PERMIT WARNING TO OWNER:
"YOUR FAILURE TO RECORD A NOTICE OF COM- CITY OF BOYNTON BEACH'
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
YOUR~TICE OF COMMENCEMENT." Date ~,~,d: ~f."o
I NOTICE
IN ADDITION TO THE REQUIREMENTS OF THIS PERMIT, THERE MAY BE ADDITIONAL RESTR CT ONS APPLICABLE Prepared By: A R M 0
ITO THIS PROPERTY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY AND THERE MAY
|BE ADDmoNAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTreES SUCH AS WATER MANAGEMENT
IDISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Date Issued:
Permit Type: Permit No.:
II~~O~,~I~E REQUIRED: SEE BACK OF PERMIT CARD FOR REQUIRED INSPECTION.
ZOgS SW !3TH WAY
Subdivision Name
Owner's Name/Address/Telephone
KERR!CK, THOMAS V
ZOO5 SW 13TH WAY
BOYNTON BEACH
A~itlonal Description
TENANT: SPRAY ON FOAM
Construction BFE FFE
Schedule of Fees
FL 33~Z6
Zoning
02-172~
5/08/0Z
OZ000017Z3
IFLZ
Sq. Ft. Valuation
RA
Legal Address
PALM BEACH LEISUREVILLE SEC 7
Contractor's Name/Addmss/Licenss/Telephone
SOUTHERN COATINGS, /NC,
Z000 NM !6TH ST
POMPANO FL
959 98%-0100
33060-791Z
General/Arch itect/E ngineer
Improvements
ROOFING PERMIT
THIS PERMIT FEE IS NOT REFUNDABLE *
OTHER FEES:
AUT.ORI,-'.E~ s I~.~ATURE n ~- ~
............. ' ' ' ' L~ ~' ~ ~'~ ~ · fq~ ~ M
· ~m~ ~HMII ~H~L BECOME NULL AND VOID UNLESS THE WORK AUTHORIZED IS COMMENCED WITHIN ONE H~N~D A~E~G~ ~ 80~DA~S ~R' ~OANCE, OR
IF THE WORK AUTHORIZED HAS NOT RECEIVED AN APPROVED INSPECTION FOR A PERIOD OF ONE HUNDRED ~6 EIGH~ (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 pdor 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.
R 0 0 ~ C 0 A.T ~ ~ G
(This A~fidaviC muse' b~ signed and sealed bY th~ SpeCial Inspector got ch
Pro~ect prior eo the issuance of a Certificate of Completion.)
Buiiding ~e~u.c # .~)~O[9~/~/?~, has been installed acco=ding Co
Beach BuiXdAn~ Code; approved documents on Bile with ~heBoynconBeaah
~ the manufacturer's speci£icacions
Special- lnspecCor..for Pro, acC Da~e
= ~- ' (dace) by_~~--~~" who £=
personally known to me or who has produced (=ype ol
iden~ifica=ion) as 'identification and who did (did n-or) ~ake an oath.
(S~) '- ~"
siTna6ure o~'person'ca~in~ acknowledgemen~
Name oE oEEicer Caking acknowledgement--typed,
prir~ed ~ stamped:
~i=le or ran~
Serial number, if any
' 'Permi£ #
PON, q ,'OV Illlllllllllllllllllll
'O01P*IL:~X~ 14r03:4l ~31~B8
Cityofeoy. ton~eech ~ ~ 1~ ~ 1246
DevelopmentDepa~m~nt Pa~a Beach Coun~y~ F]o~tda
Building Division ~o~o[hy H. ~[ken~ CJeTk
Stateof: ~/Cr;~ NOTICE OF COMMENCEMENT j
- ~ Tlti~ ~ce r~r~f~: r~or~ing ~ffice ust.
THE UNDERSIGNED hereby gives notice that improvement writ b~ ~da to ce~in mai ~, and in a~o~a~ wi~
Chapter 7~ 3, F~oHde Statutes. the followi~ information ~ provided in Ibis Notice of Commencement:
(or a~ach legal desc~pt~n) Lot ~ BJock S.bdivision
3.Gefleral description of improvement: ~ - ~ fC ~ / ' '"
4. Owner Information:
Interest In property:
Name & Address of
Fee simple titleholder
(if other than Owner }
5. Contractor information:
Contact Person:~,~'f'; ( ~-~. "~ cC[~_.F~~
Company Name r_°'x~4~rn Oc,z~finq 5. ~- '
6.Surer
mlormauon: ~tt reqmreaI
Name:
Address:
,,, Phone Number ] BondAmount
7. Lender Information:
Lender Name: ~
Address:
,,,Phone Number t ~°nd Am°unt I $
8. Persons within the State of Florida, designated by Owner upon whom notices or%thor documents may
be served as provided b)' Section 713.13(1)(a)(7), Florida Slatutes: *
Name:
Address:
Phone Number: J Fax Number: J
9. In addition to himself or herself, owner designates:
Name:
Address:
Phone Number: I Fax Number:
to receive a copy of the Llenor's Notice es provided In Section 713.t3(a)(b), Florida Statutes.
EXPIRATION DATE OF~ NOT CE: a' (explresfyearfromdateofrecordlngunlessadiff~rentdatelsspeclfled)
Who IS pemonally Know to me ar who has produced identification - /
Type ef IdanUflcation:
~\CI{~MAIN'~SI n~D"ATA\Ocvclopment\FORMS.doc~Nolic~ o1' Commencement f, tm.doc - 8.t24~0
here y cer. /tha the ,s a true co.y
.x~...' '..O .
i~:' ~ '~ of the reco~ ~n my office t~ dpy, Aug 23, 2002.
~ :~ -
[, ~ I I I :. ~DOROT~'H. WILKEM~rk of~oud, Palm Beach County, Florida