BCP2005-01510G
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City of Clearwater
Development & Neighborhood Services
100 South Myrtle Avenue, Clearwater, FL 33756
Phone (727) 562-4567 Fax (727) 562-4576
WEB: www.myclearwater.com
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PERMIT APPLICATION
PARCEL NUMBER 08' / c2<1 / lS / lf338'D / OOt.j /007D
PROJECTlJOBNAME R.6SIDt:.NrG.-S A-r WINI) t.-J+tt.D PA-SS.t9
PROJECT ADDRESS .20d WIN I) w'r Rl') f' -:;, 4 i! ZIP.3 $ 7(" 1
BUSINESS NAME
PHONE
LEGAL DESCRIPTION
NAME WIN I) w4~O Pl+-SS~ t..:r t CoN 1)(') LC-e...
J A(last name, first)
ADDRESS 0 I 111_ I N sr.
CITY S.4F~ r 1.1 H~ Il.(),.(}(i
PHONE 7~ 7(lf4d - 5'- 8'1
E-mail:
STATE 1:,- ZIP 3 4 u C;~
FAX
NAME m ~CH-A^, (C-+t ~N 01 Nf56A...1 AU./ so,-u rloNE.r lAIC.
ADDRESS .'\'+~I (3~Al..U'V10^,T C~A1rGR t!l..Vti SLUT~ ~1S-
CITY TAM P'+
PHONE 111 J /3'85' - 'j ~ 00
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STATE F (.; ZIP f.J tiJ 34
FAX
E-mail:
<i:ONTRACTOR
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COMPANY NAME: V C c..
L1C. HOLDER 5" 4M 1'.. -4- LL ~ Y
ADDRESS rJ I fQ LOU. I ~ I ~^' ~ .s T
CITY LI rr l- ~ R..OC./'-.
STATE LICENSE # C'1 C 0 LJ. 4- c.J 9'9
PHONE !5{)1/37(;, -00/7
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FAX
STATE A-r<.. ZIP 7 ~d..C> 3"
PCCLB # 1- c. (, Co (") 'i 4- " 7' 9
E-mail:
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~ENERAL
INFORMATION
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EXISTING BUILDING USE
PROPOSED BUILDING USE
NUMBER OF STORIES (Q BUILDING HEIGHT
NUMBER OF UNITS 55'
CONSTRUCTION TYPE: I II III IV V VI; P OR U
SQUARE FOOTAGE: LIVING
COMMERCIAL
GARAGE/CARPORT
OTHER
TOTAL
PLEASE FILL OUT BACK PAGE
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Office Use Only
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i;IF FAX PERMIT, PLEASE ENTER PROPERTY ADDRESS HERE:
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" DEVELOPMENT SERVICES OEPl
!'PROJECT DESCRIPTION:
.....---.ClTY..OF CLEARWATER
~~ :5 -4 N I r -4-f.l.. Y Se~e1f!... R.. 6VIS/O^,S ~() te. ;f/: I3cP o100~ -OIS-Ie:,
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NA TU RE
OF WORK
(CHECK
ALL
THAT
APPLY)
BUILDING 0 ELECTRIC 0 PLUMBING ~ MECHANICAL 0
ENGINEERING 0 LAND RESOURCES 0 LANDSCAPING 0
GAS 0 FIRE 0 ROOFING 0
TRAFFIC OPERATIONS 0
UTILITIES 0 NEAR WETLAND 0
OTHER 0
;,TYPE OF WORK: NEW 0 ADDITION 0 REMODEL 0 REPAIR 0 DEMOLITION 0 OTHER 0
:VALUATION:
$
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. BOARD REVIEW REQUIRED: DRC 0 CASE # FL OR FLS
(circle one) DATE:
COB 0 DATE:
APPROVED 0 DENIED 0
; Anyone planning to do excavation work, must notify the one-call "CALL SUNSHINE" Notification Center at 1-800-432-4770 prior to any
excavation work being done, in order to prevent underground damage. Federal D.G.T. Regulation Part 192, Sections 192.614 and 192.707.
. Application is hereby made to obtain a permit to do the work and installation as 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.
CERTIFICATION:
" HAVE COMPLIED WITH ALL THE FEDERAL, STATE AND LOCAL ASBESTOS REGULATIONS CONCERNING NOTIFICATION OF THE
'PROPER AUTHORITIES OF THE PROPOSED DEMOLITION AND RENOVATION PROJECTS.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY R:SULT IN YOUR PAYING TWICE FOR
, IMPROVEMENTS TO YOUR PROPERTY.
IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
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"1 am aware of Florida and Federal Accessibility Codes, and I certify that I have met the requirements of both.
-I certify that, this application together with any plans submitted is accurate and represents all work being done at this time. All work will be done
in compliance with all applicable laws regulating construction and zoning and if not I realize I am responsible for the removal of any construction
in violation of these laws or regulations. Any deviation from information submitted, unless approved by the Building Official will render this
permit null and void.
- PAYMENT METHOD: CASH U CHECK D *CREDIT CARD U *If paying by credit card include authorization form.
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Signature of license holder
C IifIe/ ~ {..V I L t.. I A-It-t S
Please Print Name
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NOTE:
P-~: ZUFON 6ACKLlJ,6,TER VALVE I~ FLAPPER TYPE WIT~ a-RING.
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@2003THESE PLANS ARE COPYRIGHTED AND ARE SUBJECT TO COPYRIGHT PROTECTION AS AND
"ARCHiTECTURAL WORK" UNDER SECTION 102 OF THE COPYRIGHT ACT, 17USO. AS AMENDED
DECEMBER. 1990 AND KNOWN AS ARCHITECTURAL WORKS COPYRIGHT PROTECTION ACT OF
1990 THE PROTECTION INCLUDES BUT IS NOT LIMITED TO THE OVERALL FORM AS WELL AS THE
ARRANGEMENT AND COMPosmON OF SPACES AND ELEMENTS OF THE DESIGN,
Keyplan
WALTON H. CHANCEY & ASSOCIATES
ARCHITECTS P A
1860 Republica de Cuba Tampa, Florida 33605
Phone 813-248-9258 Fax 813-247-3507 AA 1785
5365 E Cty Hwy 3D-A, Suite 108 Seagrave Beach, FL 32459
Phone 850-231-2057 Fax 850-231-3553
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28l2l DFIJ'&
DOME&TIC WATER
UP TO Rt1P ROOM
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SANITARY WASTE PIPING
Zoning Approved
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BY P/;,"}~,~NIINN"G G, . EEJP EPPOA
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SOLUTionS...
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5421 Beaumont Center Blvd., Suite 675. Tampa, F133634
Ph. 813.885-9600 Fax 813.884-0045
Certificate #8304 Project # 2003580
Mark E. Awmiller. P,E. 53973
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BPRC Submital:
Date Plotted: August 02, 2006
Date Issued: JANUARY 10th, 2005
Revisions:
&6LOO DEPT COMMENTS telS.l8.e>s
~CONTRACTOR REVISION t>4~4.0h
AREVISION 23 lZl8R>!.0h
P - 1 02
03540
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100% CONSTRUCTION DO Ii
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PROJECT NO. 03540
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