REVIEW COMMENTS
.........'-'........~__.a.............:r .a.-..i...L V -L~..1..\...JL-'"
;1"6- - 3c'OY
BUILDING PERMIT APPLICATION
(Please Print)
Permit #
('OR SUB PERMITS ONLY)
PCN # OB_L/?J 1.(& 0-10:6 ODD 0;) { ~
(Palm Beach County Propert~ Control #)
OWner's Name ,\.t.-;)""--N~'l ''''' ~~\\""N~ ~C
OWner's Addres 2... ~ "", 5;:)\::> ,,-, ~ ~N "I \
City ~~~\.-....'\
State_ ~ Zip D,..~C\\7
Fee S1mp e T1tleholder's Name
(If other than owner)
OWner's Phone #<:'\~-/~~-:?'Sl (p
Fee Simple Titleholder's Address
(If other than owner's)
Contractor's Name
Contractor's Address
City
State
Job NameCl'''~~) ~,k''""'1
Job Address 7
City >l ~c:f~~,<::l
Legal Description~
Contractor'. Phone'
Z,ip
{. ~E!-A-( '=I WG..-\O~
'CJ !~.5,.."" \.-.... "" " ~ 't
County
Bonding Company
Bonding Co.Address
ArChitect/Engineer's Name-11~~ ~IC^\
Architect/Engineer's Address '2.(piY2-- -;" d,.." """
Mortgage Lender's Name
Mortgage Lender's Address
SINGLE FAMILY: DUPLEX:
(check one)'
ESTIMATED VALUE OF CONS RUCTION:
DESCRIPTION OF WORK:
I
City
f-.lw'-f
State
wel';>
MULTI-FAMILY:
HOTEL:
.
RETAIL:v OFFICE: INDUSTRIAL:
G:" ~IINT M",~1l.D
5', Qt'DlA \(Q SITE. erG
Li), v 4 "I(J:;..,-.) ~H 'r~
,..,
$-1 Z,0p~v
!)
aClC.AO'
o
I
: ,.1)(" 't l ~
App 1cat1on 1S to obta1n a perm1t to 0 the wor
certify that no work or installation has commenced prior to
all work will be performed to meet the standards of all laws regulating construction in
jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK,
PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and AIR CONDITIONERS, ETC,
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work
will be UUCld in compliance with all applicabLe laws regU!atLng construction and zoning.
WlUUfING TO OlfHBR. YOUR FAILURB CORD OF COIlIIBHCIDOlIlT MAY DSULT IN YOUR PAYING
TWICB FOR IMPROVlDOlllTS TO YOUR P BRTY. TO OBTAIN FINANCING, CONSULT WITH YOUR
Ll!:HDER OR AN ATTORHBY BBP'ORB DCORD C \
Property owner'. or .ligeDt'. Signature Date ~ \a.... \~ ~
STATE OF FLORIDA, COUIITY. 'OF PALM BEACH ,1- fl'S- '
~he forego~?9 i9stru.eQti.~s acknowledged before me this 7<f _ ~ (date) by
-v'~~ . who is personally known to me or who has roduced
~ype of iden~~fication) as identification and who did (did not) take ar
o~th. Jut 1 () ',99:1 II>
(SEAL) ." ~ - _ /:' 0 ..-----
Signature of person tak~ 9<l,acl&'iowledgement a......:.kA A~~~ ~R
Name of officer taking n,?wledgement-,.typed, prGte!""~ stamped Nnrlll'l PlIRIlr. ~TAn (11; m4ln
Title or rank "' 'I,' I ' " Serial number, if any IYmlllIlSSIONEXPIRES NO't8. 1.
,;::. -TIT.." \"" \, ;,
Contractor'. 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
(type of identification) as identification and who did (did not) take aJ
oath.
(SEAL)
Signature of person taking acknowledgement
Name of officer taking acknowledgement--typed, printed or stamped
Title or rank Serial number, if any
(Certificate of Competency Holder)
..........Ul.....a...........1I. ~ ~:...Qi...;, Certification or Registration No.
Contractor's CertificaTe of Competency No.
LIABILITY INSURANCE EXPIRATION DATE:
WORKERS' COMPENSATION EXPIRATION DATE:
APPLICATION APPROVED BY Permit Officer
Date:
Any change in building plans or specifications must be recorde6 with this office. Any work no
covered above must have a valid permit prior to starting. In consideration of the granting of
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 been commenced. Ai
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
THIS PERMIT OR PLANS FILING FEE IS NOT REFUNDABLE
"
13'~~- )C:EJ?ffl!J' W,tHF! It: 0
" CITY OF BOYNTON BEACH O/Gl1'E:" ~\~
PLANNING & ZONING DEPARTMENT COMMENT.SHE[T
"
".!le of Revie"er ..ntJ1ZtY1-."t ~Per.it APpUaation No. I q~- ~Of
projeat Title :D .JIU/<' NJ ' ~~ Id-r\:
'rype of nevie" .ro' U 0(1..-- S, Tl!E riA-A) K€V/~ /
,TO I BuU,Uno Oepartment plans Analyst L.y.,vJU ./17#15
Date identified on the Building Department Date Stamp marking on the It)-~ ~r-
application.' ' -,. ~
Date Planning and Zoning Department received the documents for sbove- I ~
referenced Permit Application Number. _. ".. 0 ~ - 9..(
Date this Determination Sheet was given to the Building Department. /0 - ~ -9{
The follo"ino is a list of the Technical Review Committee
departments that are required to review the above-,referenced p'Ulni t
docUlllents prior to the permit being issued:
s ~ /ff!li-c tfef)
fJfJiP/r (' A-I/O,u
141> D>>-rel)
.; () - (p ,q r;.-
'By ItPP// ( 4,A/T
- '171P~'S
-- ~T PI
10,.(.. -9S
BUILDING
FIRE
ENGInEERInG
UTILITIES
POLICE
PUBLIC WORKS
PLANNING . 10NINa
RBCREATION . PARKS
FORBSTER
IIOT&S: Ke:vIeJ.A/Gn , MSt:::TI'J
/" -t, -9-1
--
.
.
-------
R~IJ'.s"-'l a#&" Jt~vI.re:O .rft/f'S',t-V/St'b ~MfS- f?~UU~D 9(''0(<75
.........'-'........~__.a.............:r .a.-..i...L V -L~..1..\...JL"'"
;1"6- - 3c'OY
BUILDING PBRMIT APPLICATION
(Please Print)
Permit I
(FOR SUB PERMITS ONLY)
PCN I OB_L/?J 1.(& 0-10:6 ODD O;){~
(Palm Beach County Propertr Control I)
OWner's Name ,\.t.-;)""--N~'l ''''' ~~\\""N
OWner's Addres 2..~ "", 5;:)\::> ,,-,~ ~N"I\
City ~~~\.-....'\
State ~ Zip D,..~C\\ 7
Fee S1mple T1tleholder's Name
~c
OWner's Phone I<:'\~-/~~-:?'Sl G,
(If other than owner)
Fee Simple Titleholder's Address
(If other than owner's)
Contractor "s Name
Contractor's Address
City
State
Job NameCl)~~) ~'-'""'1
Job Address __ 7____ _
City >l ~~'t~,<::l
Legal Description~,
Bondi;"g Company
Bonding Co.Address
Architect/Engineer's Name H~~ ~IC.\
Architect/Engineer's Address '2.(po 2.- -;" d.-L r;;.'
Mortgage Lender's Name
Mortgage Lender's Address
SINGLE FAMILY: DUPLEX:
(check one)'
ESTIMATED VALUE OF CONS RUCTION:
qESCRIPTION OF WORK:
,
Contractor's Phone I
Z,ip
{. ~e.1.-( '=I WG..-\O~
'CJ ~~s;..\.-.... ",",,, ~'t
County
City
f-.lw'-f
State
We.."
MULTI-FAMILY:
HOTEL:
RETAIL:L
OFFICE: INDUSTRIAL:
G:" ~I/NT M",~1l.D
5', Qt'DlA \(Q SI Tf. LrG
"+ 'I (J:;.. , ~H'~'
,..,
\Z,0,~
!)
aclC.AO ..
o
:..1)(" 't l ~
App 1cat1on 1S y ma e to obta1n a perm1t to I
certify that no work or installation has commenced prior to
all work will be performed to meet the standards of all laws regulating construction in
jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK,
PLUMBING, SIGNS, WELLS, POOLS. FURNACES, BOILERS, HEATERS. TANKS. and AIR CONDITIONERS, ETC.
Li)IV
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work
will be UUUt:l in compliance wit:h all applicabLe laws regu!at1.ng construction and zoning.
WlUUfING TO OWHBR. YOUR FAILURB OF COIlIIBHCIDOlIlT MAY RBSULT IN YOUR PAYING
TWICB FOR IMPROVlDOlllTS TO YOUR PR BRTY. TO OBTAllf FINANCING, CONSULT WITH YOUR
Ll!:HDER OR AN ATTORHBY BBP'ORB RBCORD C \
Property owner'. or .IigeD~'. Signature Date ~ \ a.... \:;- ~
STATE OF FLORIDA. COUIITY,OF PALM BEACH ,1- 'it'S- '
~he forego~?9 i9str~~Qti~s acknowledged before me this ~<Q ~ (date) by
-v'/~ ~ ,who is personally known to me or who has roduced
",~ype, ,', of ~d,e')tifi,cation) as identification and who did (did not) take ar
o,",:h. '" ,JllI 1 '} 1915 II> ,
(S",AL) ," . ~~ -_ /:' 0 _______
Signature of person tak~ g,)aclC'nowledgement ~ _~~T~ AMSER
N~e of officer taking~ n~,~l,edgement~rty~ed, pr1.nt ,0 stamp.a Ntrr.lWptIRIIt. ~TAUnJ;n~ln
TLtle or rank '~'" ,::' ...'Ser1.al number, l.f any IIYCOIIIII!ll:!ll:1ftN WIRES NOll&. 199&
Contractor'. Signature
STATE OF FLORIDA, COUNTY
The foregoing instrument
~ n::r\\ \ :
OF PALH'SEACH
was acknowledged before me this
, who is personally known to me or who has produced
(type of identification) as identification and who did (did not) take a,
Date
(date) by
oath.
(SEAL)
Signature of person taking acknowledgement
Name of officer taking acknowledgement--typed, printed or stamped
Title or rank Serial number, if any
(Certificate of Competency Holder)
.......u'-...g,............ Q' ",'-Q,,-i=# Certification or Registration No.
Contractor's Certificare of Competency No.
LIABILITY INSURANCE EXPIRATION DATE:
WORKERS' COMPENSATION EXPIRATION DATE:
APPLICATION APPROVED BY Permit Officer
Date:
Any change in building plans or specifications must be recorded with this office. Any work no
covered above must have a valid permit prior to starting. In consideration of the granting of
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 been commenced, Al
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
THIS PERMIT OR PLANS FILING FEE IS NOT REFUNDABLE
'.
~ ~J€ /o~-r+~,
CITY OF BOYNTON-BEACH
. 1(aJ1EJ.U
-------"
REVIEWER'S NAME:
PLANNING & ZONING DEPARTMENT
COMMENT SHEET
PROJECT NAME:.J::t."ok.J U ',))(jkJu"TS
PERMIT NO. :
TRACT/SUBDIVISION:
PROJECT ADDRESS: .:3 70 IS, fiiI> ' l-l--iUy.
PERSON RETRIEVING COMMENTS AND/OR PLANS:
DATE PICKED UP:
I plans - Comments
1 2
ZONING DISTR:>?: c. ~
_(" COMMERCIAL/RESIDENTIAL
MMsP't-- SPWV PERMIT
FILE NO.: 'f1.!=7 J
Signature
I
Print Name
The permit number identified above is the referenced number for your proposed
improvement(s). Prior to further processing on your request, the documents that
you submitted illustrating the improvement(s) shall be amended to show compliance
with the below listed comment(s). To discuss the comment(s) it is recommended that
an appointment be set-up with the reviewer identified in the upper right hand
corner, (407) 37~-6260 between 8 A.M. and 5 P.M., Monday thru Friday. Please
reference the project name and permit number when corresponding with City'S staff.
After amending the plan(s) to show compliance with the comment(s), return both sets
of plans for re-review to the Building Department. Please note that additional
comments may be generated as a result of reviewing the amended plans. All comments
shall be rectified prior to staff review approving the documents.
'I '>
'"2.')
ii';;:~f1.rii~1f;~~/( ~~~~~ PJ!!C';'1<<'
* Departments required to review the project:
~
Q&lG. ~
~IIEF7
...
Jl:IVl l-U-'!I
.: pueOMMT. UN
Page
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CITY OF BOYNTON BEACH
PROJECT NAME:
DVA/)(../N 'Do ~v"T("
.
REVIEWER'S NAME:
DATE "tt::f-~~~
RECEIVED: - U i
STARTED REV EW: 9'" r
RETURNED: _-,2,4:__
APPROVED:
PLANNING & ZONING DEPARTMENT
COMMENT SHEET
TRACT/SUBDIVISION:
PROJECT ADDRESS:
370 I S '~ED. If-r.,vt
COMMENTS AND/OR PLANS.
PERMIT NO. : 00
REVIE~( CIRCLE) :
1 2 ~ 4 REVISION
PERSON RETRIEVING
signature
I
Print Name
ZO
MMSP
DATE PICKED UP:
I Plans - Comments
FILE
DESCRIPTION: ~-q,~../~ R
- X ()Jf
~f,~/ SJf
The permit number identified above is the referenced number for your propose(
improvement(s). Prior to further processing on your request, the documents tha1
you submitted illustrating the improvement(s) shall be amended to show compliancl
with the below listed comment(s). To discuss the comment(s) it is recommended thai
an appointment be set-up with the reviewer identified in the upper right hane
corner, (407) 375-6260 between 8 A.M. and 5 P.M., Monday thru Friday. Pleas,
reference the project name and permit number when corresponding with city's Staff
After amending the plan (s) to show compliance wi th the comment (s), return both set:
of plans for re-review to the Building Department. please note that additiona
comments may be generated as a result of reviewing the amended plans, All comment:
shall be rectified prior to staff review approving the documents.
.~
t1 ?~ I'!,
-
--
37("- (,2.. G::,O
~I.J~ JR.1Y1 A-~
~~;
,4~U!;:;r7" r/a
~JAJ"" ~.z:;a,}-r tu/'T"N
J~~~~ ~~
,
* Departments required to review the project:
It.v: 2-11-95
1I1P.7:eOMMT.PItM
Page
I
of
J
,
CITY OF
2..."-1)::>
BOYNTON BEACH
PLANNING & ZONING DEPARTMENT
COMMENT SHEET
/ v::::b~ eel V)
PROJECT NAME:lh#JJ;::.,1J ~1Uc...i7"('A," ~'t>j'5
TRACT/SUBDIVISION:
PROJECT ADDRESS: 370 IS, b,x/tc"_ ,l-lU,,1'
PERSON RETRIEVING COMMENTS AND/OR PLANS:
I
signature Print Name
DATE PICKED UP: Plans - Comments
DESCRIPTION:
( k.) Te:..I2-, 0 /L,
I2x re:1l.J 0 IL
~(
12.t=1=v~ I.JH
"Ke; ,aL<)
REVIEWER'S NAME:
bo
DATE
RECEIVED:
STARTED RE
RETURNED:
APPROVED:
<:) 1/.., <;.. SIIc...
p IDQ
"'~lJ{{.J
,-
Ij/A-
The permit number identified above is the referenced number for your propose(
improvement(s). Prior to further processing on your request, the documents tha1
you submitted illustrating the improvement(s) shall be amended to show complianc.
with the below listed comment(s). To discuss the comment(s) it is recommended tha1
an appointment be set-up with the reviewer identified in the upper right han(
corner, (407) 375-6260 between 8 A.M. and 5 P.M., Monday thru Friday. PleasE
reference the project name and permit number when corresponding with City's Staff
After amending the plan(s) to show compliance with the comment(s), return both setl
of plans for re-review to the Building Department. Please note that additiona:
comments may be generated as a result of reviewing the amended plans. All commentl
shall be rectified prior to staff review approving the documents.
.~
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o '()
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VL~6
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c().u-r flU U E:
'-.J1= ')( T
~ C-_ E .
/
* Departments required to review the project:
C; €:.1; o(L, (;
j)~T.
~/lEEI'
R.V: 2-16-'5
Il.:PUCOMMT.'IlM
Page
I
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Q.') EA-e./<...-LI; AlA...lu IAJC :
~ Rt,1.~J u;:Jffi=~ ~~ :~~~{) Jr ~ otA
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ft-~ r fI- I Tee.. 1(...1 R... N Des I ~ 4J ,1fH.r J '\ ~Jsn1J6
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A-t-IV~ ~ ~ I~
CITY OF BOYNTON BEACH
q - /"3 -q~
.t,
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<<;
REVIEWER'S NAME:
PLANNING & ZONING DEPARTMENT
COMMENT SHEET
PROJECT NAME: ~ufL' u :t:>o kJu-,:::s
DATE
RECEIVED:
STARTED RE
RETURNED:
APPROVED:
TRACT/SUBDIVISION:
PROJECT ADDRESS: ~~O/
~ .. ~b. I+w'i
/
DATE PICKED UP:
I Plans - Comments
NO. :
W (CIRCLE):
3 4 REVISION
PERSON RETRIEVING COMMENTS AND/OR PLANS:
signature
I
Print Name
FILE NO.:
DESCRIPTION: t lo-) -re!!1t.../ 0 fL "R.e - ~ 'tHe.. I
~X7 t:::fl./ olU ~ti::.- -,=-'-'il'-:al S/"I
The permit number identified above is the referenced number for your proposed
improvement(s). Prior to further processing on your request, the documents that
you submitted illustrating the improvement(s) shall be amended to show compliance
with the below listed comment(s). To discuss the comment(s) it is recommended that
an appointment be set-up with the reviewer identified in the upper right hand
corner, (407) 375-6260 between 8 A.M. and 5 P.M., Monday thru Friday. Please
reference the project name and permit number when corresponding with City's Staff.
After amending the plan(s) to show compliance with the comment(s), return both sets
of plans for re-review to the Building Department. Please note that additional
comments may be generated as a result of reviewing the amended plans, All comments
shall be rectified prior to staff review approving the documents,
.~
( /o..J ..s. -rE ~ €J...; / e
I
,
* Departments required to review the project:
S~
()~I c:: .
bc::T~II./Irf7<' If.) ~
ltIy: z.tI.n
aIPnCOMMT.JIlM
Page
,
of
/
~ A./~ 'Pi! tE, q -J r- - ,r-
CITY OF BOYNTON BEACH
~~
REVIEWER'S NAME:
PLANNING & ZONING DEPARTMENT
COMMENT SHEET
/ 'M:;i-;I1 G'Je/ V
PROJECT NAME:.D..,IJJ::.. kJ 't.:blUc..iT<:.\." t..<....e~jt>r5)
TRACT/SUBDIVISION:
PROJECT ADDRESS: 370 IS, b,x/.c- ~i"
PERSON RETRIEVING COMMENTS AND/OR PLANS:
DESCRIPTION:
( U Te./2.../ 0 Il-
f2. X re1<.-J 0 fL..
,
~(
h::."fV"R.. ~ I SrI
1:>0
DATE
RECEIVED:
STARTED RE
RETURNED:
APPROVED:
I
Signature Print Name
DATE PICKED UP: Plans - Comments
The permit number identified above is the referenced number for your proposed
improvement(s), Prior to further processing on your request, the documents that
you submitted illustrating the improvement(s) shall be amended to show compliance
with the below listed comment(s). To discuss the comment(s) it is recommended that
an apPointment be set-up with the reviewer identified in the upper right hane
corner, (407) 375-6260 between 8 A.M. and 5 P.M., Monday thru Friday. Please
reference the project name and permit number when corresponding with City's Staff,
After amending the plants) to show compliance with the comment(s), return both sets
of plans for re-review to the Building Department. please note that additional
comments may be generated as a result of reviewing the amended plans, All comments
shall be rectified prior to staff review approving the documents.
I. HE.. pI, C!..- S \...Jo !-hIAJ ~
'{)
~~~O/~~~~~"~ r ~~;:~S~~U~!;Rf:p~m~L
U/~6
.
C() v-r IIlJ U €IE
"--'~ ')( ;-
?-E- r_ E .
,
* Departments required to review the project:
Il:IV: 2~U-'!
.t"ICOMMT.'ItM
Page
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Q. , ) BPl-e/<..- L'T AIAJU 11J~ :
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S7
promotion of the public health, safety, comfort, convenience,
order, appearance, prosperity or general welfare.
C.
Whenever the regulations and requirements of this chapter are
at variance with the requirements of any other lawfully
enacted and adopted rules, regulations, ordinances or laws,
the most restrictive shall apply.
Section 8.
Appeals.
IJf/EA/S
Appeals may be taken by any person aggrieved by a decision of the
Planning and Zoning Department within thirty (30) days of such
decision. There shall be an application fee as adopted by resolution
of the City Commission for appeals of administrative decision. The
process for appeals shall follow the same procedure set forth in
Chapter 4, Site Plan Review, Part III, Land Development Regulations.
Section 9. General Intent.
A. Buildings, structures and site elements are not required to
match surrounding existing developments, but shall be in
visual harmony with surrounding developments.
B. Buildings or structures located on separate parcels and
buildings or structures part of a present or future multi-
building complex, shall achieve visual unity of character and
design concepts through the relationship of building style,
texture, color, materials, form, scale, proportion and
location.
Section 10. Site Criteria.
A. Building Location.
1. Outbuildings, either located on the same parcel or an
adjacent parcel as the principal building, shall not be
located so as to totally block from the street, the
visibility of any tenant space within the principal
building on the site. Blocking shall be considered to
occur if at the street frontage, the head-on view of a
tenant space within the principal building is not
partially visible.
2. Buildings shall be designed and sited to fully utilize
the site and avoid unusable or inaccessible open space or
parking spaces.
3. Siting and orientation of buildings must respond to the
pedestrian and/or vehicular nature of the street on which
it is located.
B. Vehicular and Pedestrian Circulation.
1. Separate vehicular and pedestrian circulation systems on
a site are encouraged.
2. Vehicular and pedestrian circulation systems on adjacent
properties shall be linked to encourage cross-access.
Adopted March 11, 1995. Ordinance 095-0~
Rev1..d June 16 1995 (Scrivener'. error corrected)
9-3
J~ \qS
CITY OF BOYNTON BEACH
signature
I
Print Name
REVIEWER'S NAME:
~G"
DATE ;r ,_ --
RECEIVED: 1-l-t-9S
STARTED REVIEW: 7-~~-~-
RETURNED: 7-2. ~- CfJ..
APPROVED:
PERMIT NO.: CfS"- 3 ~
~VIEW (CIRCLE):
lJV 2 3 4 REVISION
ZONING ~S~RICT: C.3
~'COMMERCIA1)RESIDENTIAL
MPt6P ,,' SPWV PERMIT
PLANNING & ZONING DEPARTMENT
COMMENT, SHEET \ ___ _. ._1
N'e..V-J'" V::', LC: 1 (~
PROJECT NAME: ...j;v1U#!.nJ' .1::b~ 1. t"-AJ6c.V , ,4-)
WaJO'l .:s 7
TRACT/SUBDIVISION:
PROJECT ADDRESS: ,"3710 I S. FE]). I:j'Gf(wI'>j
PERSON RETRIEVING COMMENTS AND/OR PLANS:
DATE PICKED UP:
I Plans - Comments
FILE NO.: 9t"- 71
DESCRIPTION: --iJj ~''''''
~'f. ~O,
'RE . ~oJ:>E:.1
~'SH
The permit number identified above is the referenced number fOl- your proposed
improvement(s). Prior to further processing on your request, the documents that
you submitted illustrating the improvement(s) sha+l be amended to show compliance
with the below listed comment(s). To discuss the comment(s) it is recommended that
an appointment be set-up with the reviewer identified in the upper right hand
corner, (407) 375-6260 between B A.M. and 5 P.M., Monday thru Friday. Please
reference the project name and permit number when corresponding with City's Staff,
After amending the plants) to show compliance with the comment(s), return both sets
of plans for re-review to the Building Department. Please note that additional
comments may be generated as a result of reviewing the amended plans. All comments
shall be rectified prior to staff review approving the documents.
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* Departments required to review the project:
NotJE:,
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a:P6.COMMT.rIlH
Page --+-- of I
..t;;a.u -"-~ ........1-,.\0"",;1 --- - -----....... -.......
/,0 - .:;J(jV7
BUILDING PERMIT APPLICATION
(Please Print)
Permit I
(FOR SUB PERMITS ONLY)
PCN I OS--LI?> 1.(& 0-10:6 ODD 0;) { ~
(Palm Beach County propertr Control I) I ^"' I
OWner's Name*' \.t.-;)""-~~,\: ~ \~~~\\""N~ '-~C OWner's Phone IG:,\~-/'o,-""Sl VI
OWner's Addresli'l""''2...~''a "", 5;:)\::>-2='_ <<:-'~N \J,<,_ ~\:::l.
City ~~~\.-....'\.....:l
State ' ~ Zip D,..~\7
Fee S1mp e T1tleholder's Name
(If other than owner)
Fee Simple Titleholder's Address
(If other than owner's)
Contractor's Phone I
Contractor "s Name
contractor's Address
City
State
Job NameCl)~~ ~'-'""'1
Job Address__ 7____ _
City >l 'O.c:;'\.~,<::l
Legal Description~
Bonding Company
Bonding Co. Address
Architect/Engineer's Name ~~ ~/C'J
Architect/Engineer's Address '2.(pO '2-- -;" 0,"" r;;.' f-.lllJ'-f
Mortgage Lender's Name
Mortgage Lender's Address
SINGLE FAMILY' DUPLEX. MULTI-FAMILY. HOTEL:
, (check one)' - -
ESTIMATED VALUE OF CONS;rRUCTION: $_' Z,0,o.:x::>
DESCRIPTION OF WORK,I~orL. ~..M!)OT /:... I ~.x-"l?:.A...IOrL
Z,ip
(~e.l..('=I W~o~
'CJ ~"'"-....\.-.... """,, ~'t
county
City
State
We.."
RETAIL:V' OFFICE:
INDUSTRIAL:
~1U2.1C.IJ
Application is hereby made to obtain a permit to do the work and installations .s 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 laws regulating construction in this
jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK,
PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and AIR CONDITIONERS, ETC.
OWNER'S AFFIDAVIT, I certify that all the foregoing information is accurate and that all work
will be dum! in compliance wil:.o all applicabLe law. regU!8t1.ng construction and zoning.
WlUUfING TO OIfllBR. YOUR FAILURB OF COIlIIBHCIDOlIlT MAY RBSULT IN YOUR PAYING
TWICB FOR IKPROVBMBHTS TO YOUR P BRTY. TO OBTAIN FINANCING, CONSULT WITH YOUR
Ll!:HDER OR AN ATTORHBY BBFORB RBCORD C '\
Property owner's or .IigeD~' s ,SiCJDature Date ~ \ a.... \~ c:::-.
STATE OF FLORIDA, Cvulut 'Q' PALM BEACH fl'S- '
,-!he forego' instrlmeQ ',w s acknowledged before me this ~... . (date) by
-vr~ ' who is personally known to me or who has ~roduced
_. type of ide'}t~fication) as identification and who did (did not) take ar
" Jut 1 () 'tINS II> , _.
, q,),actno~t.dgeme~t ~ .k~-L. ' - -:,..~ ~-.L...~R
~n~\OIletigement-,.typed, prin;-~bgs~:'~:::~ ;:~:,~
, 'I .'/ I:: . ".'Serial number, if any 1IY1NI"1e.t:InIlW1RESNO'L~U9I
~~TI7~\"\'\; Date
OF PALM BEACH
was acknowledged before me this
, who is personally known to me or who has produced
(type of identification) as identification and who did (did not) take a,
Contractor's Signature
STATE OF FLORIDA, COUNTY
The foregoing instrument
Oath.
(SEAL) .
Signature of person ta
Name of officer taking
Title or rank
(date) by
oath.
(SEAL)
Signature of person taking acknowledgement
Name of officer taking acknowledgement--typed, printed or stamped
Title or rank serial number, if any
(Certificate of competency Holder)
.:Vill....Q............. '.0 ';~ci.L,;;, Certification or Registration No.
Contractor's Certificare of Competency NO.
LIABILITY INSURANCE EXPIRATION DATE:
\OIORKERS' COMPENSATION EXPIRATION DATE:
APPLICATION APPROVED BY Permit Officer
Date:
Any change in building plans or specifications must be recorded with this office. Any work no
covered above must have a valid permit prior to starting. In consideration of the granting of
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 ISO DAYS UNLESS the work which it covers has been commenced. Al
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
THIS PERMIT OR PLANS FILING FEE IS NOT REFUNDABLE
'"