Z. - ~/--~) 'Z.. Application Approved By Permit Officer 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 starting. 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 Certification or County Competency plus-County and City Occupational Licenses prior to obtaining permit. ISSUANCE OF THIS PERMIT DOES NOT AUTHORIZE VIOLATION OF DEED RESTRICTIONS FEES ARE NOT REFUNDABLE S:\DEVELOPMEN'~FORMS.DOC\PERMIT APPLICATION MOD.A. DOC - Revised 6/18/97. 11/4/97. 12/98.6/99. 8/99.5/00.8/00, 9/25/2000 fF%~ MY COMMISSION # DD028225 ~[jgilL ~.-=- Mo~ 22, 2005 'n,~,~-~' Date: APPLICATION # APPLICATION DATE: SETBACKS: ZONE: LEFT (THIS SIDE FOR OFFICE USE ONLY) MASTER PERMIT # APPLICATION ACCEPTED BY: RIGHT FRONT REAR 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 (A/C) # OF STORIES # OF BEDROOMS ADDITIONAL FEE BCAIF PARKS FEE PENALTY FEE PUBLIC BLDG. FEE RADON FEE ROAD IMPACT FEE SCHOOL FEE SEWER FEE WATER FEE FIRE DEPT. FEE OVERTIME FEE SUB-TOTAL 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 Recpt # S ~,~IGLE FEE Building Cleadng & Grubbing Drainage Electrical Excavation Fill Fire Alarm Fire Sprinkler Irrigation Landscaping Mechanical Paving Paving/Drainage Plumbing Roofing Sign Site Lighting SUB TOTAL TOTAL LESS PLAN FILING FEE CK # Cash Rec'd from: VALUATION FEE Accepted by: (Initials) BALANCE DUE Recpt # CK # Cash Rec'd from: Accepted by: (Initials) S:\DEVELOPMEN~FORMS.DOC\PERMIT APPLICATION MOD.A.DOC- Revised Co/18/97, 11/4/97, 12/98, 6199, 8/99. 5/00, 8/00, 9/25/2000 BUILDING DMSION DEPARTMENT OF DEVELOPMENT BIJ[LD[NG DIVISION BUILDING PERMIT APPLICATION Original Permit # Project Name: Project Address: Contractor's Name: 1/ Total Estimated Value of this Revision $ ~ ~'/'~'~,~'~ Description of Work: (Please specify in detail what is being revised from original permit.) Building: Date: D ! ,- t4 Master Permit # Value of Work: $ Va~ueofWork:$ 0 ;~'/'"'/¢~/ "" ~,",'9,:'~/ Fire Sprinkler: Value of Work: $ Irrigation: Value of Work: $ Mechanical: Value of Work: $ Plumbing: Value of Work: Roofing: Value of Work: $ Sign: Value of Work: $ Site Lighting: Value of Work: $ Clearing & Grubbing: Value of Work: $ Drainage: Value of Work: $ Excavation: Value of Work: $ Fill: Value of Work: $ Paving: Value of Work: $ I wish to revise the above referenced permit to perform the work described herein. I certify that all work will be constructed in conformance with all laws, codes, regulations, rules, etc. goy~erning Boynton Be.a.ch, an.(J~ certify that the above information is true and correct. Contractor's Signature/=~'/~ ~J~'~/) O1~. ~. Date: 0 STATE OF FLORIDA, COUNTY OF PALM BEACH The foregoing instrument was 0q/j ~),,.. / 0 ~.,_ (date) by acknowledged before me this ~O ~ ~.. Who is personally known to me oDwho has pro~"Gcea As identifica.~"and who did (did not) take an oath. SEAL ,,~.~;.. ', ;Jason Perry ( ) ..-~ ~. Signature of person taking acknowledgement /~ t,~~/~!~-'HY'"'":'~'O~'"'~n''''3'n?8225EyJ~IRES Name of officer taking acknowledgement typed, I~/~f~.ted or stamped ~' ~;~;;~,' BONDEDTHRUTROYFA~NIN,~JRANC~,iNC. Title or rank ....q ~ Serial Number, if any Application approved by ~',,,~/~~''~//~ Date '~'"-"-P ~r ~ i [~O ~i,~ - ISSUANCE OF THIS PERMIT DOES NOT AUTHORIZE VIOLATION OF DEED RESTRICTIONS FEES ARE NOT REFUNDABLE S:\[')I~VEI.OI)M I~NT' F('IRMSc~Tf;:MPI .ATF. S\FIIJIIDING I'T:.R MI'F t\PI) I .ICATION RI~VISION-ILd-Rev. 12/9,R, 6/99, 8/00, 10/Ol Original Permit # PCN 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: Utilities Police I P.W. I Parks Completed by Date records Forester Dev Dept Date entered into Permit Log Date called for comments Initials Initials Permit # Review F H Submittal Acceptance Date .......... Completed by Date to P&Z records Utilities Police P.W. Parks Completed by Date records Forester IDev Dept Date entered into Permit Log Date called for comments Initials Initials 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 & Grubb'ing Drainage Electrical Excavation Fill Fire Sprinkler Irrigation Landscaping Mechanical Paving Plumbing Roofing Sign Site Lighting Sub-Total Less Plan Filing Fee TOTAL AMOUNT DUE Receipt Number Date Permit Issued VALUE FEE Permit # Review F H Submittal .Acceptance Date . ,. Completed by Date to P&Z records Utilities I Police P.W. Parks Forester Completed by Date records JDev. Dept Date entered into Permit Log Date called for comments Initials initials S:\DEVELOPMENTxFORMS&TEMPLATES\BUILDING PERMIT APPLICATION REVISION-Igl-Rev. 12/98, 6/99, 8/00, 10/01 PREPARED 4/15/02, 14:31:17 PAYMENTS DUE RECEIPT CITY OF BOYNTON BEACH PROGRAM BP820L APPLICATION NUMBER: 01-00004235 301 N CONGRESS AVE FEE DESCRIPTION AMOUNT DUE PLAN CHECK FEE 35.00 TOTAL DUE 35.00 Please present this receipt to the cashier with full payment. Oper: Date: 4/16/8~ ToLml tendered Total Receipt no: 219661 $35. M PREPARED 3/27/02, 9:23:06 PAYMENTS DUE RECEIPT ~iTY OF BOYNTON BEACH PROGRAM BP820L APPLICATION NUMBER: 01-00004235 301 N CONGRESS AVE FEE DESCRIPTION AMOUNT DUE .............................................................. i- PLAN CHECK FEE 35.00 TOTAL DUE ,~ Please present this receipt to the cashier with full payment. Ooee: ALLEYS Date: 3/~7/B2 8B Total tendezed Total oayment Receipt no: 197811 $35.00 $35.60 CITY OF BOYNTON BEACH DEVELOPMENT DEPARTMENT 100 East Boynton Beach Blvd. P. O. Box 310 Boynton Beach, Florida 33425-0310 PLAN REVIEW COMMENTS PLEASE NOTE THAT THE EFFICIENCY BY WHICH YOU RECEIVE YOUR PERMIT DEPENDS ON YOUR RESPONSE TO THE CONTENTS OF THIS DOCUMENT. IT IS RECOMMENDED THAT YOU CAREFULLY READ AND CORRECTLY RESPOND TO ALL ASPECTS OF THIS DOCUMENT. COMMENTS: For permit application number: Project Name or Address: REVIEWED BY: Department and/or Division: Name of Reviewer: Jose Alfaro Trade: Phone # (561) 742-6260 ext. Fax # (561) 742-6259 Date Started Review: 11/09/01 Type of Review: 01-4235 Motiva Entrp./B.& M.Construction-Shell Station Planning and Zoning Hard roof and screen roof additions. Which Review: [] 1st [] 2nd [] 3rd [] 4th COMMENT DISTRIBUTION: Person identified on the application to receive comments: Name Phone # (area code:561) ext. 0 Fax # (area code:561) Date(s) reviewer called: Person who received the call [] Other THE FOLLOWING AREA SHALL BE FILLED-IN IN THE PRESENCE OF THE PLANS ANALYST AND/OR PERMIT CLERK: COMMENTS/PLANS PICKED UP: Comment(s) recd. by print name and date: OR Plans/Comments recd. by print name and date:,~, Page 2 of 2 1st 2nd 3rd 4th Plan Review Comments for Permit Application # 98- 01'4235 Your permit application and supporting documentation do not comply with the City of Boynton Beach Code of Ordinances. Prior to receiving a permit to construct or install the requested improvements the plans and documents shall be amended to show compliance with the below listed comments. Prior to making the changes to the plans and/or documents please read the attached Submittal of Corrected Plans form. This form contains important information relative to amending documents and submitting corrected plans and/or documents. Questions regarding the comments may be directed to the reviewer named above. If a conference is necessary, please schedule an appointment with the reviewer. Please note that additional comments may be generated following staff review of the amended plans. Timely approval of your project is dependent upon your prompt and correct response to the information provided in this document. Find attached, a form titled Submittal of Corrected Plans, this document shall be properly completed and stapled to the file copy of the corrected plans when submitting them to the Plans Analyst. 1- Replacing existing canopy requires approval of a minor site plan modification from Planning and Zoning Division. Please contact Lusia Galav at 742-6260. Do not remove existinq canopy until permit for replacement is secured. Jose 2 · Building February27,2002 DEPARTMENT OF DEVELOPMENT PLANNING AND ZONING DIVISION · Planning & Zoning · Occupational Licenses · Community Redevelopment Mr. Jason Perry, Permitting & Engineering Support MDM Services, Inc. 1412 Southwest 34th Avenue Deerfield Beach, FL 33432 BUiLDiNG DiVISiON Re: Shell (Boynton Beach Blvd / Congress Avenue) - Replacement Canopy MMSP 02-006 Dear Mr. Perry: In response to your request for the administrative review and approval of the modificatiOns proposed to the above-referenced, approved site plan, please be informed that the replacem, ent canqpy as shown on the revised plans date stamped 02/20/02 represents a "minor" change, as defined within the Land Development Kegulations, Chapter 4 - Site Plan Review. This project may continue to be processed by the Building Division as a permit application subject to the following conditions: 1. TI~ proposed canopy.shall not exceed the existing canopy dimensions (53 feet - 5 inches by 25 feet);. ~ 2, The pr'oposed canopy color must match the main wall color of the principal structure (Sherwin Williams #2045 Boulevard Beige); 3. If canopy lighting is proposed then said lighting must be recessed in order to avoid exce'ssi~e glare. Be advised that the proposed changes may require a modification to the building permit. Please contact me at (561) 742-6260 if you have additional questions. Sincerely, Michael W. Rumpf Director of Planning & Zoning GOt IIEGTE Cc: Lusia Galav, Principal Planner Jose Alfaro, Planner Eric Lee Johnson, Planner Gas B~tntoa & Coe~tI~-~dMSP 024)06 - C.~nop,/~lno~ l.~'.d~x: SHEk"T OF PERMIT SET DO NOT REMOVe. City of Boynton Beach · 100 East Boynton Beach Blvd., P.O. Box 310 · Boynton Beach, Florida 33425-0310 Phone: (561) 742-6350 · www. cLboynton-beach.fl.us PREPARED 3/22/02, 15:34:36 PAYMENTS DUE RECEIPT CITY OF BOYNTON BEACH PROGRAM BP820L APPLICATION NUMBER: 01-00004235 301 N CONGRESS AVE FEE DESCRIPTION AMOUNT DUE 0 1 ~ t _2_~_~ BUILDING PERMIT 806.40 TOTAL DUE 806.40 Please present this receipt to the cashier with full payment. Ope~: 140HCMOI) Date: 3/~5/6~ 66 Total tendeTed Total payment Receip~ no: 194416 ~88~.48 ~86.48 DEPARTMENT OF DEVELOPMENT BUILDING DIVISION MEMORANDUM NO. 02-080 01 -4 5 TO: FROM: DATE: SUBJECT: Diane Reese, Finance Director Don Johnson, Building Official April 23, 2002 CASH BOND - SHELL GAS STATION (Canopy Replacement) - 301 N. CONGRESS AVENUE Attached is a Cashier's Check for $1,485.00 from Petropac, Inc. This is a cash surety for the Shell gas station (canopy replacement) 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 Richard R. Morris and check XC: Timothy K. Large, Building Code Administrator Permit File # 01-4235 S:\Development\Building Div~DocumentshMemos in Word\Cash Bonds - 2002\Cash Bond - Shell Gas Station (Canopy) 01-4235.doc .01-4235 Bank of America ~ O, shier's Check No. 2 2 3 8 8 7 5 ~:~ ~: ,:~? ¢,o ~ ~ ~!...': ~ . . : ' ' ' : :' ' : ' ' "' ' "":: ':' : ' : "' ::" : ~:' ' :' .'" ":::: :' ~:~'~;~atid~'~: ~mii~F66 ;: "..:: ~ , ,, " one year Rcmtttcr I Purchased By ) 'Fo Order '" Of dormant? ice of SS.00 ocr i3ank of America. N.A San .~.ntonio, Texas I THE ORiGINAL DOCUMENT HAS RE~ECTIVE WATERN~RK ON THE BACK Authorized Signature i:6kt, OOOO~qm'- 006~,k~0020~' THE ORIGINAL DOCUMENT HAS REFLECTIVE WATERMARK_ O~ T_HE BACK CITY OF BOYNTON BEACH Boynton Beach, Florida DATE 25333 20 "-' '~ DEPARTMENT .' .... -;--':, .; , ,,,, .? .. " : ' '.z"J {":r~ ~ ff ~' 'i "'-:" DOLLARS ~,, i ......,,- ::-, - , !.,. ,,\/,,. [ , ~ , :. ,-.. c..~..~....x c,,_,, C"! .,' .-,, ,:,'4! ,.~. .~ / ' t - f", ". ~- .... ,.:_; ',. z ~ ,, ,, . .-'~ ':! -, bb._ L?..,'J! ---:;'..~: ~ .... MDM Centra~ Florida 3706 DMG Dr. Lakeland, FL 33811 863/646-9130 863/648-1106 FAX email: mclmeng ~gate.net MDM South Flori(ta 1412 SW 34th Ave. Deeff~eld Beach, FL 33442 954/427-3O76 954¢427-3420 FAX email: I~meng@aol.com MDM Atlanta 921 Fauikner Lane Bali Ground, GA 30107 770/345-396O 770/345-3961 FAX email: mdmsvs~aol.com MDM Texas 1000 Post & Paddock Suite 100 Grand Prairie, TX 75050 972/206-2202 972/602-8482 FAX email: matrndmtx Oaol.com MDM Services, Inc. Engineering and Environmental April 22, 2002 City of Boynton Beach Building Dept. 100 E Boynton Beach BIvd Boynton Beach, FL 33425 Re: Shell Gas Station-Canopy Replacement 301 N Congress (Permit # 01~4235) Engineer's cost estimate for installation and connection of Owner's canopy s~gns (2 ea., "SHELL" channel letter sets) for above referenced location provided as follows: · Sign install, labor and misc. materials: $ 750.00 · Electrical $ 600.00 /-~'-"'"~otal: $1350.00 Pli!ase~advise if a~/clarification required. · Civil Engineering · Building Design · Permitting · Geotechnical · Environmental Assessments, Remediation · Construction Management TO: FROM: DATE: RE: DEPARTMENT OF DEVELOPMENT BUILDING DIVISION MEMORANDUM NO. 02-253 Diane Reese, Finance Director Johnson, Building Official¢~' Don October 3 l, 2002 SCANNED BUILDING DIVISION RETURN OF CASH BOND - SHELL GAS STATION (Canopy Replacement) - 301 N. CONGRESS AVENUE On April 23, 2002, we sent you a memo (copy attached) regarding a cash bond of $1,485.00 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 Petropac, Inc. Attached are a Direct Payment Requisition and an Agenda Item Request form. DJ:rs Attachments XC: Timothy K. Large, Building Code Administrator James A. Wynne III/Petropac Solutions, Inc., P.O. Box 292638; Ft. Lauderdale, FL 33329 Permit File # 01-4235 SSDevetopmentkBU[LDtNG\Building DivXDocumentsMMemos in Word\Cash Bonds -2002\Return of Cash Bond - Shell Gas Station 01-4235.doc DIRECT PAYMENT REQUISITION PLEASE RETURN CHECK TO RUTH IN THE BUILDING DIV. Please issue a check in the amount of $ To: Petropac, Inc. 1,485.00 SCANNED DEC 2 7 2002 P.O. Box 292638 BUILDING DIVISION Ft. Lauderdale, FL 33329 Return of cash bond for the completion of permitted work at the Shell Gas Station located at 301 N. Congress Ave. For: Requested by Department of Development Date October 31,2002 FS Approvals: Section Admin.. ~3~_,~i<~ Don Johnso"fi Finance Dept. Ci~ Manager 001 0000 220 99 00 1,485.00 1,485.00 Attachments\Memo # 02-080, 02-253 and Agenda Item Request Form S:\Development\BUILDING~Building Oiv\Oocuments\121 Forms\Cash Bond Return-Shell Gas Station.doc Requested City Commission Meeting Dates [] August 6,2002 [] August 20, 2002 [] September 3, 2002 [] September 17, 2002 CITY OF BOYNTON BEACH AGENDA ITEM REQUEST FORM Date Final Form Must be Turned in to City Clerk's Office July 17, 2002 (5:00 p.m.) August 5, 2002 (Noon) August 19, 2002 (Noon) September 3, 2002 (8:00 a.m.) Requested City Commission Meeting Dates [] October 1,2002 [] October 15, 2002 [] November 6, 2002 [] November 19, 2002 SCANNED BUILDING DIVISION Date Final Form Must be Turned in to City Clerk's Oftice September 16, 2002 (Noon) September 30, 2002 (Noon) October 14, 2002 (Noon) November 5, 2002 (Noon) NATURE OF AGENDA ITEM [] Administrative [] Development Plans [] Consent Agenda [] New Business [] Public Hearing [] Legal [] Bids [] Unfmished Business [] Armotmcement [] Presentation [] City Manager's Report RECOMMENDATION: Resolution author/zing the release of a cash bond of $1,485.00 to Petropac, Inc. for the project known as the Shell Gas Station. EXPLANATION: On April 23, 2002, the Building Division sent to the Finance Department a cash bond of $1,485.00 for the completion of the permitted work at the Shell Gas Station (301 N. Congress Avenue). The work has been completed and the Certificate of Occupancy has been issued. PROGRAM IMPACT: None FISCAL IMPACT: None ALTERNATIVES: None Qu~us/L~ Gre~ene, Develo"~ment Director City 1Manager's Signature Development Department Department Name City Attorney / Finance / Human Resources S:\BULLETIN\FORMS~AGENDA ITEM REQUEST FORM.DOC ,oe ro oa. c solutions, inc. P.O. Box 292638 Ft. Lauderdale, FL 33329 ,~/Phone: (954)583-0548 ox: #CBC 034978 Orlando: (407) 880-0850 Tampa: (813) 875-8997 Ft. Myers: (941) 768-3535 October 30, 2002 City of Boynton Beach Building and Zoning Departmem 100 East Boynton Beach Blvd. Boynton Beach, FL 33425 Attn: Don Johnson, Building Official Dear Mr. Johnson: Shell Service Station 301 N Congress Ave. Boynton Beach, Florida Release of Cash Bond Permit #01-4235 Petropac Job #EQ-7904 SCANNED ~E~ 2 7 gOO? BU/LDING DIVISION On April 23, 2002, Petropac Inc. submitted to the City of Boynton Beach an application for a Temporary Certificate of Occupancy. The City of Boynton Beach required a Cash Bond in the mount of $1,485.00 to cover the cost of construction for the canopy over the gasoline dispensers until final inspections were obtained. The final inspections for the above referenced project were obtained, and the Permanent Certificate of Occupancy was issued on July 05, 2002. Petropac Inc. hereby formally requests the release of the Cash Bond submitted to the City of Boynton Beach on April 23, 2002 for Permit #01-4235 in the amount of $1,485.00. Upon receipt and review of this request for the release of bond and if additional information is required please contact us at your earliest possible convenience. 4ames A Wynne III i[ECEilV'E OCT" 0 200'~ BUI !NG, ,DIVISION DEPARTMENT OF DEVELOPMENT BUILDING DIVISION MEMORANDUM NO. 02-080 TO: FROM: DATE: SUBJECT: Diane Reese, Finance Director Don Johnson, Building Official April 23, 2002 SCANNED DEC 2 7 100l BUILDING DIVISION CASH BOND - SHELL GAS STATION (Canopy Replacement) - 301 N. CONGRESS AVENUE Attached is a Cashier's Check for $1,485.00 from Petropac, Inc. This is a cash surety for the Shell gas station (canopy replacement) and is to be held until ail 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 fi-om R/chard R. Morris and check XC: Timothy K. Large, Building Code Administrator Permit File # 01-4235 S:kDevelopmentkBuild/ng D/v\DocumentskMemos in Word\Cash Bonds - 2002\Cash Bond - Shetl Gas Station (Canopy) 01-,I235.doc EXHIBIT "B" EXHIBIT "C"