PERMIT APPLICATIONBP200101
CITY OF BOYNTON BF2%CH
Application Inquiry
Application number ..... : 01 00002514
Application status, date : FINALED
Property .......... : 552 E W00LBRIGHT RD
PCN ............. : ......
Lot Number ......... :
Subdivision ........ : MELEAR PUD
Zoning ........... : C3 COMMUNITY COMMERCIAL
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 ......... : 8419
SIGN
6/18/01
ANTHONY'S
JP
1800
0
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2/28/02
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2/27/02
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DEPARTMENT OF DEVELOPMENT ¢
BUILDING DIVISION
BUILDING PERMIT APPLICATION Rec. Cf ~ '7'7'K,.~'''''~
(Please Print)
COMPLETE EACH BOXED ENTRY Permit #
Owner's Address -)Il ~. 6~'~v~.~ ~J-~-~'.-¢~,ut--~J~
City Ov'L[_,x_ vx.~ C) o - State
Fee Simple Title Holder's Name
Fee Simple Title Holder's AtJdress
Contractor's Companyt
3ontact person and emergendy phone
Company Address
City (,,L~ff~-
ob Name~
ob Addres~
egal Descriptionl
(FOR SUB PERMITS ONLY)
(Palm Beach County Property Control #)
IOwner's Phone ~
ICompany Phone
State
Pager/Fax#
Bonding Company
Bonding Co. Address
Architect/Engineer's Name
ArchitectJEngineer's Address
Mortgage Lender's Name
Mortgage Lender's Address
SINGLE FAMILY
DUPLEX
Zip ~ ¢~::~ !
(If other than owner's)
(If other than owner's)
fState
Date '~~/'5J-~,/ff
STATE OF FLORIDA, COUNTY OF PALM BEACH
Twhh~ f. oregoin~was acknowledged before me this
. o Is pe .~nally known~ me or who has produced /.-, d't ' :.., ~'~% KAR, u~s[~ss~n~t~l~h eld who did (did not)
take an
~re of person tak]n ac~owied ement
.
pnnted or stamped ~ Title or ra~ Serial Number, if any
(Cert~c.~te of Comp~.J~y Holder)
Contractor's State Certification of Registration No. w___&% OOO L.~ ( k~,A
Liability ~nsurance Expiration Dat~e ~ ~ .~, tX ~!
Wor.k. er.s. Compensation~...,q~i,~~~. ~ . ~,~ I '11[, ~" ~ ~ ·
Any change in building [~ o.r specifica,:~C,Cmust be recorded with this office. Any work not covered above must have a valid permit pr or
to starting. In considera'Iion 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\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
Signature of person taking acknowledgement
printed or stamped ~ ~~ Title or rank
Contractor's Signa~~
as identification and who did (did not)
l~af'~r~ offi~'~m~led~ment- t~ed,
' J-~-~OT_AR~ F~. ~?~~~__ _If any
MULTI-FAMILY HOTEL RETAIL ~ OFFICE INDUSTRIAL
(check one) -- -- ', ,,-x ,-. ,-~-- -- --
EST!MATED VALUE OF CONSTRUCTIO~N,~ $ J ~]'L,,~,, -
IDETAILEDDESCRIPTIONOFWORK:I _~;'(4.~t( (,J' ,=~---/~ ~ ~--~(,,k_~.x..¢,~ 1¢_.44o%
.~?I~CK R~VIEWER REQUIRED:
~_____________.~,~'/~. ~ ,(~TRU~C];~''/ IFIREI OTHERI - ~
,'-q~l~ccanon is hereby requ red to ob"~atl'F~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 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~OTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO Y/OUR PROP/ERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY B~FOR~CORDING YOUR NOTICE OF COMMENCEMENT.
Property Owner's or Agent's SJgna~__..~_..~.~..~_~ ~ Date
STATE OF FLORIDA, COUNTY OF PALM BEACH
The foregoing~was acknowledged before methis 1~-~I.~ '~,l.~r~) (date) by (. [f&~¢'- t.~..~LJ.4
who is perso[fally known 3b me or who has produced
take an oath. '~_.___.~--~
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/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:
VALUATION
SINGLE FEE
Building
Clearing & Grubbing
Drainage
Electrical
Excavation
Fill
Fire Alarm
Fire Sprinkler
Irrigation
Landscaping
Mechanical
Paving
Paving/Drainage ~
Plumbing
Roofing
Site Lighting
SUB TOTAL
TOTAL
LESS PLAN FILING FEE
Cash Rec'd from:
FEE
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 MOD.A.DOC- Revised 6/18/97, 11/4/97, 12/98, 6~99, 8/99, 5~00, 8/00, 9~25/2000