PERMIT APPLICATIONB?200101
CITY OF BOYNTON BEACH
Application Inquiry
10/31/02
11:28:02
Application number ..... : 01 00004636
Application status, date : FINALED
Property .......... : 3010 S FEDERAL HWY
PCN ............. : 08-43-46-04-00-001-0131
Lot Number ......... :
10/30/02
Zoning ........... : R1AA SINGLE FAMILY (5.40)
Application type ...... : DL DEMOLITION
Application date ...... : 11/28/01
Tenant nbr, name ...... :
Master plan nbr, revwd by :
Estimated valuation .... :
Total square footage .... :
Public building ...... : NO
Work description, qty . . . :
Pin number ......... : 0621
SUN WAH & PARKING LOT
JP
10000
0
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DEPARTMENT OF DEVELOPMENT
BUILDING DIVISION SCANNED
BUILDING PERMIT APPLICATION
2003
I
Please print. All lines MUST be completed, if not applicable, write _N/. A.. ........... ~.,,-, ~ ,
Date:
F~ Sim~e T{le H~s N~e
F~ Simple T{le Hoid~'s Addr~s
City/State/Zip ·
Job Name
~ A~
C~t~p
Lega Oeecdpt~n
Bonding Company
Bonding Company Address
C~//State/ZJp
Architect/Engineer's Name
Architect/Engineer's Address
C~/state/Z~p
Mortgage Lender's Name
Mortgage Lender's Address
(Palm Beach County Property Control #) ~ .,
o,.,.,,'.Pho,~# ,5--~-/ 733 OC~'
(If other than owner's)
(If other than owner's)
City/State/Zip
(Check one below)
Single Family Duplex Multi-Family ~ Hotel
Estimated Value of Cormlructton $ . I tlT).LDO
Re{ail Off'me Industrial
(Check Reviewer Required below)
Electrical __ Mechanical ~~ __ 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 wod( will be perforated to mee{ the standards of all codes, laws, rules and regulations governing
construction in this jurisdiction. I undmstand 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 ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
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.
Property Owner's or Agent's Signature Date
STATE OF FLORIDA, COUNTY OF PALM BEACH
The foregoing instrument was
acknowledged before me this (date) by
Who is personally known to me or who
has produced As identif'mation and who did (did not) take an oath.
(SEAL)
Signature of person taking acknowledgement
Name of officer taking acknowledgement typed, printed or stamped
Title or rank Serial Number, if any
STATE OF FLORIDA, COUNTY OF PALM BEACH
The foregoing instrument was '~:x~4 "
,m pro~uc~ J.~,~,~..~CE>~ co,u~Js~ ,'~,~ J AS identification and who did (did not) take an oath.
Signature of I:~p,.t~,i~l~'ad~~,e~02 ' --
Title or rank Serial Number, if any
(Cectificate of Compatency Holder)
Contractor's State Certification of Registration No. ,.,~ f O~) ~ F/.J('
Liability Ins.rance Expiration Date ~ ~- 2~? ~' Workers' Compensation Expiration Date
Application Approved by /,'-.~,~'~ ~ . (Perm~ Officer) Date
NOTI~: This permit VOID efta' 180 DAYS UNLESS t~e work which it corem ha~ commenced. AJI Contractom must have valid State Certification o~ County Competency
plus County and City Occupational Licenses prior to obtaining parrnit.
ISSUANCE OF THIS PERMIT DOES NOT AUTHORIZE VIOLATION OF D~I=D RESTRICTION~
F~_F~ ARE NOT REFUNDABLE
(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 (Nat)
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
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
VALUE
FEE
Receipt Number
Check/Credit Card Number
Cash
Received from:
Accepted by: (Initials)
DEPARTMENT OF DEVELOPM TAN N ED
BUILDING DIVISION
BUILDING PERMIT APPLiCATION JAN 0 ? 2003
Please print. All lines MUST be completed. If not applicable, ~ lYg~ o. r~ ~ ~ / ~ ~ , r~ ~ ~
Date:
Owner's Name ~~ L~ ~ ~.t~me~ P~
F~ Sim~ T~le ~ N~e
F~ Simple T~le Holder's ~dr~s
G~y/State~ip
C~a~ ~n & e~y ~ ~
C~pany A~rms ~t ~ ,'~ ~.
City/State/Zip
Job Name
Job Address
City/State/Zip
Legal Descriplion
Bonding Company
Bonding Company Address
City/StatefZip
Architect/Engineer's Name
Amhitect/Engineer's Address
C~y/state/Zip
Mortgage Lender's Name
Mortgage Lender's Address
(Palm Beach County Property Control #)
(If other(hah o~vner's)
(If other than owner's)
City/State/Zip
(Check one below)
Single Family Duplex
Estimated Value of Consa:uction $
Detailed DeecdptJon of Work
Multi-Family ~ Hotel
Re, ail Office Industrial
(Check Reviewer Required below)
Electrical Mechanical v,/'-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 prior
to the issuance of a permit and that all work will be performed to meet the standards of ail 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, E'I'C.
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'rrORNEY BEFORE RECORI31NG YOUR NOTICE OF COMMENCEMENT.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in c(~pliance with all
applicable codes, laws, rules and regulations governing construction and zoning.
Property Owner's or Agent's Signature Date
STATE OF FLORIDA, COUNTY OF PALM BEACH
The foregoing instrument was
acknowledged before me this (date) by
Who is personall~(.rl~l~.me or wh~lN FESSER
h.. o uced MYCO U SS O,#D 2 As identification and who did (did not) take an oath.
/1~:..~...;."~'~ EXPIRES: Jane 23, 2006 I~~
(SEAL) /i ~.~:~;~,..'~-' ~o~ ~,=.o.~ ~u~.~ ~*.~
Name of ofrmer taking acknowledgement ~ty~d., printed or stamped
Title or rank . ~~ ? Serial Number, if any
STATE F OR,DA, OF
The foregoing instrument was
Whoisj:~,l~'~.~"'~y"~-ut'~ntorneor~o i~?.¢~;,~"'0, co~.~o..u.s. ! As ibentir~..ation and who did (did nct) take an oath-
Signature of person taking acknowledgement .~-- . .~
N~ne of officer taking acknowledgement typeD, pnnte~ or~tampe~
Title or rank ~ ~erim murr~er, · any
(Ceffiflcate of Competency HoMer) .~ ~;~ /
Contractor., State CerC, cat,or., of.ngis,rat,on,o. ~.fi~./'_.O I g'~::~-'-2 L.~
Liability Insurance Expiration Date ~- ~--..--, ;r--5~"% W~rkers' Compensation Expiration Date '~--( - ~ ~)~
Application Approved by
NOTE: Thie permit VOID after 180 DAYS UNLESS the work which it co.rs has commenced. A~I Contractors must have valid State CerlJflcafion or County Competency
plus County and City Occupetio~al License~ prior to obtaining permit.
ISSUANCE OF THIS PERMIT DOES NOT AUTHORIZE VIOLATION OF DEED RESTRICTIONS
FEES ARE NOT REFUNDABLE
FF-] HI--J
(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 Stories
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
Cleadng & Grubbing
Drainage
Electrical
Excavation
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
VALUE
FEE
Receipt Number
Check/Credit Card Number
Cash
Received from:
Accepted by: (Initials)
DEPARTMENT OF DEVELOPMENT
BUILDING DIVISION
BUILDING PERMIT APPLICATION
01
-46
36
Date:
Job Address
City/Slate/Zip
Legal Description
Bonding Company
Bonding Company Address
City/State/Zip
Architect/Engineer's Name
Please print. All lines MUST be completed. If_niot applicable, write N/A.
~ _ ~ ~ _ o ~ Master Permit # g) [ L.[ (.~) (,~ ' Permit #
¢'L.
PCN~
Owner's Name
F~ Sim~e T~ H~s N~e
F~ Simple T~le Hoider's ~dr~e
C~y/St~Zip
Job Name ~&~ kn~.
(Palm Beach County Property Congo/#)
z~ Code .~3 ff..v_5"
Of other than owner's)
(ff other than owner's)
Company Phone # <~ 0..~- ~' r-~2 ~-4:3-~¢¢
~ 30 / 8
Zoned
Architect/Engineer's Address
C~y/State/Zip
Mortgage Lenders Name /~ I lC}
Mortgage Lender's Address
City/State/Zip
(Check one below)
Single Family Duplex Multi-Family
EMimated Value of ConsUuc~on $10~;~
Detailed D__~_.'plJon of Work
D,,"m ~'--~,Z", ~, -'-
Hotel ~ Retell Off"me Industrial
~_~viewer Raguted below)
(..~_ (~ 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 issuance of a permit and that all wo~ will be performed to meet the standards of all codes, laws, rules and regulations governing
cormtruction in this jurisdiction. I un(ler~tand 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 ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
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.
Property Owner's or Agent's Signature Date
STATE OF FLORIDA, COUNTY OF PALM BEACH
The foregoing instrument was
acknowledged before me this (date) by
Who is pemonally known to me or who
has produced
(SEAL)
As identification and who did (did not) take an oath.
Signature of pemon taking acknowle~eme~t
STATE OF F'O.IOA, COU4Y OF
The foregoing instrument wa~
acknowledged before me this
or ,stamped
Serial Number, if any
Date
ACH
hal ~~A.~.,~.~ I As identrcation and who did ((lid not) take an oath.
'l~~: ~o.~. I
I '- ""- "-',
Titl~ ~__~ ~vo' NOV. 2~;zuuZ__l x..._) SerTal Number, if any
(CerUflcate of Competency Hoider)
Contractor's State Certification of Registration NO.
Liability Insurance Expiration Date .-~'~.z// ~.C,~-~, Workers' Compensation Expiration Date ::~"~.-~ 'ZOO "~
/
Application Approved by , ~_~._ ,~____..__..p (Permit Officer) Date
NOTI~: This peri. it 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 Occul~ional Licenses ixior to obtaining permit.
ISSUANCE OF THI~ PERMIT DOES NOT AUTHORIZE VIOLATION OF DEED RESTRICTIONS
FI~ES ARE NOT REFUNDABLE
(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 (Gm&s)
Area Square Feet (Net)
Number of Stories
Number of Bedrooms
Remarks:
.... IF THIS BOX IS I~OT COMPLET'ED, 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
Irrigation
Landscaping
Mechanical
Paving
Plumbing
Roofing
__ Sign
Site Ughting
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
CheckJCredit Card Number
Cash
Received from:
Accepted by: (Initials)
DEPARTMENT OF DEVELOPMENT
BUILDING DIVISION
BUILDING PERMIT APPLICATION
01-4636
Please print. All lines MUST be completed. If not applicable, write N/A.
Dat.: ~-2b~OZ- Master Permit # Permit# ~/'
PCN# f~ c~ - Lt"~. ~ {~- Or.(- ~ 0 -00 ~- C)~> [ (Palm Beech County Property Con~l #)_..
Fee Simple Title H~ider's Name (If other than owner's)
Fee Simpl~ Title Holder's Address (Il' other than owner's)
City/State/Zip
Contractor's Company ~~.~-~~-----~'-- Company Phone #
Contact person & emergency phone #
Company Address ~.~.~?._. /O ~,O ~.,,~ ~'lr, Pagee/Fax~
JobName ~x"~ ~-o'~,-' L.,~'-~[5, .
Legal Deecfipl~m i?~ ~ 1 '~o,.~..~ c,. ~.~'-~¥~. Zoned
Bonding Company
Architect/Engineer's Address gFP 2 3
Mortgage Lender's Name ~, ~[ ~
Mo age LendeCs Add., i 6[JiLUil b _
City/State/Zip !
(Check one below)
Single Family Duplex Multi-Family Ho~el
Estimated Value of ConatncIkm $ f~ ~,~0~2~~
Retail j Office Industrial
(Check Reviewer Required 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 o~ installation has commenced prior
to the issuance of a permit and that alii work will be performed to meat the standards of afl codes, laws, rules and regulations governing
construction in this jurisdictkm. I understand 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 ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
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.
Property Owner's or Agent's Signature Date
STATE OF FLORIDA, COUNTY OF PALM BEACH
The fm'egoing 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 pe~on taking ecl(nowledgement
Name of offlce~ taking acknowledgement typed, printed or stamped
Title or rank SePal Number, if any
Contractor's Signature ~-.:~_./~-' ~ Date .
STATE OF FLORIDA, COUNTY OF PAU~I BEACH
The foregoing instrument was
VVho' R
. .~1~ _ ,.~ ~ ~"~C'~':/495 ~ AS idantlfioaiJon and who did (did not)take an oath.
Name ~ acl~nowledgement typed, printed f~tamped '~'~,~. C ,'~
Title o~ rank Serial Number, if any
,... (Celificate of Competency Holder)
Liability Insurance Expiration Date b~- ~ --O '~ Workers' Compensation Expiration Date
Application Approved by ~~- (Perm~ Officer) Date
NOTI~: This permit VOID after 180 DAYS UNLESS the work whic~ it covers ha~ commenced. All Co~tracto~ must have valid State Certification or County Compete~'y
p~us County and City Occupational Licenses ~'ior to obtaining permit.
ISSUANCE OF THIS PERMIT DOES NOT AUTHORIZE VIOLATION OF DEED RESTRICTION~
FEES ARE NOT REFUNDABLE
FIJI Hr-]
(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 Stories
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
... Cleadng & Grubbing
Drainage
Electrical
Excavation
Fill
Fire Sprinkler
Imgation
__ 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
FEE
Accepted by: (Initials)
DEPARTMENT OF DEVELOPMEN
BUILDING DIVISION
BUILDING PERMIT APPLICATION
Please print. All lines MUST be completed. If not applicable, write N/A.
Date: Master Permit # Permit# O !--
..... (Palm Beach County Property Control
Owner's Name ~~ L~~ ~ ~~~C~ ~L~Owners Phone ~
~necSAddresS IgS~ N~ tS~ 5~~ ' ~ '
Ci~ ~~~ ~~ -- ' State ~ ~ ZipCode
Fee Simple Title Holder's Name '-~ t [ ~ ~ (If other than
Fee Simple Title Holder's Address ~ ~ (If other than owner's)
City/State/Zip
Contractor's Company ~, .. ......... C~ . ._ Comj~any~ Phone~_~ #
Contact person & emergency phone #. - - ~,J ~
Company Address q ~1~ Pager/Fax#
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
City/State/Zip
Modgage Lender's Name
Mortgage Lender's Address
City/State/Zip
Zoned
(Check one below)
Single Family Duplex Multi-Family HotelV" Retail Office Industrial
Estimated Value of Construction $ ~~)
_Detailed Description3 o[,,~/.ork_.
(C~ak Reviewer Required 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 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. ELECTR CAL, PLUMBING, SIGNS, WELLS, POOLS,
FURNACES, BOILERS, HEATERS, TANI<S and AIR CONDITIONING WORK, ETC.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FO.R IMPROVEMENTS TO YOUR PROPERTY, IF YOU INTEND TQ OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING yoUR N~-I:~/M~NCEMENT.
OWNER'S AFFIDAVIT: I certify that all the foregoing inf~;Fa~ti~:~..,~,c, ura'te and that all work will be done in compliance with all
STATE OF FLORIDA, COUNTY OF PALM BEACH
The foregoing instrument was
acknowledged before me this ~L ~'1~ ~"'~~ ~0O I (date) by
Who is per_sonally known [9 me or who
.rod ce .... *s o th.
(SEAL) ~ ¢...~~
Signature of person taking acknowledgement ~ /~~ ~
Title or rank ~~ ~ Serial Number, if any
Contractor's Signature ~ /~ Date
STATE OF FLORIDA, COUNTY OF PALM BEACH ~
The
foregoing instrument was b~~
acknowledged before me this ~ ~ ~ ~ CO / (date)
.~ho i¢ personally known to me or who
ha~ produ~d As id~~~ ~ an oath.
Signature of person taking acknowledgement ~~ ~
/~~
Name of officer taking acknowledgement typed, printed or stamped -'4~&~' ~c Bo~ ~., l~.
Title or rank Serial Number, if any
(Certificate of Competency Holder)
Contractor's State Ce~ificat~at~
Liability Insurance Expi 'r~~~//. ~orkers' Compe~safio~ [xpir~tion ~ate
Applier ion A pp roved b~.~~Z.~~~~ (Pe ~', 0 ~ced Da te
o~e~ and building agree to ~ct ~cture in fu~c~pliance ~[h the Building and Zoning Codes of the City of Boynlon Beech.
NOTE: This permit VOiD after 180 DAYS U~SS the work which ii covers has commenced. All Contractors must have valid State CedJfication or County Competency
plus Counly and Cily Occupational ticenses prior to oblaining permit.
ISSUANCE OF THIS PERMIT DOES NOT AUTHORIZE VIOLATION OF DEED RESTRICTIONS
FEES ARE NOT REFUNDABLE
S:\DEVELOPMENT~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
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 Stories
Number of Bedrooms
j~g~l~ ~.~ r
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
Irrigation
Landscaping
Mechanical
Paving
Plumbing
Roofing
Sign
Site Lighting
VALUE
·
Sub-Total
TOTAL
Less Plan Filing Fee
Receipt Number (.12 ~, L-~'~
FEE
Check/Credit Card Number
Cash
Received from:
Accepted by: (Initials)
BALANCE DUE
Receipt Number
Check/Credit Card Number
Cash
Received from:
Accepted by: (Initials)
S:\DEVELOPMENTtFORMS&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
DEC--05--01 SAT 0~ -'29 AM P. 02
~:' , , :,tj/ ~,,_.-~r!,,,
CITY OF BOYNTON BEACH
DEVELOPMENT DEPARTMENT
~ 00 East Boynlon Besr-,h l~Ivd.
P. O, BOX 310
Eoynton Beach, Florida 3342~-0310
02'4~36
PLAN REVIEW COMMENTS
PLEASE NOTE THAT THE EFFICIENCY BY WHICH YOU RECEIVE YOUR PEP, M~T
DEPENDS ON YOUR RESPONSE TO THE CONTENTS OF THIS DOCUMENT. IT IS
RE. COMMENDED THAT 'YOU CAP, F_FULLY READ AND CORRECTLY RESPOND TO
ALL ASPECTS OF THIS DOCUMENT.
COMMENTS:
For permit application ~[Jmber / review: 0_~,.:_4~35
Project Name or Address'. SUN WAH
REVIEWED
Depattmerlt. and/or Division: _B_uildlng Division
Name of Reviewe~ doh_._.p_n ,pa~lliarulo ....
Trade; _Str_~_¢[uml ':
Phone ~ [56~42-67~ e~.
Review Date:
Type of Review: S~UCT
COMMENT DISTRIBUTION:
Person identified on the application ~o receive commen~: /~'~"
Name ADVANQE CONTR,.SERVICES
PhOne ~ . (~ea~de:g54) 9~g-3200 ext,
Person who received ~e call
STAFF MEM~E~:
Comment(s) recd. by print name and
Plans/Comments recd, by print name and
C'II~F'T f~r- ~-r~lT
,:,riLL:, ~,' r,~.,'~,,~ ~ SET
DO NOT REMOVE
TRANSMISSION VERIFICATION REPORT
TIME
NAME
FAX
TEL
01-4636
12/07/2001 14:17
CITY OF BOYNTON BLDG
5617426357
DATE,TIME
FAX NO./NAME
DURATION
PAGE(S)
RESULT
MODE
12/07 14:16
91954979388040678
00:00:43
03
OK
STANDARD
EOM
SHEET OF PERMIT SET
DO NOT REMOVE
'Page 2~0f 2 Plan Review Comments for Permit Application #
01-, 636
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. For questions regarding my review please
contact me at the number listed above. If a conference is necessary, please schedule
an appointment. Phone calls and appointments are received and scheduled during
work days Monday through Friday 9:30 to 10:30 AM and 1:45 to 2:45 PM. 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.
1- PLEASE SUBMIT DEMOLITION SIGN OFF SHEET FOR ALL UTILITIES TO BE
DISCONECTED.I.E. FPL,GAS,WATER, SEWER ETC.
2-
CITY OF BOYNTON BEACH
DEVELOPMENT DEPARTMENT
100 East Boynton Beach Blvd.
P. O. Box 310
Boynton Beach, Florida 33425-0310
01'4636
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 / review: 01-4636
Project Name or Address: SUN WAH
REVIEWED BY:
Department and/or Division: Building Division
Name of Reviewer: John Pagliarulo
Trade: Structural
Phone # (561) 742-6754 ext.
Fax # (561) 742-6357
Review Date: 11-30-01
Type of Review: STRUCT
COMMENT DISTRIBUTION:
Person identified on the application to receive comments:
Name ADVANCE CONTR.SERVICES
Phone # (area code:954) 979-3200
Fax # (area code:561 )
Date(s) reviewer called:
Person who received the call
ext.
THE FOLLOWING AREA SHALL BE FILLED-IN IN THE PRESENCE OF A BUILDING DIVISION
STAFF MEMBER:
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 Plan Revie'w Comments for Permit Application #
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. For questions regarding my review please
contact me at the number listed above. If a conference is necessary, please schedule
an appointment. Phone calls and appointments are received and scheduled during
work days Monday through Friday 9:30 to 10:30 AM and 1:45 to 2:45 PM. 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.
1- PLEASE SUBMIT DEMOLITION SIGN OFF SHEET FOR ALL UTILITIES TO BE
DISCONECTED.I,.E. FPL,GAS,WATER, SEWER ETC.
2-
Building Division
FACSIMILE
- 01-~636
CITY OF BOYNTON BEACH
Department of Development
City Hall, West Wing
100 E. Boynton Beach Blvd.
P.O. Box 310
Boynton Beach, Florida 33z[25
(561) 742-6350
(561) 742-6357 Fax
TO:
FR 0~:
DA T£'
NU/¥BER OF PA GES: (including cover)
SHEET OF PERMIT SET
DO NOT REMOVE
If you receive this fax in error; or experience trouble with transmission, please notify our office
immediately, at (561) 742-6.350. Thank you.
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 / review: 01-4636
Project Name or Address: SUN WAH
REVIEWED BY:
Department and/or Division: Building Division
Name of Reviewer: John Pagliarulo
Trade:
Phone #
Fax #
Review Date:
Type of Review:
Structural
(561) 742-6754 ext.
SHEET OF ?ER II SET
(561) 742-6357
11-30-01
STRUCT
REMOVE
COMMENT DISTRIBUTION:
Person identified on the application to receive comments:
Name ADVANCE CONTR.SERVICES
Phone # (area code:954) 979-3200 ext.
Fax # (area code:561 ) ~_ ~-~z¢
Date(s) reviewer called: / - '
Person who received the call
THE FOLLOWING AREA SHALL BE FILLED-IN IN THE PRESENCE OF A BUILDING DIVISION
STAFF MEMBER:
COMMENTS/PLANS PICKED UP:
Comment(s) recd. by print name and date:
OR
Plans/Comments recd, by print name and date: