HomeMy Public PortalAboutSAM_6342i
IT F
HF GHXAY 9EgN �' RECEIVE
L ,, 00 NW 1" Avenue Delray B h FL 33444 APR 1 2D15
(561)243-7200 Fax: (561 3-7221
Website: m delra bea .com ?own of Gulfstre
PROPERTY CONT L #: �- 4 3 - L( b
N
PLEASE PRINT
JOBSITE ADDRESS
PROPERTY OWNER
HOME PHONE f
PROPERTY 0 R
BUS.
PAX
IF E PL ' - APPLK -)N
TO GULF L 1M
Appn, ty Permit S!� Mal
(FL Initials. 1-Dato
FOR 0171 �)NLY:
1"
' IiLDO PERMIT
.,� FENCg] PERMIT
PFiAiM1T FEE:
W
f— PLAN CHECK FEE.
MCR #:
CELL
E-MAIL _Q�(((1'j51(1 VYIi In Iii.'_
NOTE: PERMIT EXPIRES IF WORK IS
MUST BE ON THE JOB SITE FOR ALL If
Y ^
PLANv
ATE:
l ��
LAND:
DATE:
P & Z:
DATE:
FIRE:
DATE:
L
ENG•
DATE:
C/ 13/
T(/ �'i 'V a SLLVL GSL/ yL
STARTED WITHIN 180 -DAYS OR IF ACTIVITY LAPSES FOR 180 DAYS. PLANS
:TIONS. FINAL INSPECTION /S REQUIRED ON ALL PERMITS.
PROJECT COST (LABOR AND MATERIAL): $ �}) u
RESIDENTIAL FENCING WILL REQUIRE TWO COPIES OF PROPERTY SURVEY AND MAYR /RE ADD AL I.ANOSCCPING
COMMERCIAL FENCING WILL REQUIRE TWO COPIES OF PROPERTY SUP EYAND APP D LAN E N.
f
DESRIPTION OF'YORK:
RESIDENTIAL _ COMMERCLV._=_._ NE;W: =_�RBP CEtvl _
'OOL BARRIER? 1ES NO
1
IYPE (WOOD, CHAIN LINK, ETC) __ t ,11IF CI IAM LINK, IS IT VINYL COATED?
:TYLE (SHADOWBOX. 130.4 R D ON BOARD, E CC-)
]EIGHT r_, LEN6'CH
.R
C (�JZF 2 T—� OR
REGISFR.CP10 # WORKERS COMP # EXEMPT (FID /FEIN) #
STATE OF t9 Dr I d n v
COUNTY OF To I m E LIcb— Personally Known
The foregoing instrum acknowledged before me this /day OR
y ! Produced Identification_
of ., 16 111 g_Q, t • Type of Identification Produced
rNo 11� ,.... _'�,,.. (SEAL)
iP A "'r.'. MICHAEL SP►TgLET7
MICHAEL SPITALETTO (? 4V^OMMISSION ALEi .tO Rvsd3/10
'r•r1MA41SSiON #FF106740 IQ 'aRQ 5100 1 107
April 1, 2018
._rolca.com
1