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Item H3Meeting Date: June 20, 2012 _Division: Growth Management Bulk Item: Yes X No Department: Building Staff Contact Person/Phone *:Jerome Smith — 453-8729 AGENDA ITEM WORDING: Approval of Building Permit Refund fee to Paul Roxenberg, Permit # 121-1321 issued on 03/20/2012. ITEM BACKGROUND: An owner/building Electrical Permit # 121-1321 was pulled by Mr. Roxenberg for the electrical work on a boat lift that was going to be installed. All Florida Keys Boat Lifts was hired and on 04/20/2012 they pulled permit # 121-1806 for the boat lift and the electrical work. Paul is requesting a refund of $ 130.00 for the owner/builder electrical permit that was pulled. PREVIOUS RELEVANT BOCC ACTION: N/A CONTRACT/AGREEMENT CHANGES: NIA STAFF RECOMMENDATIONS: APPROVAL OF REFUND TOTAL COST: INDIRECT COST: BUDGETED: Yes _No li'IFFERENTL4,L OF LOCAL PR f � � SOURCE OF S: 180-54501-590993 REVENUE PRODUCING: Yes No X AMOUNT PER MONTH Year APPROVED BY: County Atty OMB/Purchasing Risk Management DOCUMENTATION: Included X Not Requiared� 111 f-110#110 I! Revised 7/09 APPROVAL FOR REFUND IN THE AMOUNT OF $ THIS DAY OF 2011 COUNTY ADMINISTRATOR 1104 1; 1 1 1 •� STATE OF FLORIDA COUNTY OF MONROE PURSUANT TO SECTION 193.40, FLORIDA STATUES, Paul RoxenbM OF 2181 San Sebastian Drive., Big Pine Key, FL. (PAYEE) (MAILING ADDRESS) HEREBY MAKES APPLICATION TO THE BOARD OF COUNTY COMMISSIONERS FOR REFUND OF 130.00 OF MONEYS PAID TO THE COUNTY, AND AS GROUNDS THEREFORE SET UP THE FOLLOWING FACTS: (STATE REASON FOR REFUND IN SPACE PROVIDED BELOW) REQUEST TO REFUND DUPLICATE PAYMENT OF ELECTRICAL FEE - PEP,)MT # 12 -1806 ATTACHED HERETO IS ADDITIONAL PROOF TO & TABLISH SUCH CLAIM, AS FOLLOWS: STATE OF FLORIDA COUNTY OF MONROE Sworn subscribed bef a me th' day of 20 by mdffy%iss'oAluxpires sieiatu& o Notary ic- State of Florida Myc ownhwm _y own (or) Produced Identification „,,,,, 'fication Produced r P. y�1 BUILDING PERMIT APPLICATION MONROE COUNTY GROWTH MANAGEMENT DIVISION DATE: Rec'd ;PERMIT # — _ INTERNAL USE Complete if applicable: ❑Eme nar Walk-Thru ❑DEMOf❑Asbstoa) ID ATF ONLY PARCEL INFORMATION Deemed Development (Planning/810): YES an NO LU District FLUM District: $,)Elevation: G Flood Panel: L Tier. �f JOB SITE INFORMATION RE#: - ,lob ZtBi SA++St. 5 ,N Tax Folio # 0(5 31 Z-S 7300 35 4 O Address: f i31A b A)E Legal Lot Location t Key: '� 1� IC MM �-3 3. Description Block/Unit '33 8 3q Information Subdiv D0- OWNER INFORMATION Note: ALL OWNER BUILDERS MUST APPLY IN PERSON - F.S.409.103(7) OWNER BUILDER &es[]No Address (mailing) Z 1 %1 SqN STfAl-; UfL City, State,Zl - c - 0 Phone: (If applicable - other than owner), Address, Mortgage Lender's Name and Address Email Address Prefor+ence: E4Yes ❑No if YES, please provide email address that communication, including correction requests, should be sent. ?4pL(tok1j P yA € OO , C Gh CONTRACTOR INFORMATION /Happllcablej SUB A Other CONTRACTOR fifappllcable) Construction 11 Other 1 AGENT Business Name Contact License # Mailing Address Email Phone Bonding Company Name, Address City, State r Pool Roofing Architect/ Engineer Name Address Type of Private j - Plan Review S inspections Private Provider f Plan Review Only I IIIProvider p InSDection Oniv falaolication) E OF JOB DETAILS I GROSS SQUARE FT: I ESTIMATED TOTAL COST: $ Z 00 " Change in Occupancy/UseL_JYESLJNO Check Roofin Permit: Change in Footprint: ❑YES❑NO g ❑NEW ❑RE -ROOF ❑RE-COVER Construction debris will be removed by❑Appiicant❑5pecialty Contractor (Name): V3Effective 9/1/2011 -updated 2/12 Page 1 • A Notice of Commencement musl be recorded & posted on the job site before the first inspection, and copy to the Building Dept • Failure to post the Notice of Commencement at the job site will result in the inability of our inspectors to offer an approved inspection. • Your failure to record a Notice of Commencement may resultin your paying twice for improvements to your property • If you intend to obtain financing, consult with your lender or an attorney before commencing work or recordi ng your Notice o f Commencement. ASSESTOS AGREEMENT: (initial N Applicable: As owner/contractor/agent of record for t he construction applied for in thi s application, I agree that I will comply with the provisions of the Florida Statute 469,003 and to notify the DEP of m y intent to demolish/remove a structure at t he above address and remove asbestos, when applicable, in accordance with state and federal law. SOLID WASTE ASSESSMENT: Upon completion of the project for which I have made application for a Building Permit, i must pay the pro -rated residential solid waste assessment, or show proof of commercial service with a franchised commercial collector prior to a Certificate of Occupancy being issued. OWNER'S AFFIDAVIT: Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has commenced prior to the issuance of a permit and that ail work will be performed to meet the standards of all laws regulating construction in this jurisdiction. "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 such as water management districts, state agencies or federal agencies.' I understand that a separate permit (sub on a permit) must be secured for Electrical Work, Plumbing, Signs, A/C, etc as appropriate. I hereby certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Owner (print qut kzC—<e Signature: Date: Qualifier (print) Signature: Date: NOTARY as to Owner NOTARY as to Qualifier Sworn to & ubscribed to before me thJ Sworn to & subscribed to before me this day ofh he day of 20 he/she is personally no> �p�Mi or has pf t1NUEh personally known to me or has produced �{� ; i� di as i�cntikratin = Won o [oweddl 1 % 9 identification and who did (did not) take an oath. My My Commission Expires on OPLAIN ROUTING CHECKS Staff: Date - Section 6-107: codes that exist on the GROU oor the site if ANY starred code to the left is checked > Route to Floodplain FIRST ed for permit: Section 122-6: If ANY of the codes to the left are checked then FLT EPB LLF GB B SBF SBU >Cheek if SOLD after 6/01/04 > Route to Floodplaln 64 . « • >Check if current owner had the sate inspection > No insa Revd Odw Daporbne ft Fee LAN d, Ed Fee $ NVIR Bic Rev $ Plan Rev $ NG Plan Rev $ Admin. $ Site Inspect $ Wastewater $ Research $ 9tdldfnp Fee Plan Rewew PRfee Tam +PR ED Outer Structural $ + Is = $2 or $25 Fioodplain $ Elect $ C $6KL $ Code (ATF) Plumb $ + $ - $ $[Tech $) or $20 Mech $ + $ _ $ $ lContractor Roof $ + is _ $ $ DBPR $ �� 10 Fuel/Gas $ + $ = { $ $ DBPR ED $ Z'U Building $ N!A = $ $ DC $ U0 -IRE Plan Rev S 1-7 r Admin. $ impact Pee D. BUILDING OFFICIAUASSISTAAIT APPROVED FOR ISSUANCE V3 Effective 9/1/2011 - updated $ se this Total > forDBPWCA s DCA ED $ A Zd ------------------------- Total 0'0 u6tOtal: FEE Credit: U115n $ 3 DBPRIDCA GRAND TOTAL Permit Fee Dpe (Other Dept + B►dg + Wad - Fee Credit on DATE Page 2 APPLICATIO FOR BUILDING PERMIT 20 .A MONROE COUNTGROWTH MANAGEMENT DIVISION " ' Y Dote: ALL OWNER BUILDERS MUST APPLY IN PERSON - F.S.489.103 7 Rec'd b Permit # /� � —Owner Name: FF�u ay r--_- Mailing Address _ ! w►ry S r r3 -0,S-rim o.-; -D'2. 13, &, PI U Tz ' Phone # S 40 _ 4.5"4 - o $ 40 E-mail Property Description Key 01 - 5rl Lot Block '3304 RE# 6031 7-�-7 3 -co35 Subdivision -Ug rcr7s AP M MM 3 S Const. Address: "Z 16I 5-A0 c,:, F_.ry3 1j'o0 Pt( Proposed Scope of work j o sT a t-L rC �tf a Iv 6 P Po rt. 1 L;F- f2 L i FLI- V A- m rL- L t PT 400a _°_.._....__ Square Feet (area, if applicable) Estimated Total Cost I d I. OeD 0 `'`' L FC . _�rz V5 Construction debris will be removed by Applicant or _ Specialty Contractor (Name) a' G c F 1 S Check applicable box for Roofing Permit: NEW RE -ROOF RE-COVER FLOOD ZONE Contractor Co. Name: A Z L FL�t _7s A ICE �s (-ZnA�- L. t `..--i S Phone: �:O-29(L292 Address: Z '�-- QUk S:60-f 14QJ JL-t i+u Q b on ract Roofing Electrical r'l-1 c I EA I L Pool Mechanical Plumbing General Remarks: Elevator FEE FEE FEE DATE ENG PLAN REVIEW DBPR QCA ENG AQMIN FEE 8 DBPRIDCA FEES cZ� BLDG. ED. -, I - TOTAL DBPRlDCA ENG SITE INSP i 3 c9- ENG RESEARCH REVIEW PLANNING TECH C.EINVEST FIRE MARSHALL O cc FLOOD REVIEW EDUCATION BIO REVIEW ti Ia ✓ (� BUILDING 1 (00 ROOFING ELECTRICAL ' D A/C -MECHANICAL' PLUMBING GAS TOTAL FEES ,� 0� ( ) APP FEE CREDIT RECEIPT: PERMIT FEEIDUE BUILDI OF ICIAL, ASSISTANT BOIL[ DMo ments and Settingslmaldonado-m SHORT 6107 Settings%Temporary Internet NG APPLICATION 2 PAGE - OV"!NER'S AFFIDAVIT: I certify that all the foregoing information is 2urate and that all work will be . " done in compliance with all applicable laws regulating construction and zoning. "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 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. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FAILURE TO POST THE 'NOTICE OF COMMENCEMENT' AT THE JOB SITE WILL RESULT IN THE INABILITY OF OUR INSPECTORS TO OFFER AN APPROVED INSPECTION. Upon completion of the project for which I have made application for a Building Permit, I must pay the pro -rated residential solid waste assessment, or show proof of commercial service with a franchised commercial collector prior to a Certificate of Occupancy being issued. I hereby certify that I have read and examined this application and know that 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 local, state or federal laws regulating construction or the performance of construction. Owner (print) oXE a363 Qualifier (print) P tct4vLos Signature` Signature: Date: 3 5 12. _ Date: 3 /S/r z NOTARY as to Owner l/ NOTARY as to Qualifier Sworn to & subscribed to before me this Sworn to & subscribed to before me this day of c,, , 20�, he/she is day of /' l c , . , 20 12 , he/she is personally known to me or has produced personally known to me or has produced as identification as identification and who did (did not) take an oath. and who did (did not) take an oath. My Commissi) es JAMES L CROSS My CommissiW JAMes L CROSS ip `- MY COMMtS310N # DD93417t3 MISSION # DD934t76 EXPIRES October 19, 2013 XPIRES October t9, 2013 F Ssrvicexam F tam L. U. Dist.��Pagegr&� Flood o e Designation Base Flogdpevation_ Panel No 3 a<< By - Date Y Verify whether any of these codes exist on the ground floor of a site proposed for permit: FL.7* SBF CHECK IF SOLD AFTER 6/1/04- NEED SALE INSPECTION L:PB* GBU CHECK IF CURRENT OWNER ALREADY HAD THE SALE 1NSPF,CTION:' IF SO NO INSPECTION NEEDED L.L.F* GBF Pcrmit Clerk Initial SBU IF ANY OF THE ABOVE CHa CKEU %I *IF ANY STARRED ITEM IS CHECKED, ROUTE TO FLOOD IF NO SALE INSPECTION REQUIRED PURSUANT TO SECTION 6-I07 ( PAGE 2 OR 2) D-0ocuments and Settingsknaldonado-maria\Local SettingslTemporary Internet FileslContent.Outlook\RZA53NE9%BUILDING APPLICATION 2 PAGE SHORT (2).dou 6107 MONROE COUNTY BUILDING PERMIT APPLY OPERATOR: benderd ISSUE OPERATOR: maldonam APPLICATION / PERMIT NUMBER: 12101321 PERMIT DATE: 03/22/2012 APPLICATION DATE: 03/20/2012 DCA DATE: EXEMPT PARCEL ID: 00312573003500 LEGAL DESCRIP: BK LT 34 DOCTOR'S ARM SUBD 3RD ADD N SECTION C BIG PINE KEY PB6-41 OR611-602/603Q OR897-462 (UN/RE A/D ON FILE)(CSP) OR1222-1999AG(J B) OR1222-2000(JB) APPLIED VALUE: $200 PERMIT TYPE: 51 PERMIT TYPE NAME: ELECTRIC OWNER'S NAME/ADDRESS/PHONE GENERAL CONTRACTOR ROXENBERG PAUL B REV TR DTD ] ROXENBERG PAUL B REV TR DTD 16048 PURCELLVILLE RD PURCELLVILLE, VA 20132 PURCELLVILLE, VA 20132 1 SUBCONTRACTORS: TYPE ID NAME NO SUBCONTRACTORS ASSIGNED CONST ADDRESS/ CONDITIONS OF PERMIT: 2181 SAN SEBASTIAN DR., DR'S ARM BIG PINE KEY BOAT LIFT ELECTRIC **NOTICE OF COMMENCEMENT NOT REQUIRED** PERMIT APPROVAL TO INSTALL ELECTRIC SERVICE FOR FUTURE BOAT LIFT PER APPROVED PLANS IN FILE. NO OTHER WORK ALLOWED ON THIS PERMIT. INSPECTIONS REQUIRED PER PERMIT CARD. ALL TRASH AND DEBRIS MUST BE REMOVED TO A LEGAL DUMP SITE. DEEMED NON -DEVELOPMENT. PERMITNUMBER: 12101321 1 of2 MONROE COUNTY BUILDING PERMIT 11Z4k"_0MAUT -IWI Due to the nature of the work applied for, the Planning Department did not review this application. There may be development and/or land uses on the site that are no longer in compliance with a county regulation(s) or established unlawfiilly without the benefit of proper approvals. Approval of this permit does not deem all development as conforming or deem unlawful development as lawful. The Growth Management Division reserves the right to require that such development be brought into compliance through the proper approval process or terminated upon future discovery. PLANS REVIEW NOTES: ELECT kasprzaa P * NO NOTES FINAL 03/20/2012 tuckerm P * NO NOTES MAR-BLDG 03/20/2012 benderd L * NO NOTES MAR-BLDG 03/21/2012 maldonam L * NO NOTES OFFICIAL 03/21/2012 benderd P PASSED PER JS 03/20/2012 TO MARIA In consideration of the granting of this permit, it is agreed that in all respects the work will be performed and completed in accordance with the permitted plans and the applicable Building, Zoning and Environmental codes Monroe County, State of Florida and Federal agencies. This permit may be revoked at any time upon the violation of any of the provisions of said laws, ordinances or rules and regulations or upon any change in the plans and specifications unauthorized by this department. 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 such as Water Management Districts, State Agencies, and/or Federal Agencies. Permits shall expire and become null and void if work, as defined in this permit, is not commenced within 180 days from the date of issuance date or 180 days from the DCA date and does not meet 180 day inspections thereafter unless extended by the Buildigg-i-6 . AGENT DEPARTMENT PERMIT NUMBER: 12101321 2 of 2 0 10 ITEMS OF 10 MONROE COUNTY, FL PERMIT RECEIPT Sec:14 Twp:66 Rng:29 Sub: B1k: Lot: RE: ........: 00312573003500 DATE ISSUED.......: RECEIPT #.... ..... REFERENCE ID # .... NOTES ............. SITE ADDRESS ...... SUBDIVISION ...... CITY .............. IMPACT AREA ....... 03/22/2012 02000007498 12101321 OPERATOR: maldonam COPY # : 1 2181 SAN SEBASTIAN DR DOCTOR'S BIG PINE OWNER ROXENBERG PAUL B REV TR DTD ADDRESS 16048 PURCELLVILLE RD CITY/STATE/ZIP ...: PURCELLVILLE, VA 20132 RECEIVED FROM ....: ROXENBERG CONTRACTOR ........ LIC # *OWNER* COMPANY ..........: ROXENBERG PAUL B REV TR DTD ADDRESS ..........: 16048 PURCELLVILLE RD CITY/STATE/ZIP ...: PURCELLVILLE, VA 20132 TELEPHONE ......... FEE ID ---------- UNIT ------------- QUANTITY ---------- AMOUNT ---------- PD-TO-DT THIS REC NEW BAL CONT-INVES FLAT RATE 1.00 11.00 ---------- 0.00 ---------- 11.00 ---------- 0.00 DBPR UNITS 110.00 1.80 0.00 1.80 0.00 DBPR RE ED UNITS 110.00 0.20 0.00 0.20 0.00 DCA UNITS 110.00 1.80 0.00 1.80 0.00 DCA RE ED UNITS 110.00 0.20 0.00 0.20 0.00 E- 0 EDUC FLAT RATE 1.00 2.00 0.00 2.00 0.00 E- 1 MIN UNITS 1.00 50.00 0.00 50.00 0.00 E- 3B OUT EACH OUTLET 1.00 10.00 0.00 10.00 0.00 E- E PLAN UNITS 1.00 50.00 0.00 50.00 0.00 T- 1 FLAT RATE 1.00 3.00 0.00 3.00 0.00 TOTAL PERMIT 130.00 0.00 ------------------- 130.00 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER CHECK 130.00 1411 - TOTAL RECEIPT 130.00 APPLY OPERATOR: benderd MONROE COUNTY BUILDING PERMIT ISSUE OPERATOR: maldonam APPLICATION / PERMIT NUMBER: 12101806 1 PERMIT DATE: 05/07/2012 APPLICATION DATE: 04/20/2012 1 DCA DATE: - PARCEL ID: 00312573003500 1 LEGAL DESCRIP: BK LT 34 DOCTOR'S ARM SUBD 3RD ADD N SECTION C BIG PINE KEY P136-41 OR611-602/603Q OR897-462 (UN/RE A/D ON FILE)(CSP) OR1222-1999AG(J B) OR1222-2000(JB) APPLIED VALUE: $10000 PERMIT TYPE: 37 PERMIT TYPE NAME: BOAT DAVITS -LIFTS OWNER'S NAME/ADDRESS/PHONE GENERAL. CONTRACTOR ROXENBERG PAUL B REV TR DTD ALL FLORIDA KEYS BOATLIFTS INC 2181 SAN SEBASTIAN DR. F:305.289.1707 C:305.896.5567 MARATHON, FL 33050 BIG PINE KEY, FL 33043 1 305 745-5000 5404540848 SUBCONTRACTORS: TYPE ID NAME EC 09732 EFFICIENT ELEC OF THE KEYS LLC EC 1269 CONST ADDRESS/ CONDITIONS OF PERMIT: 2181 SAN SEBASTIAN DR., DR'S ARM BIG PINE KEY BOAT LIFT **NOTICE OF COMMENCEMENT REQUIRED*** PERMIT APPROVAL FOR 6,000 LB ELEVATOR BOAT LIFT PER APPROVED SEALED PLANS IN FILE. ******************************** ELECTRIC INCLUDED IN THIS PERMIT. ******************************** All permits for this type of application must pass electrical inspection. Permit will not receive final building inspection and will remain open PERMIT NUMBER: 12101806 1 of 3 MONROE COUNTY BUILDING PERMIT till power supply is install to the compliance of NEC article 210.8 (C) — no exceptions. Any electrical work without an approved permit will be considered as After The Fact. ************************************************** BIO APPROVED 04/24/12 BY JV FOR;BOATLIFT 1)NO FILL THIS PERMIT. 2)NO LAND CLEAR THIS PERMIT. 3)ALL CONDITIONS OF ACOE / FDEP PERMITS APPLY. 4)TURBIDITY CONTROL FOR ALL IN -WATER WORK. 5)CLEATS OR SECURE TIE -DOWNS MUST BE PROVIDED WHILE VESSEL IS ON LIFT. 6)LIFT DOCK & BOAT MAY NOT EXCEED 25% OF CANAL WIDTH. 7)ALL SETBACKS & OPEN -SPACE REQUIREMENTS APPLY. *********************************************** ACOE PERMIT SAJ-2012-0675 (GP -RR) DATED: 04/16/2012 DEP FILE NO.44-0310589-001 DATED 03/08/2012. NO OTHER WORK THIS PERMIT WITHOUT AN APPROVED REVISION. ALL TRASH AND DEBRIS TO BE REMOVED TO A LEGAL DUMP SITE. DEEMED NON -DEVELOPMENT DEO EXEMPT PLANS REVIEW NOTES: FINAL maldonam L db for final review MAR-BLDG 04/20/2012 benderd L * NO NOTES BIO 04/24/2012 vaserisj A BIO APPROVED 04/24/12 BY JV FOR;BOATLIFT 1)NO FILL THIS PERMIT. 2)NO LAND CLEAR THIS PERMIT. 3)ALL CONDITIONS OF ACOE / FDEP PERMITS APPLY. 4)TURBIDITY CONTROL FOR ALL 1N-WATER WORK. 5)CLEATS OR SECURE TIE -DOWNS MUST BE PROVIDED WHILE VESSEL IS ON LIFT. PERMIT NUMBER: 12101806 2 of 3 MONROE COUNTY BUILDING PERMIT 6)LIFT DOCK & BOAT MAY NOT EXCEED 250% OF CANAL WIDTH. 7)ALL SETBACKS & OPEN -SPACE REQUIREMENTS APPLY. EXAM 04/30/2012 kostich P * NO NOTES ELECT 05/01/2012 kasprzaa N All permits for this type of application must pass electrical inspection. Permit will not receive final building inspection and will remain open till power supply is install to the compliance of NEC article 210.8 (C) — no exceptions. Any electrical work without an approved permit will be considered as After The Fact. MAR-BLDG 05/01/2012 benderd L MY MISTAKE HAD ELECT. ON IT (DB) ELECT 05/04/2012 kasprzaa P * NO NOTES * OFFICIAL 05/04/2012 maldonam L * NO NOTES MAR-BLDG 05/07/2012 maldonam L * NO NOTES In consideration of the granting of this permit, it is agreed that in all respects the work will be performed and completed in accordance with the permitted plans and the applicable Building, Zoning and Environmental codes Monroe County, State of Florida and Federal agencies. This permit may be revoked at any time upon the violation of any of the provisions of said laws, ordinances or rules and regulations or upon any change in the plans and specifications unauthorized by this department. 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 such as Water Management Districts, State Agencies, and/or Federal Agencies. Permits shall expire and become null and void if work, as defined in this permit, is not commenced within 180 days from the date of issuance date or 180 days from the DCA date and does not meet 180 day inspections thereafter unless extended by the Building Official. k-1 , c-,� " 0WNER/CON TRACT0R/C0NTRACT NT BUIT, G EPARTMENT PERMIT NUMBER: 12101806 3 of 3 0 ,F 15 ITEMS OF 15 MONROE COUNTY, FL PERMIT RECEIPT Sec:14 Twp:66 Rng:29 Sub: Blk: Lot: RE: ........: 00312573003500 DATE ISSUED.......: RECEIPT #.......... REFERENCE ID # .... NOTES ............. SITE ADDRESS ..... SUBDIVISION ....... CITY .............. IMPACT AREA ....... 05/07/2012 02000008023 12101806 OPERATOR: ma COPY # : 1 2181 SAN SEBASTIAN DR DOCTOR'S BIG PINE OWNER ............: ROXENBERG PAUL B REV TR DTD ADDRESS ..........: 2181 SAN SEBASTIAN DR. CITY/STATE/ZIP ...: BIG PINE KEY, FL 33043 RECEIVED FROM ....: ALL FL KEYS BOAT A CONTRACTOR .......: HOGEBOOM, JAN LIC # 11932 COMPANY ..........: COASTAL DOCKS, LLC. ADDRESS PO BOX 522500 CITY/STATE/ZIP ...: MARATHON SHORES, FL 33052 TELEPHONE ........: (305) 289-0461 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL B- 0 EDUC FLAT RATE 1.00 2.00 - 0 00 - 2.00 - 0.00 B- 1 MIN DOLLARS 1.00 50.00 0.00 50.00 0.00 B- BIO EDU FLAT RATE 1.00 10.00 0.00 10.00 0.00 B-19D DOCK EACH 1.00 50.00 0.00 50.00 0.00 CONT-INVES FLAT RATE 1.00 11.00 0.00 11.00 0.00 DBPR UNITS 210.00 2.84 0.00 2.84 0.00 DBPR RE ED UNITS 210.00 0.32 0.00 0.32 0.00 DCA UNITS 210.00 2.84 0.00 2.84 0.00 DCA RE ED UNITS 210.00 0.32 0.00 0.32 0.00 - 0 EDUC FLAT RATE 1.00 2.00 0.00 2.00 0.00 E- 1 MIN UNITS 1.00 50.00 0.00 50.00 0.00 E- 3B OUT EACH OUTLET 1.00 10.00 0.00 10.00 0.00 - 5A MOTO MOTORS 1.00 50.00 0.00 50.00 0.00 LDR 2-ACC FLAT RATE 1.00 60.00 0.00 60.00 0.00 T- 1 FLAT RATE 1.00 3.00 0.00 3.00 0.00 TOTAL PERMIT 304.32 - 0.00 ---------- 304.32 ------------ 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER CHECK 304.32 __-------- 1174 --------------- TOTAL RECEIPT 304.32 File Edit Actions Detaits Unks Favorites HeIX 3 Al a W 9A 1!9;V a,% V Pe'r-A Infomi"kion 40 LocVton HIna a Permit Number' 11-1-21--0,1321 1 Address* Status Kposed__State 0Y/State Master Number RE: Project Unit Apply Date Operator Abend . .. . ...... Own er Erd Permit Issue Date 0 1 2 2412 Operator maldonam Owner Xame Certkate 4ssued Operator Use it Certificate Type CiertkateNumber Address City/StateZzip Warty Zoning lf�ppl Defhed Fields 7ermit Detafs Permit Type Usage (lass WWTA�� US C-404 Type Parma Form O%nershIp f1 - Private — .... .. -------- - - Permit [ssued 03/22/2012 The type of permit to' be, issiaed-_ lh4A�) MIR11 �06 �C. 0 1.0rimt ,nation [kiENSERG PAULO REV TR DTD )711 - F— / 71 _o v,11 Home - 2F81 SAWS b A 6� B;G PINE KEY L 33043 PwposeYSpedal Conditione 21e1 SA N 9-73ASTIAN DR-, DA-S km BIG BOAT LIFT ZU-CTRIC '"NOTICE OF COMMENCEMENT1 NOT R-EQUIREr REMINIT APPROVAL TO INSTALL ELECTRIC S &VEURE BOAT LIFT PER APPROVED PLANS I PTO OTHER FORK ALLOWU ON THIS ;2AMIT. INSPECTIONS RZQUIP_-D P-21Z I-'T-RYIT CARD. ALL TRASK AND DEBRIS MUST BE R7--XOV-=D SITE -