BCP2005-01510H
PROJECT
LOCA TION
PROPERTY
OWNER
ARCHITECTI
ENGINEER
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
@ I] a (VII] Inn
AUG 1 S 2006 ~I
EIIElQPME.l\l, Sf
""'-cJJ,~ ~.f ~~~~"/CfS 0l:P1
PERMIT APPLICATION
PARCEL NUMBER 0 'it / ~? I /5 / l.j J.J r-O I C04 / Q") Cj"o
PROJECT/JOB NAME R. ~ S I bC NC e.s 4- T Lv IN j) w A-A.ti pA 5SA-{/ ~
PROJECT ADDRESS aCOl Wl~-tR-'~ () st.,e ZIP 337' 7
BUSINESS NAME PHON," r 027) lit, 7' os J,
LEGAL DESCRIPTION
NAME WfNDw<i(tD P'+'S$.tC7t:= (cNiX>5 L / C
.A~ (last name, first)
ADDRESS 101 m Ii I AI S1
CITY ~19 F'~ TY HAlJ.BCJR.
STATE ~ L- ZIP
NAME NOR..rHs Ibe I5AJC:rING~IJ.I"'t.r
ADDRESS wI C l.. (7 velA-^" f) <; T SUI rE: C( ]~
CITY CL.61tfl.. w~reR... STATE ~L zlpj17S5""
PHONE 7 tl. 7 '+ L/ .3 ,J l! ~ 9 FAX
COMPANY NAME: V c..c.
L1C. HOLDER 5 A- M lc:., .4 L L c 7'
CONTRACTOR ADDRESS ~ 1(" L 0 (.(./ :5 J k-N h oS r
CITY I / -rrl.. c Mel<.
STATE LICENSE #c.c.,c 0 'f Y 4- ~
PHONE
E-mail:
FAX
E-mail:
PHONE '501 3710 00/7
FAX
STATE -4 f(. ZIP' 7 tl tUJ 3
PCCLS # 1- Ct; c 0 l.Jl.J l/ , CJ
E-mail:
GENERAL
INFORMATION
EXISTING BUILDING USE
PROPOSED BUILDING USE
NUMBER OF STORIES fo BUILDING HEIGHT
CONSTRUCTION TYPE: I II III IV V VI; P OR U
~f5
NUMBER OF UNITS
SQUARE FOOTAGE: LIVING
COMMERCIAL
GARAGE/CARPORT
OTHER
TOTAL
PLEASE FILL OUT BACK PAGE
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Office Use Only
~ IF FAX PERMIT, PLEASE ENTER PROPERTY ADDRESS HERE:
PROJECT DESCRIPTION:
n ~ V I S ION. To ~ I V I L 5 Co P ~ 'f I.L N J; R c., ~o U. AJ l\
8c.Pd()() 5 -OISIO
NATURE
OF WORK
(CHECK
ALL
THAT
APPL Y)
BUILDING 0 ELECTRIC 0 PLUMBING 0 MECHANICAL 0
GAS 0 FIRE 0 ROOFING 0
ENGINEERING 0 LAND RESOURCES 0 LANDSCAPING 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
$11'
I
VALUATION:
BOARD REVIEW REQUIRED: DRC 0 CASE # FL OR FLS (circle one) DATE:
CDS 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 O.O.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:
I 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 RESULT 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.
I 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 CHECKU 'CREDIT CARD 0 'If paying by credit card include authorization form.
~ tu~
Signature of license holder
C fH<.1 ~ l/-J I L LI ~ c;.
Please Print Name
8'"ltrloG
I I Date
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,.\F'PROVED
,;lrY OF CLEARWATER
PUBLIC W.OR. 'K.S. A~D( INf.r TAAf1"
By: \~z.JJ I.. L.uL~
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I!;
NOTFS:
1. EXISTING ABOVEGROUND UTILITY FACILITIES
IN THE PUBLIC RIGHT -OF-WAY TO BE RELOCATED
AND / OR PLACED UNDERGROUND WHEN
THE PROPERTY WHICH THE UTILITIES SERVE
IS REDEVELOPED,
2. FOR DEVELOPMENT THAT DOES NOT
INVOLVE A SUBDIVISION, ALL UTILITIES
INCLUDING INDIVIDUAL DISTRIBUTION LINES
SHALL BE UNDERGROUND UNLESS SUCH
UNDERGROUNDING IS NOT PRACTICABLE
3. NEW WATERLINES TO BE MINIMUM 30" DEEP MAX.42"
4. PROPOSED UNDERGROUND WATER MAINS &
HYDRANT(S) TO BE INSTALLED AND IN SERVICE
PRIOR TO CONSTRUCTION PER NFPA 241.
5. FDC SHALL BE IDENTIFIED BY A SIGN THAT
STATES .. NO PARKING FIRE DEPARTMENT CONNECTIOt\I'
6. FDC SHALL BE MAINTAINED WITH 7-1/2' CLEARANCE
TO FRONT AND SlOES.
7. FHA SHALL BE MAINTAINED WITH 7-1/2' CLEARANCE
TO FRONT AND SIDES. 4' CLEARANCE REAR.
AS-BUFf "1. r::'~ A I',l~ ~) V"
i ...! ~',.~,r\" \i.;,. I'~.'I: ~ T BE
SUBMrTTED PRIOR TO
fiNAL INSPECTION
riEVrl:::\~~L.f.', ,., _~. ',''',-:/':';;;i-
8i':~~,c;' " . 'J ~~:
CV\6 \ -
City Of CIemwater
Public Works Administration
All Sod,Sidewalk and Sprinkler Damage
To Be Repaired Prior To Final Inspection
20
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10
20
40
Zoning Approved
CITY OF CLEARWATER
R ANN.!i.NG DE...W. \fY,
BY _ ' QI&(a
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I NES Comm.: 0348 I
I Drawn By: B.J.V. I
I Checked By: H.G. I
I Issue Date: 03/02/06 I
Revisions:
No. Date Description
& 04/14/04 PER CITY
& 05/16/05 PER CITY
& 03/10/06 ADD SAN. SEWER
CONNECTION
& 03/31/06 REV. FIRE CONNECTION
PER FIRE DEPT.
&. 05/01/06 PER G.C.
& 05/15/06 KI:.V,
BEAM CONFLICT
& 05/15/06 REV. FIRE CONNECTION
PER FIRE DEPT.
& 07/25/06 REV. GRA'DING-
PER CONTRACTOR
& 08/09/06 PER CONTRACTOR
D / /
D / /
D / /
D / /
~ DESIGN/DEVELOPMENT
o PERMITTING & BIDDING
o CONSTRUCTION DOCUMENTS
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THIS DRAWING IS AN INSTRUMENT OF SERVICE AND SHAll r ~EMAli'J"d~E PROPERTY OF THE
ENGINEER, AND SHALL NOT BE REPRODUCED. PllBU$HtD DRUSEn IN ANY 'WAY WITHOUT
THE CONSENT OF THE ENGINEER. ..' @CO.PYR~GHT, 200~, NOT PUBLISHED
1 \ " Ii ' . t '"~, I
~... i,. ~ii1tIJfiJl9 2006
RAM A. GOEL, Ph.D.; ~.E,. #474~1 '
COPIES OF THESE PLANS ARE NOT VALID' UNLESS
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DO:
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C:l g>
Z 'c
::;; 0
So I'-J