PERMIT WARNING TO OWNER: - 0 2 - 1 3
"YOUR FAILURE TO RECORD A NOTICE OF COM- CITY OF BOYNTONBEACH
MENCEMENT MAY RESULT IN YOUR PAYING TWICE BUILDING DIVISION
FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANC-
ING, CONSULT WITH YOUR LENDER OR AN AIIORNEY BEFORE RECORDING
YOL*RAI(DTICE OF COMMENCEMENT." Date Applied: ~..'"16/0Z
NOTICE ] Prepared By: A R M
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 MAYI
BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT
DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.
Permit Type: Permit No.: 0 Z 0
Ii~~T'~I~~ REQUIRED: SEE BACK OF PERMIT CARD FOR REQUIRED INSPECTION.
City Range
0/3 ~3
Twnshp.
Section
3Z
O3
Block I Lot
011 02'90
Plat/Book/Page
Property Address Zoning Reviewed by
114,9 SW £TTH PL RA
Subdivision Name Legal Address
GOLF VIEW HARBOUR ZND SEC
Owner's Name/Address/Telephone Contractor's Name/Address/License/Telephone
AUBRE¥ %; FURR SR
11-~ SE Z?TH PL
BOYMTGN BEACH
FL 33~f. 6- 78
AUBREY W FURR SR
1144 SE Z7TH PL
Z BOYMTON BEACH FL 33~Z6-?83Z
AdditionalDescri~ion Ge~ral/Amhit~t/E~ineer
TENANT: 6 FT WOOD W/ Z GATES
IFLZ
Construction BFE FFE
Occupancy I Scl. Ft. Valuation 5 0 0
Improvements
FENCE
~ho~ledRes * THIS PERMIT FEE IS NOT REFUNDABLE
OTHER FEES:
AUTHORIZED SIGNATURE
bio T I Ci~. '. CALL
THIS PERMIT SHALL BECOME NULL AND VOID UNLESS THE WORK AUTHORIZED IS COMMENCED WITHIN ONE HUNDRED AND EIGHTY (180) DAYS AFTER ISSUANCE, OR
IF THE WORK AUTHORIZED HAS NOT RECEIVED AN APPROVED INSPECTION FOR A PERIOD OF ONE HUNDRED AND EIGHTY (180) DAYS.
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 starling, In consideration
of the granting of this permit, the owner and builder agree to erect this structure in full compliance with the Building and Zoning Codes of the City of Boynton Beach,
Florida. This permit fee is not refundable.
DEPARTMENT OF DEVELOPMENT
BUILDING DIVISION
OWNER-BUILDER AFFIDAVIT
Permit App3~catifln No.
Owner: j./q-//t,J-b~e~ ¢O, )'~xte~ ,fie,
I hereby apply for a Building Permit in the City of Boynton Beach, Florida, and will personally supervise and
control the permitted construction and will observe all the requirements of the Building, Electrical, Plumbing,
Mechanical, Zoning and other technical codes as adopted and enforced by the City of Boynton Beach.
WHEN ISSUED, I UNDERSTAND THAT THIS PERMIT IS FOR CONSTRUCTION OF
IMPROVEMENTS EXEMPT UNDER 489.103 (7) OF THE FLORIDA STATUTES, AND CERTIFY
THAT I AM THE BONA FIDE OWNER OF SAID PROPERTY. I ALSO UNDERSTAND THAT:
State law requires construction to be performed by licensed contractors. I have applied for a permit under an exemption
to that law. The exemption allows me, as the owner of my property, to act as my own contractor with certain restrictions
even though I do not have a license. I must supervise the construction myself. I may build or improve a one-family or
two-family residence or a farm outbuilding. The building must be for my own use and occupancy. It may not be built or
substantially improved for sale or lease. IfI sell or lease a building I have built or substantially improved myself within 1
year after the construction is complete, the law will presume that I built or substantially improved it for sale or lease,
which is a violation of this exemption. I may not hire an unlicensed person as my contractor. My construction must be
~one according to buil.ding codes and zoning regulations. It is my responsibility to make sure that people employed by
me have licenses required by state law and by county or municipal licensing ordinances.
· .
I certify that I J~ave not completed a residence or duplex under an~oWl~-l~r~ within the past twelve
I, THE OWNER OF~P. ROPERTY DESCRIBED AS
(Address)
DO HEREBY CERTIFY THAT I HAVE READ THE FOREGOING, AND AM XWARE OF MY
RESPONSIBILITIES AND LIABILITIES FOR CONSTRUCTION WORK ON THE ABOVE
DESCRIBED PROPERTY AND DO HEREBY COVENANT AND AGREE TO ABIDE BY ALL OF THE
AFORESAID STIPULATIONS. I FURTHER UNDERSTAND THAT ANY FALSIFICATION OF THE
/..d STATEMENTS CONSTITUTES FRAUD AND MAY RESULT IN CANCELLATION OF THIS
AND THE IMPOSITION OF OTHER PENALTIES AS PRESCRIBED BY LAW.
Owner // Date
STATE OF FLORID& COUNTY OF PALM BEACH · J / t4 f t"'- e _ '
The foregoing instrument was acknowledged before me_ this_ q~/,[b/{.c~ 7_. Qt,)ddt by [-~ ~)6t tI/E t/ ~'-~ ~,~(~, ,
who is personally known tome or who has produced O/.~./-~ OlD ~OI c~ ,L~/c~ _ ~a~(ty~f idehtification) as identificahon
and who ' .
Signature ~ t,~t~at~cgSc~ _~_~_~~ ~'~
Name ofo - ' ow e g6nSe-nt--typed, printed or stamped '
Title
Revised 6/00, 3/01 - J:kSHRDATAkDevelopment'ff:ORMS.doc\Owner-Builder Affidavit.doc- REV. 5-2-01