PERMIT APPLICATIONBP200101
CITY OF BOYNTON BEACH
Application Inquiry
12/18/02
13:09:12
Application number ..... : 02 00001493
Application status, date : FINALED
Property .......... : 1575 SW 8TH ST
PCN ............. : 08-43-45-29-25-006-0000
Lot Number ......... :
7/26/02
Zoning ........... : PCD
Application type ...... : S
Application date ...... :
Tenant nbr, name ...... :
Master plan nbr, revwd by :
Estimated valuation .... :
Total square footage .... :
Public building ...... : NO
Work description, qty . . . :
Pin number ......... : 7208
PLANNED COMMERCIAL DEV.
SIGN
4/23/02
SIGN PACKAGE IN COMPLEX
1500 0
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DEPARTMENT OF DEVELOP1V ENT
BUILDING DIVISION
02-.1493
BUILDING PERMIT APPLICATION
(Please Print)
COMPLETE EACH BOXED ENTRY
Rec. #
Permit# ~)~"-[V?5
(FOR SUB PERMITS ONLY)
owner'sNameI ¢.
IOwner's Add~ess]
lc tyJ
zff oo6
Jason McArbhur
2600 N. Military Trail, Suite 100
Boca Raton
(Pa,m Beach cou.tv
IOwner's Phone
State FlOrida
Fee Simple Title Holder's Name n/a
Fee Simple Title Holder's Address n/a
Contractor's Company~ WP South BuJ. lders (FL So. ) LLC
Contact person and emergency phone ~
Paul Ederle 561-893-0094, ext.105
Company Address 1110 Northchase Pkwy, suite 150
City Marietta State
~ob Name Alta Chase
Mob Address 1575 SW 8bh Street, Boynton Beach FL
ILegal DescriptionJ TRACT F. WOOLBRIGHT PLACE
in Plat Book 67, Page-i:_47, Public Records of
Bonding Company n/a
ICompany Phone
Zip 33433
(Ifotherthan owner's)
(lfotherthan owner's)
561-893-0094
Pager/Fax# 561-893-0095
GA Zip 30067
33426
PLAT 1, a~cordin~ %0 thg_Plat thereof as recorded
Palm Beach county, Florida. Zoned
Bonding Co. Address n/a City
Architect/Engineer's Name
Architect/Engineer's Address
Mortgage Lender's Name
Mortgage Lender's Address
SINGLE FAMILY DUPLEX MULTI-FAMILY HOTEL
check one)
ESTIMATED VALUE OF CONSTRUCTION
DETAILED DESCRIPTION OF WORK:I
CHECK REVIEWER REQUIRED:
~ ~ ~ ~STRUClJ IFIRE~
State
Tseng Consulting Group
21 NE 166th Street, North Miami Beach, FL 33162
Mellon Bank , N.A.
1735 Market Street, Philadelphia, PA 19103
APR 2 3 2OO2
=F!L~ c. oPye
_mUiLDiNG DIVISION
INDUSTRIAL
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 Y(~I~ PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
Property Owner's or Agent's Signature ~ ~.~_, L t', ~ Date
STATE OF FLORIDA, COUNTY OF PALM BEACH
The foregoing instrument ;vas acknowledged before me this ,~.- Z ..~ ' ~92 '~.(date) by "~,k~ Ut_ /4' ~'t)~"~/_ k?
who is nersonallv known to me or who has produced ,, as identification and who did (did not)
- · ' ~-:~; ':,t ..... ' '
tale an oath. _ ,~ ~ , ~ gl .
(SEAL) ~/ .... ~ /~ %..~,~ ~~~,2005
Signature of person taking ackno~y.J.edgement ~/~._~H.ct~ g.Y /f~-/.~.)t~~e A~~ ~l~ljc~ acknowledgement - typed,
printed or stamped / ) /q . , _ff ., Title or rank Serial Number, if any __
Contractor's Signature .
STATE OF FLORIDA, COUNTY OF PALM BEACH
The foregoing instrument was acknowledged before me this /7/ - 2 ~ -g~ ~
.who i~s personally known to me or who has produced
take an oath.
,SEAL) x~ .~.,~g~. ~&A,X~
Signature of person taking acknowledgement ·
printed or stamped -- ~,/- Title or rank
(date) by
as identification and who did (did not)
Nam[?~c~hl~_~wledgement- ~ed,
' ~ ~~er, if any
(Certificate of Competency Holder)
Contractor's State Certification of Re, istration No.
Liability Insurance Expiration Da~e-)~ /~ .~
Workers' Compensation Expir~,~tl/c~Date [ _ff
Application Approved By L~ Permit Officer 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 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
J:\SHRDATA\DEVELOPMENT~FORMS.DOC\PERMIT APPLICATION A. DOC- Revised 6/18/97, 11/4/97, 12/98. 6/99, 8/99, 5/00, 8/00, 9/25/2000
APPLICATION #
APPLICATION DATE:
SETBACKS:
ZONE:
(THIS SIDE FOR OFFICE USE ONL
LEFT
RIGHT
MASTER PERMIT #
APPLICATION ACCEPTED BY:
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 (NC)
# 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:
Recpt #
VALUATION
SINGLE FEE
Building
Clearing & 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 #
FEE
Cash Rec'd from:
Accepted by: (Initials)
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
BALANCE DUE
Recpt # CK #
Cash Rec'd from:
Accepted by: (Initials)
J:\SHRDATA\DEVELOPMENT\FORMS.DOC\PERMIT APPLICATION A.DOC-Revised 6/18/97, 11/4/97, 12/98, 6/99, 8/99, 5/00, 8/00. 91251200r)
PREPARED 4/23/02, 17:08:39 PAYMENTS DUE RECEIPT
CITY OF BOYNTON BEACH PROGRAM BP820L
APPLICATION NUMBER: 02-00001493 1575 SW 8TH ST
FEE DESCRIPTION AMOUNT DUE ..
....................................................... ~---- 0 2- ~- 1-4-9-3---
SIGN PERMIT
TOTAL DUE ~
Please present this receipt to the cashier with full payment.
Total tende?ed
Total palment
Receipt no: