PERMITWARNING TO OWNER: - 0 :[ - 0 7 8 0
"YOUR !:ALLURE 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~ICE OFCOMMENCEMENT." Date Ai~lied: ~.,"~ 6,"0 ~
i NOTICE I Prepared By: A R M 0 L D.~
IN ADDITION TO THE REQUIREMENTS OF THIS PERMIT, THERE MAY BE ADDITIONAL RESTRICTIONS APPLICABLE J
TO THIS PROPERTY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY AND THERE MAY I
BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT I Date Issued:
DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. I
Perm~ Type: Permit No.:
RE~ ISiON/ROOFING
INSPECTIONS ARE REQUIRED: SEE BACK OF PERMIT CARD FOR REQUIRED INSPECTION.
City J Range
08 43
Property Address
Twnshp. Section
45 Z8
4/30/01
0100000780
Sub Dvsn. Block Lot Plat/Book/Page
OOZ0
Z1
003
Zoning Reviewed by
410 SW 3RD AVE RA
Subdivision Name Legal Address
SUNNYDALE LT 2 BI, F 3
Owner'sName/Addmss/~lep~ne
ODENAT /EAN A
BOYNTON BEACH
FL 33435-48
Additional Description
TENANT: FROM TILE TO SHINGLE 4/ix"
Construction [ BFE
Occupancy [
Schedule of Fees
FFE FLZ
Sq. Ft. Valuation
Contractor's Name/Address/Ucense/Telephone
ODENAT J ~-;At'J A
General/Architect/Engineer
Impmvemen~
RE-ROO~ '
.~ ~EE ~S NOi
PAID 35.00 DATE- 4/30/01 RECEIPT#- 0000008679
000000000
AUTHORIZED SIGNATURE ........................
NOTICE: CALL 74Z-6355 FOR INSPECTIONS Z4 HOURS IN ADVANCE ('B~FORE 5 :O0 P.M. )
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 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,
FIodda. This permit fee is not refundable.
WARNING TO OWNER: - 0 1 - 0 7 $ 0
"YOUR FAILURE TO RECORD A NOTICE OF COM- C~TY 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 AITORNEY BEFORE RECORDING
YOUWNOq'ICE OF COMMENCEMENT." Date Applied: 2/Z6'/01
J NOTICE J Prepared By: ARMOLDR
IN ADDITION TO THE REQUIREMENTS OF THIS PERMIT, THERE MAY BE ADDITIONAL RESTRICTIONS APPLICABLE I
TO THIS PROPERTY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY AND THERE MAY J
BE ADDmONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT] Date Issued:
13STRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. ~
Permit Type: Permit No.:
ROOFING PERMIT
INSPECTIONS ARE REQUIRED: SEE BACK OF PERMIT CARD FOR REQUIRED INSPECTION.
Z/7. 6./01
0100000780
City Range
08 4,3
Twnshp. Section Sub Dvsn. Block Plat/Book/Page
4,5 Z8 Z1 003 002,0
Lot
Property Address Zoning Reviewed by
4,10 SW 3RD AVE RA
Subdivision Name Legal Address
SUNNYI~AI.k LT 7. BI, K 3
Owner's Name/Address/Telephone
ODgNAT JEAN A
GA~;?l~:), SA]
Additional Description
Construction f BFE
Occupancy I Scl. Ft.
Schedule of Fees
FFE
IFLZ
Valuation
Contractor's Name/Addmss/Ucense/Telephone
;~iT, NAT JEAN A
G ^ :F; }~ :i F,I, SA INCi, USL<
General/Architect/Engineer
Improvements
.T ~'~E 15 NUT K~-~w-UNUABbE z
]-'AI:.~ 35,0£ DA'SE- 2/26/01 R~:~ ..... -
AUTHORIZED S IGNA~UR
~:,;~,;: CAt, I. ~z- ~.:;r,.~, ';~'~,, TU~;~'~:~:'r'~ c'm?, ;:4 ~c~,
THIS PERMIT SHALL BECOME NULL AND VOID UNLESS THE WORK AUTHORIZED IS COMMENCEI ~THIN ONE HUNDRED AND EIGHTY (180) DAYS AFTER ISSUANCE, OR
IF THE WORK AUTHORIZED HAS NOT RECEIVED AN APPROVED INSPECTION FOR A PERIOD OF ~NE 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 gra~ting 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.
Permit Application No.
Owner:
DEPARTMENT OF DEVELOPMENT
BUILDING DIVISION
Building
Planning & Zoni.g
Occupational Licenses
Comtttttnil), Red~,ttlopment
Neighborhood Xpeciallst
OWNER-BUILDER AFFIDAVIT
01-0780
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 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 fam'~ outbuilding. The building must be
for my own use and occupancy. It may not be built for sale or lease. IfI sell or lease more than one
building I have built myself within one (1) year atter the construction is complete, the law will
presume that I built 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 done according to building 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 have not completed a residence or duplex under an owner-builder permit within
the past thvelve (12) months.
I, THE OWNER OF PROPERTY DESCRIBED AS
(legal description)
(Address)..
DO HEREBY CERTIFY THAT I HAVE READ THE FOREGOING, AND AM AWARE
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 ABOVE STATEMENTS
CONSTITUTES FRAUD AND MAY RESULT IN CANCELLATION OF THIS PERMIT
AND '~HE IMPOSITION OR OTHER PENALTIES AS PRESCRIBED BY LAW.
.., gmpg iosLrument wlasacknowl~edged~efore rrg_ this ~ ! (date)
by {4b~Se~l Iq I{LU!O_ ~ 7P. JadO ~1~ is personally k~nown to me o~
~~,~.].~..x~.~- O~ (type of identification) as identification and who did not)take an oath.
# CC 990444 } '
i~edgement
e of officer taking acknowledgernent--type~I,'pfint'4d or stampled
Title
Revised 6/00. J:kgHRDATAXDevelopment~ORMS.doc',Owner-Builder Affidavit. doc. 8/24/2000
America's Gateway to the Gulfstream
lO0 East Boynton Beach Bh, d., P.O. Box 310 Boynton Beach, Florida 33425-0310 Phone: (561) 74~-6350
Fa, t56~LJ~D~ DEPAFtTMENT ,,