HomeMy Public PortalAboutPRR 21-2828
Renee Basel
From:Brandon J. Camilleri <Brandon.Camilleri@csklegal.com>
Sent:Wednesday, February 3, 2021 4:30 PM
To:Rita Taylor
Cc:Daniel E. Levin
Subject:Public Records Request (3777 N. Ocean Blvd, Gulf Stream FL 33483)
\[NOTICE: This message originated outside of the Town of Gulfstream -- DO NOT CLICK on links or open attachments
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Renee:
Please allow this email to serve as our public records request for: all permits, permit applications, inspection records,
correspondence, NOA’s, product approvals, plans, and any other documents that are part of the permit file,
associated with the following permits:
18-00177084 – 6/15/2018 – POOL OR SPA – RESIDENTIAL
17-00172206 – 10/19/2017 – ALTERATION – INTERIOR & EXTERIOR – RESIDENTIAL
17-00171390 – 8/23/2017 – DEMOLITION – INTERIOR/EXTERIOR
12-00138351 – 4/13/2012 – ELECTRICAL WORK
Thank you,
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Brandon J. Camilleri
Associate
Tel: (561) 621-1823 | Fax: 561-683-8977
Brandon.Camilleri@csklegal.com
Cole, Scott & Kissane P.A.
222 Lakeview Avenue, Suite 120
The Florida Law Firm
West Palm Beach, Florida 33401
561-383-9200
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2
TOWN OF GULF STREAM
PALM BEACH COUNTY, FLORIDA
Delivered via e-mail
February 4, 2021
Brandon Camilleri [mail to: Brandon.Camilleri@csklegal.com]
Re: GS #2828 (3777 N. Ocean Blvd. permits)
Please allow this email to serve as our public records request for: all permits, permit applications,
inspection records, correspondence, NOA’s, product approvals, plans, and any other documents
that are part of the permit file, associated with the following permits:
• 18-00177084 – 6/15/2018 – POOL OR SPA – RESIDENTIAL
• 17-00172206 – 10/19/2017 – ALTERATION – INTERIOR & EXTERIOR – RESIDENTIAL
• 17-00171390 – 8/23/2017 – DEMOLITION – INTERIOR/EXTERIOR
• 12-00138351 – 4/13/2012 – ELECTRICAL WORK
Dear Brandon Camilleri [mail to: Brandon.Camilleri@csklegal.com]:
The Town of Gulf Stream received your public records request on February 3, 2021. You should
be able to view your original request at the following link:
https://portal.laserfiche.com/Portal/DocView.aspx?id=174503&repo=r-430100cc
A similar request was received on January 11, 2021 from Daniel Levin at your firm. The City of
Delray Beach serves as the Town’s building official and issues all building permits for
construction in the Town. The Town has submitted your request to the City of Delray Beach to
provide these records.
Once the Town hears back from Delray Beach, we will use our very best efforts to further
respond to your public records request in a reasonable amount of time. Alternatively, you could
request these records directly from Delray Beach by going to the following link:
https://delraybeach.govqa.us/WEBAPP/_rs/(S(eddlx5j05q3yi2qalgrolb43))/supporthome.aspx
Sincerely,
Reneé Rowan Basel
As requested by Rita Taylor
Town Clerk, Custodian of the Records
TOWN OF GULF STREAM
PALM BEACH COUNTY, FLORIDA
Delivered via e-mail
February 17, 2021
Brandon Camilleri [mail to: Brandon.Camilleri@csklegal.com]
Re: GS #2828 (3777 N. Ocean Blvd. permits)
Please allow this email to serve as our public records request for: all permits, permit applications,
inspection records, correspondence, NOA’s, product approvals, plans, and any other documents
that are part of the permit file, associated with the following permits:
• 18-00177084 – 6/15/2018 – POOL OR SPA – RESIDENTIAL
• 17-00172206 – 10/19/2017 – ALTERATION – INTERIOR & EXTERIOR – RESIDENTIAL
• 17-00171390 – 8/23/2017 – DEMOLITION – INTERIOR/EXTERIOR
• 12-00138351 – 4/13/2012 – ELECTRICAL WORK
Dear Brandon Camilleri [mail to: Brandon.Camilleri@csklegal.com]:
The Town of Gulf Stream received your public records request on February 3, 2021. You should
be able to view your original request and partial response at the following link for:
• 18-00177084 – 6/15/2018 – POOL OR SPA – RESIDENTIAL
• 12-00138351 – 4/13/2012 – ELECTRICAL WORK
https://portal.laserfiche.com/Portal/DocView.aspx?id=174503&repo=r-430100cc
A similar request was received on January 11, 2021 from Daniel Levin at your firm and the Town
has supplied him with partial records for
• 17-00172206 – 10/19/2017 – ALTERATION – INTERIOR & EXTERIOR – RESIDENTIAL
• 17-00171390 – 8/23/2017 – DEMOLITION – INTERIOR/EXTERIOR
They can be found at the following link:
https://portal.laserfiche.com/Portal/DocView.aspx?id=173960&repo=r-430100cc
The Town now estimates that to fully respond to your request will require $9.00 to make copies
of the plans.
If the costs of producing these documents will exceed your deposit, the Town will provide you
with an initial production of responsive records and an estimate to produce any additional
responsive records. If the costs of production are less than the deposit, the Town will provide you
with the responsive records and a refund.
Deposit Due: $9.00 in cash or check.
Upon receipt of your deposit, the Town will use its very best efforts to further respond to your
public records request in a reasonable amount of time by coordinating production with the City
of Delray Beach.
If we do not hear back from you within 30 days of this letter, we will consider this request
closed.
Sincerely,
Reneé Rowan Basel
As requested by Rita Taylor
Town Clerk, Custodian of the Records
cry of DELRAY BEACH
COMMUNITY IMPROVEMENT DEPT.
561) 243 -7200
INSPECTIONS — CALL (561) 243 -7218
Contractor, Owner, Agent
Permit -Type. .
Permit Phone Access#:
FAILURE TO COMPLY WITH THE
MECHANICS' UEN LAW CAN
RESULT IN THE PROPERTY
OWNER PAYING TWICE FOR
BUILI)ING IMPROVEMENTS"
Date Applied: 4
BA.RF ER= Prepared. by.,
Date Issued: " 6
Permit No
X012035
WEb
City Range Twnshp. Section Sub Dvsn. Block Lot. Plat/ e
20 t:`
4vw, 2 s fbV.J.. 4.,r .p",, am•.. -..'
Property Address Zoning
r l..l. 6 ,r;V -R, HAF3 G1.:. 0
Reviewed by
00 2, 0o 001
4I01.,W9 :il.:ls - tl' "lF dlF kie ^.^ .'( t: o r,Pti
Subdivision Name
t"y a- i"'i °,J
Improvements
I I: l! l =.r # i',I I Y F 3 19,_c_'l_g ° I f' 1—
Owner's Name /Address /Telephone Contractor's Name /Address /License /Telephone
111:7 ,'T -r' ItI -' :ixI_r :. ; l L'l t,' >hg E CA ,Le Ui,1f =aC''L ,. TIFIE.
Ll E"k., '0k` a'`1H G'RA Z TUS R ,T :I:'i' L . 1-11—OR
3777 N ` :Ir.,EAN 21-VD
i%IL.I -N S7.'3-`;law'P)IIII F";L ;. 34837436
FIVII ELE C `l l?I I:.LC5 1 ° 218':+ 1 -11199
603 7 Wl:„ 0'' I t3l000 VILLAGE t.::i: P
LAKE WI+IE?TH Fl., w 21.6a
Additional Comments
THIS PERMIT SHALL BECOME NULL AND VOID UNLE33 FHE AND EIGHTY (1801 DAYS AFTER
Construction EPI /EER FFE FLZ :
FOR A PERIOD
Occupancy Sq. Ft.
DAYS FRAM TIME tORK IS
Valuation
n ta I n 0(D
work not covered above, must have a valid permit prior to starting. In consideration
of the granting of this permit, the owner and gilder agree to erect this structure in full. compliance' with the Code of Ordinances of the City of Delray Beach,
Florida.
50 0
Schedule of Fees and Additional Information
C R(7 r ' >"I I V'i ACCOUNT
f T -E 2, e40 t0 u0. FfR "id f 2G^ 2 0 Qn
r l..l. 6 ,r;V -R, HAF3 G1.:. 0 2„o'o 00 2, 0o 001
4I01.,W9 :il.:ls - tl' "lF dlF kie ^.^ .'( t: o r,Pti n. °`
ai t"y a- i"'i °,J w %,h,4f`e.._ e'..Ua n s,vh•y•_,s,"tr'
I I: l! l =.r # i',I I Y F 3 19,_c_'l_g ° I f' 1—
111:7 ,'T -r' ItI -' :ixI_r :. ; l L'l t,' >hg E CA ,Le Ui,1f =aC''L ,. TIFIE.
L' R:: ",II , iEf =;E ,' ,;.g'la F I-"FI Q V U Ci f S ,.
THIS PERMIT SHALL BECOME NULL AND VOID UNLE33 FHE AND EIGHTY (1801 DAYS AFTERWORKAUTHORIZEDISCOMMENCEDwrrHINONEHUNDRIgo
Ji y4l,iJWCE: OR IF THE WORK AUTHORIZED IS NOT IN8PECTED
COMPLETED. -
FOR A PERIOD OF QNE HUNDRED AND. EIGHTY Q§Q) DAYS FRAM TIME tORK IS
Any change in building plans or specifications must be recorded with this office. My work not covered above, must have a valid permit prior to starting. In consideration
of the granting of this permit, the owner and gilder agree to erect this structure in full. compliance' with the Code of Ordinances of the City of Delray Beach,
Florida.
Ll
MY OF ORM 1fflr1U:Sk6,
APR pi
100 NW 1*` Avenue Delray Beach FL 33444 ,
Website .7mydelraybeach.com 1' "n of Gt l trvc {.
PROPERTY CONTROL #: 20 - 43 _ 45 _ 34 _05
PLEASE PRINT:
JOBSITEADDRESS 3777 N Ocean Blvd
PROPERTYOWNERNAME Deborah Grazioso
HOME PHONE () CELL
PROPERTY OWNER ADDRESS 3777 N Ocean Blvd
ELECTRICAL CONT'R (COMPANY) NAME PVM Electric
ELECTRICALCONT 'R(COMPANY)ADDRESS 6037 Wedgewood Village Cir
CITYLake Worth ST FL ZIP 33463
BUS. PHONE 5( 61 ) 357.1066 CELL
FAX 561.357.1375 E -MAIL mminter @pvmelectric.com
AT
Date
FFICE USE ONLY:
BLDG. PERMIT #:
ELEC. PERMIT #:
PERMIT FEE:
PLAN CHECK FEE:
MCR #:
APPROVALS:
ELEC: , DATE: `f -1& 2
FIRE- DATE:
NOTE: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 -DAYS OR IF ACTIVITY LAPSES FOR 180 DAYS PLANS MUST
BE ON THE JOB SITE FOR ALL INSPECTIONS. FINAL INSPECTION IS REQUIRED ON ALL PERMITS.
TYPE OF INSTALLATION (PLEASE CHECK ALL WORK TO BE PERFORMED BY A SINGLE ELECTRICAL CONTRACTOR.
EACH SEPARATE COST TO INCLUDE LABOR & MATERIAL)
q / COST q / COST
NEW CONSTRUCTION
ALTERATION
SPA
RA= AMI
GENERAL REPAIR
GENERATOR _
SLAB INCLUDED? Y N
SEPARATE APP)
SITE LIGHTING
FIRE ALARM _
3 SETS OF PLANS REQD)
1$
TEMP. SERVICE/POLE
L,-'/ $ 5CO. !70
LOW VOLTAGE:
BURGLAR ALARM
VOICE, DATA, ETC.
SERVICE CHANGE
EXISTING SERVICE SIZE:
PROPOSED SERVICE SIZE:
DESCRIPTION OF WORK (Scope of work, # devices, etc.):
EC 13004851 OR 45- 3027862
SIGNATURE OF QUALIFIER CONTR. REGISTRATION # WORKERS COMP # EXEMPT (FID /FEIN) #
STATE OF fk
COUNTY OF &A%
L&
jf
The foregoing instrument was acknowledged before me this day
of Amn, 20 la byS-E, Yf1 1 e , A& 1-r J.
P
ature of Public
Personally Known i/
OR
Produced Identification JL
Typo4Identifigation Produced
R: trJ A i
MYCCx as i Rvsd.3 /10
EKpIItES:Deo A 14
i eoo xornxx n rc=r mi*00-
qL
www:mydelraybeach.com
100 NW 1"Avenue •Delray Beach,FL 33444
(561)243-7200 •Fax (561)243-7221
ACCEPTED BY PERMIT NO.,-
RECEIVED
Iy gr gg.APR#?'ff»st JUN 1 2 7 0/
TO7NO 'FL91%,22%yes«gen,ea
Initials.Date%HJ#ING PERMIT APPLICATION
APPL DATE
Fa 5617985908
sate"z1%37
CONTRACT R &DESIGNER INFORMATION
Phone Ext._
Cell _
FOR PERMIT EXPEDITERS ONLY (fer penit pick-up}:
Contact Name _
□Check if Owner/Builder (See Page 3)
Contractor License No."!"7"
workers'comp No."""·"
Company ROYAL PALM POOLS
Address 16333 TEMPLE BLVD
state Zip
OWNER INFORMATION
Ste or Apt#/Floor _
Project Name (if applicable)
Legal Description BLKS A,B&Z PALM BCH SHORE ACLT 4E OF
&ADJTO SR A-I-A BLKB
Name _
Address"77"OGE""""
City GULFSTREAM
Home Phone ()_
Cell Phone ()_
Fax No.()_
Email Address _
City LOXAHATCHEE
Phone 5617983711
1-----------------------1 Cell --------HPROPERTYINFORMATIONyEmaROYAL.PALMPooLs@AH00.co
Property Control Number:Architect/Engineer's Name _
_20434534050010770 ----------------Address _
Address of Proposed Work
3777 NORTH OCEAN BLVD GULF STREAM
ADDITIONAL INFORMATION
ZipState
Fee Simple Title Holder (if other than owner)_
Address City State .Zip _
Mortgage Lenderbonding Company
Address Address _
City State Zip City
DESCRIPTION OF PROPOSED IMPROVEMENTS
MISCELLANEOUS PERMITS -FEE SCHEDULE II*
ALTERATIONS &GENERAL CONSTRUCTION-SCHED.111*
TOTAL COST OF CONSTRUCTION:$_
COST OF CONSTRUCTION WITHOUT TRADES:
$_
NOTE:
ALL SUB-TRADES TO BE FEE'D SEPARATELY.THESE
INCLUDE ELEC,MECH,PLBG,ROOFING,LOW VOLTAGE,
HOOD/SUPP SYSTEM,FIRE SPRINKLERS,IRRIGATION,
LANDSCAPING,PAVING,ETC.
*SEE BUILDING PERMIT FEE SCHEDULE FOR DETAILS
Is the building served with an automatic fire sprinkler system?D Yes ~No
Is this a change in the Use or Occupancy?Dl Yes [No
For Impact Fee Credit,Existing or Previous Structure Demolished?□Yes W No
Type of Structure Demolished:□SFR □Commercial □Commercial Accessory Building
PLEASE CHOOSE ONE OF THE FOLLOWING:
NEW CONSTRUCTION &ADDITIONS -FEE SCHEDULE I
TOTAL COST OF CONSTRUCTION TO INCLUDE:/
STRUCTURAL;ROOFING.EEC,MECH,PLB S,3 ,5 e0
f9 112,500,'s 2'1,20
NOTE:"]"
OTHER ASSOCIATED TRADES TO BE FEE'D SEPARATELY
UNDER FEE SCHEDULE II OR Ill.
THESE INCLUDE:LOW VOLTAGE,HOOD/SUPPRESSION
SYSTEM,FIRE SPRINKLERS,IRRIGATION,LANDSCAPING,
PAVING,ETC.
PERMIT VALUATION
Is this a City or Re-hab project?[I Yes ]No
Current Use or Occupancy _
Description of the ·terior/Exterior Alterati
-1 -
IT¥
Initial s.To wn of Gulfstream F L
G PERMIT APPLICATION
www.mydelraybeach.com
»R E C E I V E D 4kw1"Avenue •Delray each,FL 33444
JUN 192018 (561)243-7200·Fax (561)243-7221
i -
APPL DATE I F.B.C.VERSION ACCEPTED BY l PRMrr No./-//7fq
OWNER INFORMATION CONTRACTOR &DESIGNER INFORMATION
Name D Check if Owner/Builder (See Page 3)
Address 3777 N OCEAN BLVD Contractor License No.U-17077
City GULFSTREAM state"Z4 Workers'Comp No.WC131558320
Home Phone ()Company ROYAL PALM POOLS
Cell Phone ()Address 16333 TEMPLE BLVD
Fax No.()City LOXAHATCHEE State"zip33+70
Email Address Phone 5617983711 Fa 5617985908
Cell
PROPERTY INFORMATION Email ROYALPALMPOOLS@YAHOO.COM
Property Control Number:Architect/Engineer's Name e n73 5_la
_20434534050010770 ---10922±L.tsp.t..-.....
Address of Proposed Work
3777 NORTH OCEANBLVD GULF STREAM FOR PERMIT EXPEDITERS ONLY tor penit pick-upk:
Legal Description BLKS A,B&Z PALM BCH SHORE ACLT A4E OF Contact Name
&ADJTOSRA-I -A B LKB Phone Ext.
Ste or Apt #/Floor Cell
Project Name (if applicable)
ADDITIONAL INFORMATION
Fee Simple Tit le Holder (if other than owner)lA
r
Address City State Zip
Mortgage Lender Bonding Company
Address Address
City State Zip City State Zip
DESCRIPTION OF PROPOSED IMPROVEMENTS
Description of the proposed work (New Construction,Addition,Interior/Exterior Alteration,Windows/Doors,etc.)
/w £a l},f w,lo
ls this a City or Re-hab project?[]Yes [Z]No Is the building served with an automatic fire sprinkler system?J Yes £No
Current Use or Occupancy Pru st.Is this a change in the Use or Occupancy?D Yes No
PERMIT VALUATION
For Impact Fee Credit,Existing or Previous Structure Demolished?DJ Yes 0 No
Type of Structure Demolished:SFR □Commercial □Commercial Accessory Building
PLEASE CHOOSE ONE OF THE FOLLOWING:
NEW CONSTRUCTION &ADDITIONS -F EE SCHEDULE I *MISCELLANEOUS PERMITS -FEE SCHEDULE I I
TOTAL COST OF CONSTRUCTION TO INCLUDE:✓ALTERATIONS &GENERAL CONSTRUCTION -SCHED.I
TOTAL COST OF CONSTRUCTION:$
STRUCTURAL,ROOFING,ELEC,MECH,PLBG,O COST OF CONSTRUCTION WITHOUT TRADES:•L,2 $•NOTE:NOTE:
OTHER ASSOCIATED TRADES TO BE FEE'D SE PARATELY ALL SUB-TRADES TO BE FEE'D SEPARATELY.THESE
UNDER FEE SCHEDULE IL OR III.INCLUDE ELEC,MECH,PLBG,ROOFING,LOW VOLTAGE,
THESE INCLUDE:LOW VOLTAGE,HOOD/SUPPRESSION HOOD/SUPP SYSTEM,FIRE SPRINKLERS,IRRIGATION,
SYSTEM,FIRE SPRINKLERS,IRRIGATION,LANDSCAPING,LANDSCAPING,PAVING,ETC.
PAVING,ETC.
*SEE BUILDING PERMIT FEE SCHEDULE FOR DETAILS
-1 -
APPLICATION CERTIFICATION AND ACKNOW LEDGEMENT
Applica tion is hereby made to obtain a permit to do the work and installation as indicated.I certify that no work or installation has
co mmenc ed prior to the is s uanc e of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction.A City Building Permit does not assure compliance with Homeowners Association's rules,
regulations and/or deed restrictions.Applicant is advised to obtain approval from the Homeowners Association before
improving any property.Applicant further ac knowledges the following:
•Separate permits must be secured for ELECTRICAL,PLUMBING,MECHANICAL,WELLS,POOLS,FIRE SPRINKLER,
SIGNS,LANDSCAPE,IRRIGATION,ROOFING,SHUTTERS,ETC.
•This permit becomes null and void if work or construction authoriz ed is not commence d within six (6)months or if
co nstruc tion or work is sus pended or abandoned for a period of six (6)months at any time after work is commenc ed.
Permit will be cons idered suspended or abandoned if it does not pas s an ins pection within 180 day s and will be subject to
a reactiv ation fee in the amount in force at the time of reactivation.
•Failure to comply with all applicable construction regulations may result in the withholding of future permits .
•Submiss ion of any false information or mis representation is a violation of law and shall result in revoca tion of your permit.
•NOTICE:In addition to the requirements of this permit,there may be additional restrictions applicable to this property that
may be found in the public records of this county ,and there may be additional permits required from other governmental
entities suc h as water management districts ,state agenc ies ,or federal agenc ies .
W ARNING TO OW NER:YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TW ICE FOR IMPROVEMENTS TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION.IF YOU INTEND TO OBTAIN
FINANCING,CONSULT W ITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING W ORK OR
RE CORDING Y OUR NOTICE OF COMMENCEMENT.
OW NE R'S AFFIDAV IT:I hereby certify that I have read and examined this application and know the same to be true
and correct.All provisions of laws and ordinances governing this type of work will be complied wit h whether specified
herein or not.The grant ing of a permit does not presume to give aut hority to violate or cancel the provisions of any
other state or local law regulating construction or the performance of const ruction.
PROPERTY OWNER
STATE OF R C
STATE OF FLORIDA,COUNTY OF PALM BEACH
The foregoing instrument was acknowledged before me
"Joe .»18.
».CHr »et
/_P ersonally Known o
Type of Ident ification.yI
Signatur e of Notary
-2-
GENERAL CONTRACTOR
STATE OF FLORIDA,COUNTY OF PALM BEACH
5a #
Signatu r e of Qualifier<Sr eve7s
Pr inted Name of Qualifier
STA TE OF FLORIDA,COUNTY OF PALM BEACH
The foregoing instrument was acknowledged before me
T s ""a s hula 20a.
»sec<nos
'_P ersonall y Known OR
P roduced Identification
Type of Identificati ree-
C •T HIS P A GE F OR B UILDING DE P A RT ME NT US E ONLY ·
-=uro I77004 APPL_[CATION DATE:
CN:--------------
□Noo'es[_nip0 LiSirig[historic .
D ev elopm ent/C ondom inium /parim ent N am e
Pile
Set Backs:Front
T y pe of F oundat ion:M onolit hic
Side Street
St em Wall
Side Interior Fear
Square F oot age of C om m erc ial D em olit ion:
T y pe/Siz e of Ac c es s ory Building.
Type of St ructure Demolished:[]SFR []Commercial []Commercial Accessory Building
ST R U C T U R E SET U F PER M IT C A L C U L A T ION
()]Dq[Cy
(nS[[/De
Roof Type
}[((}_n%
Plan Sq.Ft.(N C)
Plan Sq.Ft.(Under Roof)
}in[gh }[r {[e/.
D EPA R T M EN T A PPR OVA L S
Adjusted Value $24.00PermitFee$
Electrical $3 4 0 0
rev #%ad il $80.00
Mechanical $
R oofi ng $
Pav ing $
I rrigat ion $
C OU N TY I M PA C T F EES
Sourc e:
(C redit )I m pac t F ee Am ount Due
Park s $$$
Public Bldgs.$$$
$~Sc hools $$
Road $$$
170.0
$
A D DIT ION A L F EES
Total Permit Fee
Landscaping $
Shutter $
wsc emt f0runs
owe nab lrc leak
Plan Check Fee $
CR #
$G$
$7 €2
Water/Sewer $
Parks /Rec $
Master Plan $
Tota as t orat es "$'q
roa r =us I/'720
Public Utilities1 21
Plan Review
SPRAB/C OA
Engineering
Landscaping /Irrigation
Env .Services
Planning &Zoning
Fire Department
Occ.Load
-4-Rvsd 5/10
o o SGiG@ vessssw.errs7av
sa e#±"#,100 NW 1"Avenue Delray Beach FL 33444 [r itials.Date.'I..s.a "woo«ow#eon."
FOR OFFICE USE ONLY:
PROPERTY CONTROL #:2"_1 1_9":"7"
PLEAS E PRINT :
JOB S ITE ADDRES S 777 NORTH OCEAN BLVD G ULFSTREAM
Pornrv ow:E R Awe _371_Qea,Kd
HOME PHONE .)-CEIL.
PROPERTY OWNER ADDRESS 3777 NORTH OCEAN BLVD GULFSTREAM
ELECTRICAL CONT R co«s NA».ea<tna,_Mey Eh
ELECTRICAL CONT'R (COMPANY)ADDRESS 2_y3 fa@vie fd
rle st kl,keal.sEL 3306sores.gs "2£$7%,
+x 3/-4 t9-3 9 An a s/won @eloa t.af
BLDG.PERMIT +:
arcor..[&-(77@&
PERMIT FEE.
PLAN CHECK FEE:
MCR #:
et¢¢4 ¢%¢$¢¢¢¢¢¢4 $¢t#tit
Arm0y9$9,7L,h
EEC<EDT4/I FIR£:---DATE:I
I
NOTE:PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180-DAYS OR IF ACTTWTY LAPSES FOR 180 DAYS.PLANS MUST
BE ON THE JOB SITE FOR ALL INSPECTIONS.FINAL INSPECTION IS REQUIRED ON ALL PERMITS.
NEW CONSTRUCTION
TYPE OF IN STALLA TION (PLEA SE CHECK ALL WORK TO BE PERFORMED BY A SINGLE ELECTRICAL CONTRACTOR
EAC H SEPARATE C OST TO INCLUDE LABOR &MATERIAL)
/COST V/cosT
1S FIRE AL ARM /$
3 SETS OF PLANS REOD»
ALTERATION /S
l s 1so"°TEMP.SERVICE/POLE '$
POOL/SPA
(SEPARATE APP)LOW VOLTAGE:
GENERAL REPAIR i $BURGLAR ALARM $
VOICE,DATA,ETC.7$
GENE RA TOR 7$
SLA B INC LUD ED?¥Y N SERVICE CHANGE 1$SEPARATE APP)
SITE LIGHTING ·S EXISTING SERVICE SIZE:
PROPOSED SERVICE SIZE:
Rvsd.3/10
Persona lly K nown__
OR
Produced Identification
Type of Identification Produced
DESCRIPTION OF WORK (Scope of work,#devices,etc.):.
67hi f,spa cg@ pest per el±
sareor Ma El
courY or.BL,a,Bh 44
The fu<qmng in,.....,.was,okno~me th;,t .,"'>
or.yn,aoL,s 'ct £ash5a
4,//£4 us«cu38 o u rs34_o»({<({e{ff4gs5 irr R or cisrrio Wo k5S is c@ rs ESEWT Tr»
100 NW A"Avenue Delray Beach FL 33444
(661)243 -7200 Fax:(6 1)243 -7221
Hobstte:..mydelra beach.com
RECEIVED
JUN 2 LECTRICAVPERMITNPP'\IGAION
ts«own erg.gee}),]
I nitials _'Ff2 Date.I,
F O R OF F I C E US E ONLY:
PROPERTY CONT ROL #:3"_.1_"2 -97"
PLEASE PRINT:
JOB S I TE ADD RES S 777 NORTH OCEAN BLVD GULFSTREAM
ro rER r O NE R Ase3 7 2_0ea,d LL .
HOME PHONE 'CEIL
PRO PE RTY O WNE R A D D RE SS 3 777 N ORTH OCEAN BLVD G ULFSTREAM
ELECTRIC AL c oN rR «cox a£.a,</na,_Mey_eE&
ELECTRICAL CONT'R (COMPAN ADDRESS z y_$f$a -ie [d
r_lest l,e a l.st 3 3 0 6
rs·so.a."#3,+82/-4r9 -339 on vast#on@ot adf .~.f
BLDG.PERMTT #:-
EL EC PERMI T #.
P ERMIT F EE:
P LAN CHECK F EE:
MCR #:
teem#see#tenet%#pt4
AP P ROVALS :
ELEC:DATE:
F IRE :DATE:
NOTE:PERM IT EXPIR ES IF WORK IS NOT S TARTED WITHNN 180-DAYS OR IF ACT7WTY LAPSES FO R 180 DAYS.PLA NS MUST
BE ON THE JOB SITE FOR ALL INSPECTIONS.FWAL INSPECTION IS REQUIRED ON ALL PERMITS.
NEW CONSTRUCTION 1$
AL TERATI ON /s
POOL'S PA vu«tac 0s too,6?
(SEP ARA TE APP
GENERAL REPAIR +$
GENERATOR 7$
SLA B INCLUDED?¥Y N
(SEPARATE APP)
SITE LIGHTING /S
TYPE OF INSTALLATION PLEASE CH ECK ALL WORK TO BE PERFORMED BY A SINGLE ELECTRI CAL CONTRACTOR.
EACH S EPARATE COST TO INCLUDE LABOR &MA TERIA L)
V/COST V/cosT
FIRE AL ARM /$
(3 S ETS OF PLANS REOD»
TEMP.SERVICE/POLE /S
LOW VOLTAGE:
BURGLAR ALARM VS
VOICE,DATA,ETC.iS
SERVICE CHANGE S
EXISTING SERVICE SIZE:
PROPOSED SERVICE SIZE:
Rvsd.3/10
Persona lly Known __
OR
Produced Identification
Type of Identificarlon Produced
vlforesots_""a,
eo/cm
•/ad.4 co 38 oven s o
§~InER CONTR.REGISTRA'flON #W ORKERS COMP#__EX_E_,MPT---(-FID /FE__IN_)_#
DESC RIPTION OF WORK (Scope of work,#devices,etc.):
€tic fu pool epop.eoh oe las
The ..
of dkt=-I
k k k #¥k k k ¥k k k ¥k k k ¥k k k ¥¥k ¥k jk k k k k #
B L DG P E RM IT#:~----
o r s +l8 -I77R
P E RM IT FE E ;
P L A N CHE CK FE E :-----
MCR#:-----
APP RO V ALS :
.so5 Are.228
FIRE :DA TE :
E S D :DA TE :
FO R O FFICE US E O NL Y :
PL E A SE PRIN T :
o stre o ness 3777Noca/Iv"
P R O P E RTY (OWN E R NAM E
HO M E P HO NE ('CE L L
P R O P E RTY O WN E R AD D RE S S a•
LUG cor R co»PA Ae "T @ Ploalon4
P L UM B ING CO N T'R (CO M P ANY)A D D RE ss P0 2 1 8
c rr To h sr F]z 339
us oNE Si)248 -4 3 4 7 cu 5+-2 CZ74 7
FAX 50g fl E MAI L
DT Y D F D R R A Y BEA c;'~~~-PLUMBING PERMIT APPLICATION%7 h'{@7'rvE m w o e s e As Ao Re srrow«ts
1 0 0 NW A"A ve n u e De l r a y B e a ch FL 3 3 4 44 1+,_
(5 6 1 )2 4 3 -7 2 0 0 Fa x:(5 6 1 )2 4 3 -7 2 2 1 '·-(7 tu n ¢
W ebs it e:_m ydelraybeac h.c om By.
PROPERTY co NTRo L #.Q o.83_l_yr.9$_.@oy.17
NOTE:PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180-DAYS OR IF ACTIVITY LAPSES FOR 180 DAYS.PLANS
MUST BE ON THE JOB SITE FOR ALL INSPECTIONS.FINAL INSPECTION IS REQUIRED ON ALL PERMITS.
DESCRIP TION OF WORK:_}_RE S ID E N TIAL _C O MME RCIAL
TYP E OF INSTALLATION-CHECKALLTHAT AP P LY:
NEW RE PAIR/REPLAC EMENT
ELEC TRIC GAS
WATER CONNECTION:
PROJECT cOST LABOR AND MATERA:s lg_
GENERAL PLUMBING:
WATER HEATERS:
SEWER CONNECTION:
SOLAR PANEL INSTALLATION:
SCOPE OF WORK (Describe WORK and LOC ATION:Kit chen/Bedroom/Gar age,etc):_
Tol ft o>£>Teal £I ]
0 FIRE SPRINKLER:(3 SETS OF PLANS REQUIRED)
NUMBER OF HEADS NEW RE PAIRJREPLAC EMENT/RELOC A TION
PROJECT COST (LABOR AND MATERIAL):$_
l o
8
°
-
Rvsd.3 /1 0
EXEMP T (FID /FE IN)#
(SEAL)
OR
WORKERS COMP#
REPAIR/REPLAC EMENT GENERATOR
L.P.NUMBER OF OUTLETS:----
CFC12$7
CONTR.REGISTRATION #
0 GAS WORK:NEW
TYPE OF GAS:NATURAL:
{){)F {)]]
PROJECT COST (LABOR AND MATERIAL):$_
STATE or R (oion4
C OUNTY oF Pc Loo_J5«}Personally Known
The foregoing instrument was acknowledged before me th;a l 'aay OR 13
\
a 'J ,h D Produced Identificatior('""
Of/-\,OlU by[o'u\''9dhhydhfhl9doleofIdentificationProduced
cvM!E L VI E E.Y ULAN L )-g3;&.·L
'[?@ ?commission +GG 0 7 4 so 6
>.l le{es Expires February 20.2021
Sig1 "%;"Bonded TNru Troy Fam insurance 800-385-7019
2.I
SIG N A T URE O F Q U ALi
ors aaJl ecav eo P7uwems raw eeuoso92>.°i%%i$$j4±sf$is-
100 NW 1st Avenue Delray Beac h FL 33444 JUN 1 2 2018 I .P!'1°Ponni t s=~al
(561)243-7200 Fax :(561)243-7221 nirials_Date.li2/l s
e bsite:mydelrab each.com [own of Gulfstream.FL
I FO R OFFICE USE ONLY :
PROPERTY CONTROL #:20-43-45-34-05-001-0770-BLDG PERMI T #-----
PLB G PERM IT #:
DA T E:
DATE:
DA TE :
PERMIT FE E :
PLAN CHECK FEE:
MCR #;
APPRO VA LS:
PLBG:
FIRE :
ESD :
PLEA SE PRIN T:
o s rT E A DD REs s "77OTTOGE"PG"STREAM
PRO PERT Y O WNER NAME
H O ME PH O NE ()CELL
PRO PERTY O WNER AD D RESS 9777NORTHOCAVPGUPSTREAM
PLUMBING CO NT'R (C OMPANY NAME Q"A"go
PLUM BIN G CON T'R (COM PAN Y)A D D RESS 163TEMPE
crryLOXAHATCHEE ST z1"""e
BU S.PH O NE ,·617%"7'CELL
FA 5617985908 E-MAIL !l {ha 2pol e hex,at
T T T 7
N OTE:PER MIT EXPIR ES IF WORK IS N OT STAR TED WITHIN 180-DA YS OR IF A C TI VI TY LAPSES FOR 180 DA YS.PLANS
MUST BE ON THE JOB SITE FOR ALL INSPECTIONS.FINAL INSPECTION IS REQUIRED ON ALL PERMITS.
DESCRIPTION OF WORK:__RESIDENTIAL COMMERCIAL
TYPE OF INSTALLATION-CHECK ALL THA T APPLY:
]]GENERAL PLUMBING:'_NEW REPAIR/REPLACEMENT
WATERHEATERS:__ELECTRIC __GAS
SEWER CONNECTION:WATER CONNECTION:
SOLAR PANEL INSTALLATION:
SCOPE OF WORK (De sc ribe W ORK an d LOCATI ON:Kitc he n/B ed room/Ga ra ge ,e tc ):
Pwi sh @ ,a,par
[]FIRE SPRINKLER:(3 SETS OF PLANS REQUIRED)
N U MB E R OF HE ADS _NEW RE P AIR/RE P LA C EMENT/RE LOC ATION
PROJE CT COS T (LABORAND MATERIAL):S _g2reg__}_gye
'}')/{)..
P RO JECT C OS T (LABOR ANDMATERIAL):s__r_@_..u..
0 GAS WORK:NEW
TYPE OF GAS:N A TU RA L :
SIG N~
RE P AIR/RE P LAC EMENT GENERATOR
L.P .NUMB E R OF OUT LETS :_
KA7g]JC•3/Sy32o
C ONTR.RE GIS TRATI ON #WORKE RS C OMP #EXEMPT (FID /FEIN)#
s r are or 1.
c our o».Ea &bn
The foregoing instrument was acknowledged before me this S""day
of ve,20l8 by 51T S
Pers o n ally Kno w n
OR
Produced Identification
Type of Identification Produced
Rvsd.3/10
6/12/2018
Detail by Entity Name
Florida Lim it ed Liabilit y Com pany
3777 N OC EAN BLVD LLC
Detail by Entity Name
Fili n g In forma tio n
Do cument Nu mb er
FEI/EIN Nu mb er
D ate Filed
State
Status
Princ ipa l Addre s s
L17000095110
82-1369468
04/28/2017
FL
AC T IVE
6530 W ROGER S C IR C LE
SU IT E #33
BOC A R AT ON ,FL 33487
Ma iling Addre s s
6530 W ROGER S C IR C LE
SU IT E #33
BOC A RAT ON ,FL 33487
Re gis te re d Age nt Na me &Addre s s
MAN F R E,LIN D A
6530 W R OGER S C IR C LE
SU IT E #33
BOC A RAT ON ,FL 33487
Authorized Person(s)Detail
Name &A d d r ess
Titl e MGR
FESSLER ,R OBER T G
6530 W R OGER S C IR C LE ST E 33
BOC A R AT ON ,FL 33487
Annua l Re ports
Rep o rt Year
2018
Filed D ate
02/05/2018
Doc ume nt Ima ge s
02/05/2018--ANNUAL REPORT View image in PDF format
94/28/2017 --Florida Limited Liability ----------~
http://search.sunbiz.org/lnquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=lnitial&searchNameOrder=3777N0CE...2/2
View image in PDF format
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C ITY OF DELRAy BEACH
C OMMU N ITY IMPR OVEMEN T D EPT.
(561)243-7200
IN SPEC TION S -C A LL (561)243-7218
5o evens
Contractor,Owner,Agent
Date Applied:
Prepared b y:
Date Issued:
6/15/18
TIERNEYB
7/17/18
"F AILURE TO COMPLY WITH THE
MECHANICS'LIEN LAW CAN RESULT IN
THE PROPERTY OWNER PAYING TWICE
FOR BUILDING IMPROVEMENTS"
Permit Type:POOL PERMIT -RES
Permit Phone Access#:2 2 4 7 450
8/12 Permit No.:
18-00177084 000 000 POOR 00
Citv Ranae Twnsh.Section Subdivision Block Lot Plat/Book/Page
20 43 45 34 05 001 0770
Property Address Zonina Reviewed By
3777 N OCEAN BLVD UK PE
7TT OT7 1'Arrt 'f AI 17TAT...l ho
Subdivision Name Improvements
POOL OR SPA -RESIDENTIAL
Owner's Name/Address/Telephone Contractor's Name/Address/License/Telephone
3777 N OCEAN BLVD LLC ROYAL PALM POOLS 561-798-3711
3777 N OCEAN BLVD 16333 TEMPLE BLVD
DELRAY BEACH FL 33483
LOXAHATCHEE FL 33470
Additional Comments
POOL &SPA
Construction EPI/EER FFE FLZ Occupancy Sa.Ft Valuation
.00 .00 R 22900
Schedule of Fees and Additional Information
AMT CHRG AMT PAID AMT DUE ACCOUNT
PERMIT FEES 524.00 .00 524.00 001-0000-329.21-00
OTHER FEES:
BLDG SURCHARGE-DCA 11.68 .00 11.68 001-0000-208.05-00
BLDG SURCHARGE-DBPR 17.52 .00 17.52 001-0000-208.06-00
GRAND TOTAL 553.20 .00 553.20
SPECIAL NOTES &RESTRICTIONS:
REMODEL POOL,ADDING SPA,ENTRY
FOUNTAIN
ELEC:EASTMAN
DECK:N/A
**N.O.C.REQD PRIOR TO INSPECTION**
****$1.00 HOLD FOR NOC****
**ELECTRICAL FINAL MUST BE APPROVED
BEFORE POOL FINAL CAN BE SCHEDULED**
**POOL FINAL CANNOT BE SCHEDULED USING
THE ,AUTOMATEDSYSTEM(VRU),CLL
THIS PERMIT SHALL BECOME NULL AND VOID UNLESS THE WORK AUTHORIZED IS COMMENCED WITHIN ONE HUNDRED AND
EIGHTY (180)DAYS AFTER ITS ISSUANCE,OR IF THE WORK AUTHORIZED IS NOT INSPECTED FOR A PERIOD OF ONE HUNDRED
AND EIGHTY (180)DAYS FROM TIME WORK IS COMPLETED.
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
starting.In consideration of the granting of this permit,the owner and builder agree to erect this structure in full compliance with the Code of
Ordinances of the City of Delray Beach.
C ITY OF DELRAy BEACH
C OMMU N ITY IMPR OVEMEN T D EPT.
(561)243-7200
IN SPEC TION S -C A LL (561)243-7218
Contractor,Owner,Agent
Date Applied:
Prepared by:
Date Issued:
6/15/18
TIERNEYB
7/17/18
"FAILURE TO COMPLY WITH THE
MECHANICS'LIEN LAW CAN RESULT IN
THE PROPERTY OWNER PAYING TWICE
FOR BUILDING IMPROVEMENTS"
Permit Type:MISCELLANEOUS PERMIT
Permit Phone Access#:2 2 4 7 4 9 2
8/12 Permit No.:
18-00177084 000 000 MISN 00
Citv Ranae Twnshp.Section Subdivision Block Lot Plat/Book/Pae
20 43 45 34 05 001 0770
Property Address Zonina Reviewed By
3777 N OCEAN BLVD UK PE
j rr r7 r or rrr t/7TA T-------,--·--------
Subdivision Name Improvements
POOL OR SPA -RESIDENTIAL
Owner's Name/Addr ess/Telephone Contr actor 's Name/Addr ess/License/Telephone
3777 N OCEAN BLVD LLC ROYAL PALM POOLS 561-798-3711
3777 N OCEAN BLVD 16333 TEMPLE BLVD
DELRAY BEACH FL 33483
LOXAHATCHEE FL 33470
Additional Comments
ENTRY FOUNTAIN
Construction EPI/EER FFE FLZ Occupancy Sa.Ft Valuation
.00 .00 R 10500
Schedule of Fees and Additional Information
PERMIT FEES
GRAND TOTAL
SPECIAL NOTES &RESTRICTIONS:
REMODEL POOL,ADDING SPA,ENTRY
FOUNTAIN
ELEC:EASTMAN
DECK:N/A
260.00 .00
AMT DUE ACCOUNT
260.00 001-0000-329.35-00
260.00
AMT CHRG AMT PAID
260.00 .00
THIS PERMIT SHALL BECOME NULL AND VOID UNLESS THE WORK AUTHORIZED IS COMMENCED WITHIN ONE HUNDRED AND
EIGHTY (180)DAYS AFTER ITS ISSUANCE,OR IF THE WORK AUTHORIZED IS NOT INSPECTED FOR A PERIOD OF ONE HUNDRED
AND EIGHTY (180)DAYS FROM TIME WORK IS COMPLETED.
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
starting.In consideration of the granting of this permit,the owner and builder agree to erect this structure in full compliance with the Code of
Ordinances of the City of Delray Beach.
CITY OF DEL RAy BEACH
COMMUNITY IMPROVEMENT DEPT.
(561)243-7200
INSPECTIONS -CALL (561)243-7218
Contractor,Owner,Agent
Date Applied:
Prepared by:
Date Issued:
6/15/18
TIERNEYB
7/18/18
"FAILURE TO COMPLY WITH THE
MECHANICS'LIEN LAW CAN RESULT IN
THE PROPERTY OWNER PAYING TWICE
FOR BUILDING IMPROVEMENTS"
Permit Type:ELECTRICAL PERMIT
Permit Phone Access#:2 2 4 7 4 6 8
8/12 Permit No.:
18-00177084 000 000 E3 00
City Range Twnshp.Section Subdivision Block Lot Plat/Book/Paae
20 43 45 34 05 001 0770
Property Address Zoning Reviewed By
3777 N OCEAN BLVD UK PE
7TT r7 ~'f Al 17TA T
a a ~·~.o±
Subdivision Name Improvements
POOL OR SPA -RESIDENTIAL
Owner's Name/Address/Telephone Contractor's Name/Address/License/Telephone
3777 N OCEAN BLVD LLC EASTMAN MERRY ELECTRIC,INC.561-615-0908
3777 N OCEAN BLVD 2155 PRAIRIE RD
DELRAY BEACH FL 33483
WEST PALM BEACH FL 33406
Additional Comments
Construction EPI/EER FFE FLZ Occupancy Sa.Ft Valuation
.00 .00 R 2500
Schedule of Fees and Additional Information
PERMIT FEES
AMT CHRG AMT PAID
134.00 .00
AMT DUE ACCOUNT
134.00 001-0000-322.20-00
THIS PERMIT SHALL BECOME NULL AND VOID UNLESS THE WORK AUTHORIZED IS COMMENCED WITHIN ONE HUNDRED AND
EIGHTY (180)DAYS AFTER ITS ISSUANCE,OR IF THE WORK AUTHORIZED IS NOT INSPECTED FOR A PERIOD OF ONE HUNDRED
AND EIGHTY (180)DAYS FROM TIME WORK IS COMPLETED.
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
starting.In consideration of the granting of this permit,the owner and builder agree to erect this structure in full compliance with the Code of
Ordinances of the City of Delray Beach.
CITY OF DELRAy BEACH
COMMUNITY IMPROVEMENT DEPT.
(561)243-7200
INSPECTIONS -CALL (561)243-7218
Contractor,Owner,Agent
Date Applied:
Prepared by:
Date Issued:
6/15/18
TIERNEYB
7/17/18
"FAILURE TO COMPLY WITH THE
MECHANICS'LIEN LAW CAN RESULT IN
THE PROPERTY OWNER PAYING TWICE
FOR BUILDING IMPROVEMENTS"
Permit Type:PLUMBING PERMIT
Permit Phone Access#:2 2 4 7 4 7 6
8/12 Permit No.:
18-00177084 000 000 P3 00
City Ranae Twnshp.Section Subdivision Block Lot Plat/Book/Paae
20 43 45 34 05 001 0770
Property Address Zoning Reviewed By
3777 N OCEAN BLVD UK PE
7r Pery ro rrrry y o rrrj o r----,--------
Subdivision Name Improvements
POOL OR SPA -RESIDENTIAL
Owner 's Name/Address/Telephone Contractor's Name/Address/License/Teleohone
3777 N OCEAN BLVD LLC RCA PLUMBING INC
3777 N OCEAN BLVD P.O.BOX 3218 JUPITER FLORIDA
DELRAY BEACH FL 33483
TEQUESTA FL 33469
Additional Comments
AUTOFILL FOR POOL
Construction EPI/EER FFE FLZ Occupancv Sa.Ft Valuation
.00 .00 R 400
Schedule of Fees and Additional Infor mation
PERMIT FEES
GRAND TOTAL
SPECIAL NOTES &RESTRICTIONS:
REMODEL POOL,ADDING SPA,ENTRY
FOUNTAIN
ELEC:EASTMAN
DECK:N/A
AMT CHRG
80.00
80.00
AMT PAID
.00
.00
AMT DUE
80.00
80.00
ACCOUNT
001-0000-322.30-00
THIS PERMIT SHALL BECOME NULL AND VOID UNLESS THE WORK AUTHORIZED IS COMMENCED WITHIN ONE HUNDRED AND
EIGHTY (180)DAYS AFTER ITS ISSUA NCE,OR IF THE WORK AUTHORIZED IS NOT INSPECTED FOR A PERIOD OF ONE HUNDRED
AND EIGHTY (180)DAYS FROM TIME WORK IS COMPLETED.
Any change in building plans or specifications must be r ecor ded with this office.Any wor k not cover ed above,must have a valid permit pr ior to
starting.In consider ation of the gr anting of this per mit,the owner and builder agr ee to er ect this structur e in full compliance with the Code of
Or dinances of the City of Delr ay Beach.
CITY OF DELRAy BEACH
COMMUNITY IMPROVEMENT DEPT.
(561)243-7200
INSPECTIONS -CALL (561)243-7218
Contractor,Owner,Agent
Date Applied:
Prepared by:
Date Issued:
6/15/18
TIERNEYB
7/17/18
"FAILURE TO COMPLY WITH THE
MECHANICS'LIEN LAW CAN RESULT IN
THE PROPERTY OWNER PAYING TWICE
FOR BUILDING IMPROVEMENTS"
Permit Phone Access#:2247484
8/12 Permit No.:
18-00177084 000 000 P3 01
Permit Type:PLUMBING PERMIT
Citv Range Twnshp.Section Subdivision Block Lot Plat/Book/Page
20 43 45 34 05 001 0770
Property Address Zonina Reviewed By
3777 N OCEAN BLVD UK PE
717 n7 NTrn1t 1rTTrn7TAT
lea a a.e •.o..
Subdivision Name Improvements
POOL OR SPA -RESIDENTIAL
Owner's Name/Address/Telephone Contractor's Name/Address/License/Telephone
3777 N OCEAN BLVD LLC ROYAL PALM POOLS 561-798-3711
3777 N OCEAN BLVD 16333 TEMPLE BLVD
DELRAY BEACH FL 33483
LOXAHATCHEE FL 33470
Additional Comments
ENTRY FOUNTAIN
Construction EPI/EER FFE FLZ Occupancy Sa.Ft Valuation
.00 .00 R 1000
Schedule of Fees and Additional Information
PERMIT FEES
GRAND TOTAL
SPECIAL NOTES &RESTRICTIONS:
REMODEL POOL,ADDING SPA,ENTRY
FOUNTAIN
ELEC:EASTMAN
DECK:N/A
170.00 .00
AMT DUE ACCOUNT
170.00 001-0000-322.30-00
170.00
AMT CHRG AMT PAID
170.00 .00
THIS PERMIT SHALL BECOME NULL AND VOID UNLESS THE WORK AUTHORIZED IS COMMENCED WITHIN ONE HUNDRED AND
EIGHTY (180)DAYS AFTER ITS ISSUANCE,OR IF THE WORK AUTHORIZED IS NOT INSPECTED FOR A PERIOD OF ONE HUNDRED
AND EIGHTY (180)DAYS FROM TIME WORK IS COMPLETED.
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
starting.In consideration of the granting of this permit,the owner and builder agree to erect this structure in full compliance with the Code of
Ordinances of the City of Delray Beach.
C ITY OF DELRAy BEACH
C OM M U N ITY IMPR OVEMEN T D EPT.
(561)243-7200
I N S P E C TI ON S -C A LL (561)243-7218
5cot Co ns
Contractor,Owner,Agent
Dat e Applied:
Prepared by:
Dat e Issued:
6/15/18
TIERNEYB
7/17/18
"FAILURE TO COMPLY WITH THE
MECHANICS'LIEN LAW CAN RESULT IN
THE PROPERTY OWNER PAYING TWICE
FOR BUILDING IMPROVEMENTS"
Permit Phone Access#:2247476
8/12 Permit No.:
18-00177084 000 000 P3 00
Permit Type:PLUMBING PERMIT
Citv Ranae Twnsho.Section Subdivision Block Lot Plat/Book/Page
20 43 45 34 05 001 0770
Property Addr ess Zonina Reviewed By
3777 N OCEAN BLVD UK PE
71 7 OT7 I'NTH7pt DMTTNTrT7TAT
a a.a...
Subdivision Name Improvements
POOL OR SPA -RESIDENTIAL
Owner's Name/Address/Telephone Contractor's Name/Address/License/Telephone
3777 N OCEAN BLVD LLC RCA PLUMBING INC
3777 N OCEAN BLVD P.O.BOX 3218 JUPITER FLORIDA
DELRAY BEACH FL 33483
TEQUESTA FL 33469
Additional Comments -
AUTOFILL REV G 01 4/1/19 TIE
Construction EPI/EER FFE FLZ Occupancy Sa.Ft Valuation
.00 .00 R 400
Schedule of Fees and Additional Information
PERMIT FEES
OTHER FEES:
REVISED PLANS -1ST TIME
GRAND TOTAL
SPECIAL NOTES &RESTRICTIONS:
REMODEL POOL,ADDING SPA,ENTRY
FOUNTAIN
ELEC:EASTMAN
DECK:N/A
AMT CHRG
80.00
75.00
155.00
AMT PAID
80.00
.00
80.00
AMT DUE
.00
75.00
75.00
ACCOUNT
001-0000-322.30-00
001-0000-329.31-00
THIS PERMIT SHALL BECOME NULL AND VOID UNLESS THE WORK AUTHORIZED IS COMMENCED WITHIN ONE HUNDRED AND
EIGHTY (180)DAYS AFTER ITS ISSUANCE,OR IF THE WORK AUTHORIZED IS NOT INSPECTED FOR A PERIOD OF ONE HUNDRED
AND EIGHTY (180)DAYS FROM TIME WORK IS COMPLETED.
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
starting.In consideration of the granting of this permit,the owner and builder agree to erect this structure in full compliance with the Code of
Ordinances of the City of Delray Beach.
ACCOUNT#ITEM
CITY O F DELRAY BEA CH
BUILDING DIVISION
CASH RECEIPT
FEE
4596 M
z
COMMENTS:
L
l%
Bldg.
Permit
•EL#8
Please Print r atne 0,
De l-'·/[
125-0000-322.10-00 BUILDING PERMITS I SITE WORK PERMITS
001-0000-341-45.00 COPIES I PHOTOCOPY
125-0000-329.45-00 CUSTOM TUB INSPECTION
125-0000-329.15-00 DEMOLITION PERMITS
125-0000-329.46-00 EARLY SUBMITTAL
125-0000-322.20-00 ELECTRICAL PERMITS/TEMP FOR TEST
125-0000-329.16-00 ENCLOSURE PERMITS
125-0000-329.52-00 ENGINEERING AFFIDAVIT
125-0000-329.17-00 FENCE PERMITS
125-0000-329.18-00 GAS PERMITS
125-0000-329.34-00 LANDSCAPE PERMITS
125-0000-322.50.00 MECHANICAL I AIR COND /HTG PERMITS
125-0000-329.35-00 MISCELLANEOUS PERMITS
125-0000-329.55-00 OPEN PERMIT/PROPERTY SEARCH
125-0000-329.20-00 PAVING PERMITS
125-0000-322.30-00 PLUMBING PERMITS/IRRIGATION PERMITS
125-0000-329.21-00 POOL PERMITS
125-0000-359-20.00 REINSPECTION FEE
125-0000-329.22-00 ROOF PERMITS
125-0000-329.23-00 SEAWALL/DOCK PERMITS
125-0000-329.14-00 SHUTTER PERMITS
125-0000-322.40-00 SIGN PERMITS
125-0000-329.36-00 TRAILER (SALES)PERMITS
125-0000-329-37-00 TRAILER (CONSTRUCTION)PERMITS
125-0000-329.27-00 TREE PERMITS
125-0000-_
Customer's Signature
PZB Staff:------~~f:c:::..___
Customer/Owner/Contrac{r:
A«res.?(/[.
NOV.2017
Distribution:White -Customer..,,Yellow -Finance Pink -Building
ACCOUNT#ITEM
CITY O F DELRAY BEA C H
BUILDING DIVISION
CASH RECEIPT
FEE
/7
4632M
Bldg.
Permit
COMMENTS:
#{0y
~
""-Date:T -
•
mate
•Cu 9mer's Semawre
PZB Staff:-------\V~-'---------------
125-0000-322.10-00 BUILDING PERMITS/SITE WORK PERMITS
001-0000-341-45.00 COPIES I PHOTOCOPY
125-0000-329.45-00 CUSTOM TUB INSPECTION
125-0000-329.15-00 DEMOLITION PERMITS
125-0000-329.46-00 EARLY SUBMITTAL
125-0000-322.20-00 ELECTRICAL PERMITS /TEMP FOR TEST
125-0000-329.16-00 ENCLOSURE PERMITS
125-0000-329.52-00 ENGINEERING AFFIDAVIT
125-0000-329.17-00 FENCE PERMITS
125-0000-329.18-00 GAS PERMITS
125-0000-329.34-00 LANDSCAPE PERMITS
125-0000-322.50.00 MECHANICAL I AIR COND /HTG PERMITS
125-0000-329.35-00 MISCELLANEOUS PERMITS
125-0000-329.55-00 OPEN PERMIT/PROPERTY SEARCH
125-0000-329.20-00 PAVING PERMITS
125-0000-322.30-00 PLUMBING PERMITS/IRRIGATION PERMITS
125-0000-329.21-00 POOL PERMITS
125-0000-359-20.00 REINSPECTION FEE
125-0000-329.22-00 ROOF PERMITS
125-0000-329.23-00 SEAWALL/DOCK PERMITS
125-0000-329.14-00 SHUTTER PERMITS
125-0000-322.40-00 SIGN PERMITS
125-0000-329.36-00 TRAILER (SALES)PERMITS
125-0000-329-37-00 TRAILER (CONSTRUCTION)PERMITS
125-0000-329.27-00 TREE PERMITS
125-0000-_
NOV.2017
Distribution:White -Customer Ye ll ow -F in an ce Pink -B uil din g
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City of Delray Bea ch Flor ida
100 NW 1ST AVE
DELRA Y BEA CH FL 33444
CER TIFICATE OF OCCUPANCY/CERT IF ICATE OF COM PLET ION
A p p l i c a t i o n N u m b e r .
C O I s s u e D a t e .
P a r c e l N u m b e r .
P r o p e r t y A d d r e s s
S u b d i v i s i o n N a m e
L e g a l D e s c r i p t i o n
P r o p e r t y Z o n in g
O w n e r .
C o n t r a c t o r
D e s c r i p t i o n o f Work
V a lu ation ..·...
Occupancy Ty pe ...
Bu ild ing cod e Ed it ion
NOTES:
18-00177084 000 000
8/08/1 9
20 43 45 34 05 001 0770
3777 N OCEAN BLVD
DELRA Y BEACH FL 33483
BL KS A ,B &Z PA LM BCH SHORE A C
LT 4 E OF &,AD J TO SR A -1-A
BLK B
UN KN OWN
3777 N OCEAN BLVD LLC
3777 N OCEAN BLVD
DELRA Y BEACH FL 33483
ROYA L PALM POOLS
POOL OR SPA -RESIDEN TIAL
$37 ,3 00
RES3,D EN T IAL
S BC :1994 ,1 997 ,2 001 ,2 004,2 007 ,2 010,2 014
...Stev e Tob ias ,
REMODEL POOL,AD D IN G SPA ,EN TRY
FOUN TA IN
ELEC :EA STMAN
DECK :N /A
CODE VER :FBC 2017
Building Off icial .
VOID UN LESS SIGN ED BY BUILD ING OFFIC IAL OR DESIGNEE
The described portio n of th e structu re has been in sp ected for
complian ce w ith th e requ iremen ts of the code for th e occupancy
and div is ion of occuparcy and the use fo r wh ich th e proposed
occupancy is classified .
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E»RECEIVED 4
JUN 12 2018
Town of Gulfstream,FL
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TOWN OF GULF STREAM
100 SEA R OAD
GU LF STR EA M ,FLOR ID A 33483
PRIVATE SWIMMING POOLS SAFETY REQUIREMENTS
AFFIDAVIT OF RESPONSIBILITY
(561)243-7200 Fax:(561)243-7221
or 3a3.%
S ubmit this form along with your application for a pool,spa or hot tub.
Company Name:_ROYAL PALM PO O LS_Lic ens e NumbER -U-17077
ate:£-A8 Permit Number.[-[77o8/
Section R4501.17 of the 2014 Florida Building Code and Chapter 515 of Florida Statutes
requires the prov is ion of spec ifi c pool barriers around the entire perimeter of the pool.
In addition to this ex ec uted affidav it,all prov is ions for the required pool barrier shall be
shown on the plans ,and manufac turer's produc t complianc e information mus t be
supplied.
I (We)ac k nowledge that a new swimming pool,spa or hot tub will be cons truc ted or
ins talled at the abov e addres s ,and hereby affirm that one or more of the following
methods will be us ed to meet the requirements of the Florida Building Code,R4501.17
and Florida Statutes ,Chapter 515.
Please initial all applicable methods:
The pool will be equipped with an approv ed safety pool cov er that complies with
ASTM F 1346,Standard Performanc e Spec ifi c ations for Safety Cov ers for
Swimming Pools ,Spas and Hot Tubs .
A continuous barrier ("Kiddie/Child Fenc e")will be us ed to is olate the pool from
the home.Plans submitted to show the loc ation of the end whic h is not
remov able without the us e of tools .Mus t comply with R4501.17.1.15 Florida
Residential Building Code,whic h includes ASTM D 5034 and ASTM D 3787 and
ASTM G 53
A c ontinuous barrier suc h as a dwelling wall,sc reen enclos ure or fenc e that
meet R4501.l 7 shall be us ed to prev ent ex ternal ac c ess to the pool.
Additionally ,all doors and windows that meet R4501.17 that lead to
the pool from the interior of the home,shall hav e an ex it alarm meeting the
requirements of UL 2017.
Other methods to be us ed.Pleas e spec ify :
Page 1 of 3
Re vise d :8 /2 0 1 7
I understand that by not hav ing one or more of the approv ed safety pool barriers
installed,or not creating a complete barrier around the perimeter of the pool,spa or hot
tub at the time of fi nal ins pec tion,will cons titute a violation of Chapter 515.F.S,and will
be cons idered a mis demeanor of the sec ond degree,punis hable as prov ided in Chapter
775.F.S.
Qualifier's Signature Date Qualifier's Name (Pleas e Print)
The foregoi ng is trun gent y as ac k nowledged before me this _"a4 or _[v n€_,
20_LE_,by [[01$who is personally k nown to me or who has produc ed
(Ty pe of ID)Iaasidentification.
Signature and
SEAL
--(8
Date Property Owner's Name (Pleas e Print)
SEAL
Signatur e and
4
T he §or egoing ins tr ument was ac k nowledged befor e me this {?day of Je,111 e ,
20['_,by us up0 La3kiho per s onally k now to me or who has pro duc ed
(T y pe of ID)r as identiRcation.
+See a tta che d for inspe ction se que nce
Page 2 of 3
3777 N Ocean Blvd LLC
6530 W Rogers Circle Suite #33
Boca Raton,FL 33487
R ECEIVED «
JUN 15 2018
Town of Gulfstream,FL
TOWN OF GULF STREAM
100 SEA ROAD
GULF STREAM,FLORIDA 33483
June 12,2018
To Whom It May Concern,
Chris Lapinski is an authorized agent to act on behalf of 3777 N Ocean Blvd LLC.He has permission to
sign all permits and documents related to 3777 N Ocean Blvd LLC.
Thank you for your time and consideration regarding this matter.
Owner
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TOWN OF GULF STREAM
PALM BEACH COUNTY, FLORIDA
Delivered via e-mail
March 3, 2021
Brandon Camilleri [mail to: Brandon.Camilleri@csklegal.com]
Re: GS #2828 (3777 N. Ocean Blvd. permits)
Please allow this email to serve as our public records request for: all permits, permit applications,
inspection records, correspondence, NOA’s, product approvals, plans, and any other documents
that are part of the permit file, associated with the following permits:
• 18-00177084 – 6/15/2018 – POOL OR SPA – RESIDENTIAL
• 17-00172206 – 10/19/2017 – ALTERATION – INTERIOR & EXTERIOR – RESIDENTIAL
• 17-00171390 – 8/23/2017 – DEMOLITION – INTERIOR/EXTERIOR
• 12-00138351 – 4/13/2012 – ELECTRICAL WORK
Dear Brandon Camilleri [mail to: Brandon.Camilleri@csklegal.com]:
The Town of Gulf Stream received your public records request on February 3, 2021. You should
be able to view your original request and partial response at the following link for:
• 18-00177084 – 6/15/2018 – POOL OR SPA – RESIDENTIAL
• 12-00138351 – 4/13/2012 – ELECTRICAL WORK
https://portal.laserfiche.com/Portal/DocView.aspx?id=174503&repo=r-430100cc
A similar request was received on January 11, 2021 from Daniel Levin at your firm and the Town
has supplied him with partial records for
• 17-00172206 – 10/19/2017 – ALTERATION – INTERIOR & EXTERIOR – RESIDENTIAL
• 17-00171390 – 8/23/2017 – DEMOLITION – INTERIOR/EXTERIOR
They can be found at the following link:
https://portal.laserfiche.com/Portal/DocView.aspx?id=173960&repo=r-430100cc
The Town received your deposit of $9.00 and the remainder of your request is available to be
picked up at Town Hall any time between the office hours of 8:00 AM and 4:00 PM.
We consider this request closed.
Sincerely,
Reneé Rowan Basel
As requested by Rita Taylor
Town Clerk, Custodian of the Records