PERMIT WARNING TO OWNER:
"YOUR FAILURE TO RECORD A NOTICE OF COM- C,TY OF BOWNTO~nO~ ~E4A6CH ~
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 ATTORNEY BEFORE RECORDING
YOL~R~(~ICE OF COMMENCEMENT." Date Applied: +/"t 9/"OZ
NOTICE I Prepared By: H A Y S L
IN ADI~ TO THE REQUIREMENTS OF THIS PERMIT, THERE MAY BE ABOITIONAL RESTRICTIONS APPLICABLEI
TO THIS PROPERTY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY ANO THERE MAY I
BE ADDrrlONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT Date Issued: ~ / 1 cj / 0 Z
DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.
Permit Type: Permit No.: 0 Z 00001 ~, 46
REQUIRED: SEE BACK OF PERMIT CARD FOR REQUIRED INSPECTION.
City Range
08 43
I Twnshp.
46
Section
O~
Sub Dvsn.
Z~
Block I Lot
000 O05Z
Rat/Book/Page
Property Address Zoning Reviewed by
~30 SE 34TH AVE RA
Subdivision Name Legal Address
GULF STREAM E~TS PL
Owner's Name/Address/Telephone Contractor's Name/Address/Ucense/Telephone
AL AL
GOSS, LARRY R ET
%30 SE 3%TH AVE
BOYNTON BEACH
551 733-98Z9
FL 33435
GOSS, LARRY R ET
430 SE 34TH AVE
BOYNTON BEACH
56I 733-98Z9
Additional~scri~ion Gensral/Amhit~t/Engi~er
TENANT: CIRCULAR DRIVEWAY
Construction
BFE FFE FLZ
FL 33~35
Valuation Improvements
1,800 DRIVE WAY
~hedu~of~es * THIS PERMIT FEE IS NOT REFUNDABLE *
OTHER FEES:
NOTIOn; CALL 7~Z-6355 FOR IMSPECTIOM.~
THIS PERMIT SHALL BECOME NULL AND VOID UNLESS THE WORK AUTHORIZED IS COMMENCED WITHIN ONE HUNDRED AN~'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 starting. 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.
DEPAI MENT OF DEVELOPMENT.
BUILDING DIVISION
OWNER~J~ER AFFIDAVIT
0 1446"
PmTfit Appfi .c~on No.
Owner:
I hereby apply for a Building Permit in the City of Boynton Beach, Florida, and will personally' supends~ 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 T1TK FLORIDA STATUTES, AND CERTIFY
THAT I AM THE BONA FIDE OWNER OF SAID PROPERTY. I ALSO UNDERSTAND THAT:
State law requ/res construction to be pedormed by licensed conWac/ms. I have appliai for a permit under an exemption
to that law. The exemption allows me, as the owner ofmy ~, to act as my own contractor with c~tain reslzic6ons
~ though I do not have a license. I must supervi~ the ~ myse~ I may build or ' .m~ove a one-family or
two-~~~oral~m2a~ The ~ must be for my own us~ and ~. It may not be bu~ or
~ally ~ved for sale or ~ IfI seJ] or lease a bui~ng I have b~t or substantially improved myselfwithln 1
year after the constm~on is comple~ the law will premm~¢ that I built or subs~xfi~ly improved it for sale or
which is a violation of this ex~:mption. I may not hire an unli~ person as my contract. My construction must be
done according to building codes and zoning regulation~ It is my r~sponsibility to make sure that people employ~cl by
me have li~ required by state law and by county or municipal licensing ordinances.
I certify that I have not completed a residence or duplex under an owner-builder permit within the past twelve
(12) months.
I, THE OWNER OF PROPERTY DESCRII~ED AS
DO HE.BY CER~ ~T I ~ ~ ~ FOrGOInG, ~ ~ AW~ OF ~
~S~NS~I~S ~ L~~S FOR CONS~U~ON WO~ ON T~ ~O~
DESC~ED PROPER~ ~ DO ~BY CO~N~ ~ AGUE TO ~E BY ~L OF ~
~O~S~ S~A~ONS. I ~~R ~E~T~ ~T ~ F~S~CA~ON OF ~
~O~ STATE~NTS CONS~S ~~ ~ ~Y ~S~T ~ C~C~LATION OF T~S
PE~T ~ ~ ~OS~ON OF O~R PEN~S ~ P~S~ED BY LAW.
STATE OF FLORIDA, COUNTY OF PALM BEACH
The foregoing immm~ent was acknowledged before me this c/_ / ~ _ 0 Z (date) by
who is personally known to me or who lms produced k~n~ro~ '7o /~t..
and who did no0 take an oath.
Sigmmr~ ofpc~,on taking acknowledgement --
Name of officer talcing acknowledgement-typ~prmled or stumped -.~o, ~/, .~
Title
(type of identification) as identification
Revined 6.~0. 3fi31 - J.6SHRDATA~,Dm~kmmea~h=ORMS.doc',Own~-l~n'lder A/Y-ldavitdo~ REV. 5-2-01