PERMIT APPLICATIONBP200101
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PCN ....
Lot Number
CITY OF BOYNTON BEACH
Application Inquiry
number ..... : 01 00002767
status, date FINALED
........ : 100 BUTTONWOOD LN
....... 08-43-45-18-04-004-0000
7/13/01
Zoning .......... : PUD PLANNED ZONED DISTRICT
~App!!ca,tion It, y,pe ...... : E ELECTRIC PERMIT
App/lca~lon image ...... : 7/05/01
Tenant nbr, I name ...... : SANDALWOOD DR COMMON AREA
~Malst. er, pl, an~nbr;.revwd by . : WLB
Ls~ma~ea va/ua~on .... : 300
~To,t.a! s,qua..r ~.footage .... : 0
FUD/1 C DUl/ Il ng ...... : NO
Work descri)tion, qty . . . :
Pin number ........ : 1939
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2/20/02
16:47:43
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DEPARYMENT
BUILDING DIVISION
OF DEVELOPMENT
BUILDING PERMIT APPLICATION
(Please Print)
COMPLETE EACH BOXED ENTRY
Rec. #
Permit #
PCN# 08 4:45 18 04 002 0000
Iiwner's I Adelnhia Cable Communications
wner'sAddre~ssI 1~95 S.W. 4th Avenue
ityl Delrav ~ea~----
Fee Simple Titie Holder's Name
(FOR SUB PERMITS ONLY)
(Palm Beach ~ Property Control #)
· O~ne--~hone ~561-279-2522
State F1
Fee Simple Title
Contractor's Gl
Contact persor
Willia~
Company Addre
City West Pa
ob NameI C·
ob Address~
egal Descripti
Bonding Compa
Bonding Co. Ad(
Architect/Engine
Architect/Engine
Mortgage Lende
Mortgage Lende
SINGLE FAMIL'~
check one)
ESTIMATED V/~
DETAILED DES
CHECK REVIEWEF
Application is here
commenced prior 1
regulations govern
SIGNS, WELLS, F
OWNER'S AFFIDi
codes, laws, rules
WARNING TO ¢
PAYING TWICE
WITH YOUR LEI
Property Owner
STATE OF FLOR
The foregoing instru~
who is personally l~n
take afl' oath. ~
(SEAL) 1~,
Signature of per,
printed or stamped
Contractor's Sic
STATE OF FLOR/
The foregoing inst~
who is personall.!;
take an'math, i~
Holder's Address
)mpan~ Higgins Electric
and emergency phone ~
t Ray Higgins 561-684-0410
ss 3037 Haverhill Romd
ICompany Phone
Pager/Fax#
State FI
.lm Beach
TV
Sandalwood Drive Common Area, Boynton Beach
~nJ Sub: Chalet 4
ly Ashton Agency
Iress P.O. Box 7100 City Winter Park
~r's Name
9r's Address
"s Name
"s Address
__ DUPLEX __ RETAIL OFFICE
LUE OF CONSTRUCTIONI $300.00
CRIPTIONOFWORi~:I . 1) 15 amp 120 volt CAtV ?owe~ Supply Servlce
:REQUIRED:
Zip 33444
(Ifotherthan owner's)
(Ifotherthan owner's)
561-684-041~
561-684-6653
Zip 33417
Zoned
MULTI-FAMILY ~/~ HOTEL
State F1
INDUSTRIAL
ument was acknowledged before me this
~u- ,~ ~N C. BRUM~K
,lent was ,ac~,owledi~ed before me this 07- __O _~_ 2 _O ( (date) by ~J fL- L , ,'~ ~ R,~ y h//~ q I~ '~.
~e~~ced i .... --~t~fi~thn and who did (did not)
~[~~~'~~~~"~ame of omcer taking ac~owledgement- t~ed,
~ ~' ~ ~ ~ ~ ~ ~ Title or rank Serial Number, if any
n ature.~~~~ /~~f ~ Date 07~0 ~ /
DA, CO~TY OF PALM B~AC~
(date) by
as identification and who did (did not)
WNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT ,, YOUR
FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
4DER OR AN ATTORNEY BEFOR[REC,ORDIN~ NOTI~,~OF COMMENCEMENT.
's or Agent's Signature _ Date ~ 7- o 3 - o /
iDA, COUNTY OF PALM BEACH / ~ ~/t~t'
~VIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
~nd regulations governing construction and zoning.
~ ISTRUC'I1 ' IFIREI pTHER~
3y required to obtain a permit to do work and installations as indicated. I certify that no work or installation has
o the issuance of a permit and that all work will be performed to meet the standards of all codes, laws, rules and
ing construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL, PLUMBING,
OOLS, FURNACES, BOILERS, HEATERS, TANKS AND AIR CONDITIONING WORK, ETC.