HomeMy Public PortalAboutPRR 14-1526From: Chris O'Hare [mailto: chrisoharegulfstream @gmail.coml
Sent: Wednesday, October 01, 2014 8:39 PM
To: Bill Thrasher
Subject: public record request - permit for Town Hall ramp
PUBLIC RECORDS REQUEST
Pursuant to Article 1. Section 24 of the Florida Constitution and Chapter 119.07 of the Florida Statutes I
wish to make a public records request of your agency for the following records:
The first three pages of any permit application for construction of the concrete ramp
currently being built on the north side of Town Hall at 100 Sea Road.
If you contend that any of the records I am seeking, or any portion thereof, are exempt from inspection or disclosure
please cite the specific exemption as required by S 119.07(l)(e) of the Florida Statutes and state in writing and with
particularity the basis for your conclusions as required by 4119.07(1)(f) of the Florida Statutes.
Please take note of 4119.07(c) Florida Statues and your affirmative obligation to (1) promptly acknowledge receipt
of this public records request and (2) make a good faith effort which "includes making reasonable efforts to
determine from other officers or employees within the agency whether such a record exists and, ifso, the location at
which the record can be accessed." I am, therefore, requesting that you notify every individual in possession of
records that may be responsive to this public records request to preserve all such records on an immediate basis.
If the public records being sought are maintained by your agency in an electronic format please produce the records
in the original electronic format in which they were created or received. See 4119.01(2)(f), Florida Statutes.
If you anticipate the production of these public records to exceed $1.00 please notify me in advance of their
production with a written estimate of the total cost. Please be sure to itemize any estimates so as to indicate the total
number of pages and/or records, as well as to distinguish the cost of labor and materials.
All responses to this public records request should be made in writing to the following email
address: chrisoharegulfstreamna gmail.com
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APPL DATE 71-1
F.B.C. VERSION
ACCEPTED BY
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PERMIT NO.
W ER INFORMATION
CONTRACTOR & DESIGNER INFORMATION
Name I •w 1 o f=R
❑ Check if Owner /Builder (See Page 3)
Address 100 .Sor, • ?a ,)rl
Contractor License No. GiG /S /�oG�
Workers' Comp No.
City �m IF' Sreom StateFL Ztp 33 473
Home Phone ($141 ) ,9`76 511(,
Company 44uZc:o X-4ic.
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Fax No. (5f 1 ) '3i1 1 mg
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Email Address r+u, f -Sfrcem . or
Phone .� /-488-0822 Fax 621- &7- 72L�.t
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PROPERTY INFORMATION
Email t%24KC A"ZcaCAC . Ce
Property Control Number:
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ArchitectfEngineer's Name .� itc resaY�
Address of.P-[oposed Work
Address /27749 bu, FvusrL�L c y0
PERMIT iOITERSONIY[for ermitpick -upl:
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Legal Description (-rtri�c�rynm it3 r L S f,4�
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Contact
Contact Name
Nam
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Cell 6&1-4547-72-24L
Ste or Apt # / Floor
Project Name (if applicable)
ADDITIONAL INFORMATION
Fee Simple Title Holder (if other than owner)
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, Interfor /Exterlor Alteration, Windows/Doors, etc.)
f+DL1 1�Y/�Q• ✓i NLl,rS 75 -_ Tq
Is this a City or Re-heb project? Yes ❑ No Is the building served with an automatic fire sprinkler system? ❑ Yes 2 No
Current Use or Occupancy Ta W rJ 4ALl— Is this a change in the Use or Occupancy? ❑ Yes lief No
PERMIT VALUATION
For Impact Fee Credit, Existing or Previous Structure Demolished? ❑ Yes ❑ No
Type of Structure Demolished: ❑ SFR []Commercial ❑ Commercial Accessory Building
PLEASE CHOOSE ONE OF THE FOLLOWING:
NEW CONSTRUCTION & ADDITIONS - FEE SCHEDULE I'
MISCELLANEOUS PERMITS- FEE SCHEDULE II•
ALTERATIONS & GENERAL CONSTRUCTION- SCHED. Ill`
TOTAL COST OF CONSTRUCTION TO INCLUDE:
TOTAL COST OF CONSTRUCTION: $
STRUCTURAL, ROOFING, ELEC, MECH, PLBG
$ O
ST OF CONSTRUCTION WITHOUT TRADES'
NOTE:
NOTE:
OTHER ASSOCIATED TRADES TO BE FEED SEPARATELY
ALL SUB - TRADES TO BE FEED SEPARATELY. THESE
UNDER FEE SCHEDULE II OR III.
INCLUDE ELEC, MECH, PLBG, ROOFING, LOW VOLTAGE,
THESE INCLUDE: LOW VOLTAGE,`HOOb /SUPPRESSION
HOOD /SUPP SYSTEM, FIRE SPRINKLERS, IRRIGATION,
SYSTEM, FIRE SPRINKLERS, IRRIGATION, LANDSCAPING,
LANDSCAPING, PAVING,..ETC.
PAVING, ETC.
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APPLICATION CERTIFICATION AND ACKNOWLEDGEMENT
Application is hereby made to obtain a permit to do the work and installation as Indicated. 1 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. 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 acknowledges 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 authorized is not commenced within six (6) months or if
construction or work is suspended or abandoned for a period of six (6) months at any time after work is commenced.
Permit will be considered suspended or abandoned If it does not pass an inspection within 180 days and will be subject to
a reactivation 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.
. Submission of any false information or misrepresentation Is a violation of law and shall result in revocation of your permit.
• NOTICE: In addition to the requirements of this penult, there may be additional restrictions applicable to this property that
may be round In the public records of this county, and there may be additional permits required from other governmental
entitles such as water management districts, state agencies, or federal agencies.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE 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 WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR
RECORDING YOUR NOTICE OF COMMENCEMENT.
OWNER'S AFFIDAVIT: 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 with whether specified
herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any
other state or local law regulating construction or the performance of construction.
PROPERTY OWNER
STATT
AVL O>FLORID/X;�� F PALM BEACH
Si eoEch �I `I--
Printed Nuneof() na
STATE OF FLORIDA, COUNTY OF PALM BEACH
The foregoing instrument was acknowledged before me
This u, day 20
By _''tt�
1/ ✓i'ersonally Known OR
Produced Identification—
Type of Identification:
Signature of Notary•
-2-
Notary Public - State of Florin
My Comm. Expires Mar 10, 20
Commission A FF 099915
GENERAL CONTRACTOR
STA A, TY OF PALM BEACH
Sigaa eo r
Prated Name of Qualifier
STATE OF FLORIDA, COUNTY OF PALM BEACH
The foregoing instrument as ac
owledged before me
This Z4 day
20
By Z.
Personally Known OR
_Produced Identification
Type of Identification: 01 Z )
UOy -01 -4 %—�
Signanue of Notary
F.'A. Wh
Eon - M E iprtes Mar 10 2018
Cummission a FF 099915
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