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PERMIT APPLICATIONBP200101 CITY OF BOYNTON BEACH Application Inquiry 2/08/02 13:35:16 Application number ..... : 01 00002644 Application status, date : FINALED Property .......... : 2378 SW 8TH AVE PCN ............. : 08-43-45-29-11-067-0110 Lot Number ......... : 7/20/01 Zoning ........... : R1AA SINGLE FAMILY (5.40) Application type ...... : RR RE-ROOF Application date ...... : 6/26/01 Tenant nbr, name ...... : Master plan nbr, revwd by : Estimated valuation .... : Total square footage .... : Public building ...... : NO Work description, qty . . . : Pin number ......... : 8729 TILE - SLOPED RA 3500 0 Press Enter to continue. F3=Exit F5=Land inq F10=Fees F11=Receipts F7=Appl names F12=Cancel FS=Tracking inq F13=Val calcs Fg=Bond inquiry F24=More keys DEPARTMENT OF DEVELOPMENT BUILDING DIVISION BUILDING PERMIT APPLICATION Rec. # COMPLETE EACH BOXED ENTRY Permit # (FOR SUB PERMITS ONLY) PCN# (Palm Beach County Property Control #) Owner's NameL..~_~,,~",~ .,,¢/~,~-~ ]Owner's Phone~ .~/- Owner's Address] ,.~.~j-"' ~:S"~..~ /~.ff~'~t,~ ICity I / state ~ zip ._~_~ r. fz. '~' Fee Simple~itle Holder's Name /,//v,~ (If other than owner's) Fee Simple Title Holder's Ad_dress /k', 4- (If other than owner's) Contractor's Compan~ )r-~..I/te~ ~.,~t$~ .~'/~. ]Company Phone Contact person and emergency phone ~ Company Address City ob Name ob Addres~ - egal Description] Pager/Fax# State /~"~... __ ~ICE INDUSTRIAL Bonding Company Bonding Co. Address Architect/Engineer's Name //.,/~,~ · Architect/Engineer's Address ------- Mortgage Lender's Name Mortgage Lender's Address SINGLE FAMILY .~ DUPLEX MULTI-FAMILY HOTEL City (check one) -- ESTIMATED VALUE OF CONSTRUCTIONI $ .~..5'"~, o~ IDETAILED DESCRIPTION OF WORK':I ~,~r~,ov¢ ,o/_~7 ~ ~/~~ ~ CHECK REVIEWER REQUIRED: Application is hereby required to obtain a permit to do work and insta~ations as in'cared. I ce~i~ that no work or installation has commenced prior to the issuance of a permit and that all work will be pedormed 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 cedi~ 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 ~ICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN A~ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. Property Owner's or Agent's Signature ~ ~~~~ ~ ~~ ~ Date STATE OF FLORIDA, CO~TY OF PALM BEACH The foregoing instrument was acknowledged before me this ~ / ~ (date) by ~g~ who is personally known to me or who has produced ~Z ~ ~ _ _ ~ O ~'~* ~ ~ -~~ ~nd ~(did not) t~ath. Linda Buford Sm~h /) ~j ~u~,200~ ~ ~ . ~ ~, ~ ~'~e o~[~m~l~6~d~~~e or printed or stamped Title or rank S,.n.,u e / The foregoing ins~ment was ac~owledged before me this ~ ~~ (date) by wh~ersonally ~own to me or who has produced ' ~ ' and who did (did not) ta~e an oath. ~ / ~ ,~ LY~ ANN HAYS ~ ' Signa~re of person taking acknowledgement ~~~ledgement - ~ped, printed or stamped ~ ~ff Title~ ra~ ............. - ~~ber, if any (Ce~ificate of C~mpetency. Holder) Contractor's State Codification of Registration No. ~ ~ ~ ~ O ~ ~ Liabili~ Insurance Expiration D~e~ ~--'~t ~ ~'~ ~ ~(0/// Workers' Compensation Expi~ate ~ ,~-- I ~ I ( f~]~ / Application Approved By [ ~ ~ ~ ~rmit 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 starling. 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 Ci~ of Boynton Beach. officer taking acknowledgement - typed, Serial Number, ~ any 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 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 MOD.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 ONLY) 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 (A/(~)., # 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: SINGLE FEE Building Clearing & Grubbing Drainage Electrical Excavation Fill Fire Alarm Fire Sprinkler Irrigation Landscaping Mechanical Paving Paving/Drainage Plumbing Roofing Sign Site Lighting VALUATION FEE SUB TOTAL TOTAL LESS PLAN FILING FEE Cash Rec'd from: ~_~J-? Accepted by: (Inifi21_~ / .-'~' h~.," L'J/'20d L [,1' ]4 } ',,,.,i ' 0L/23 D['rAMI-D:\D[ COUNTY. FLORIDA MF. TRO-D&DK FLAGLEP. BUILDING PRODUCT CONTROL NOTICE OF ACCEPTANCE b'Ionier Lifetile I.,LC 135 NW 20 St. Boca P, aton FL 3343 Your application for Product Approval of: IIUII, D[O'G COOE COMPLIANCE OF'FIC£ METKO.OADE FLAGLER BUILDt~G t t0 xu'~ST FLrxGLER STREET. SUITE 1603 MiAMi. FLORIDA 33[30-1563 (505) 375-290l FAX (305) 375-2903 CONTRACTOR LIC~h'SI~G SECTIO~ (305) ~75-25Z7 ~AX (~05) ~75-2553 CONTRACTOR ENFORCE~t~NT SECTIONS (305) 375-2966 FAX 005) 3~5-2903 PROOUCT CONTROL DIVISION 005) 3~5-2902 FAX (305) 372-6339 A t/azz th' ~'hake an d Slate Flat Profile Tile under Chapter 8 of ihe Code of Miami-Dude County governing the use of Atternate Materials and Types of Construction, and completely described herein, has been recommended for acceptance by the Miami-Dude County Building Code Compliance Office (BCCO) under the conditions specified herein. This approval shall not be valid a~er the expiration date stated below. BCCO reserves tSe right to secure this product or material at an~ime from a jobsite or manuhcrurer's plant fo? qu-xlity control testing. If this product or material fails to perform inthe approeed maimer, BCC0 may revoke, modi~', or suspend tlxe use of such product or material immediately. BCCO reserves the right to revoke this approval, if it is determined BCCO that this product or material fails to meet the requirements of the Sour Florida Building Code. The expense of such testing will be incurred by tF, e manufacturer. Acceptancel'4o.:99-1012,07 (Revises No.: 98-0604.01) Expires: 12/16/2002 'Chic[ Product Control Division THIS IS THE COVERSHEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL CONDITIONS BUILDING CODE & PRODUCT REVIEW COMMITTEE This application for Product Approval h~ been reviewed by the BCCO and approved by the Building Code and Product Review Committee to be used in D~de County, Florida under the conditions set forth, above. A!.L WORK I~VOLVED ON THIS MIT.SHALL CONFORM ~,~'i ;'.t-~ AI_L (;IT~ OF B/OYNTON BEACH I~UILDING CODES. .lutern~t mall address: postm~tstcr~baitding¢odconliae*c°m Director