PERMITWARNING TO OWNER: - 0 1 .. 0 9 7 1
"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 ATTORNEY BEFORE RECORDING
YOIJR'qqOTICE OF COMMENCEMENT. Date,'~,ed: 3i
I NOTICE I Prepared By: C O~',~ K L I N C
Permit Type:
BUILDING PERMIT
INSPECTIONS ARE REQUIRED:
Date Issued:
Permit No.:
SEE BACK OF PERMIT CARD FOR REQUIRED INSPECTION.
08 4.3
Property Address
Lot
3/'09/0i
0100000971
Twnshp. Section Sub Dvsn. Block Plat/Book/Page
~5 gl 1~ 000 i~.00
Zoning Reviewed by
503 NW 9TH AVE RA
Subdivision Nome Legal Address
CHt:RR? HILt, S BOil'HI'ON
Owner's Name/Address/Telephone Contractor's Name/Address/License/Telephone
MC GRADY, E &
503 NW 9TH AVE
BOYNTON BEACH
737-8906
FL 334.35
503 NW 9TH AVE
BOYNTON BEACH
737-8906
Additional~scription General/Amhit~t/Engineer
TENANT: REROOF/ AND NEW DRIVEWAY
FL 334.35
Construction
Occupancy
BFE FFE FLZ
Sq. Ft.
Valuation
Z , UUU
Schedule of Fees ~ THIS PERM
Improvements
_HLUG- M J..5 L;
FEE IS NOT REFUNDABLE
CREDITED 35,00 DATE- 3/09/'01 RECEIPT#- 0000007700
000000000
AUTHORIZED SIGNATURE//}----~ '
NOTICE: CALL 74-2-6355 FOR INSPECTIONS ?.4. HOURS LN .ADVANCe: ~BEFDRE 5:00 ~,j~,~
THIS PERMIT SHALL BECOME NULL AND VOID UNLESS THE WORK AUTHORIZED IS COMMENC ,F_J~{~T~-IIN ONE HUNDRED AND EIGHTY (180) DAYS AFTER ISSUANCE, OR
IF THE WORK AUTHORIZED HAS NOT RECEIVED AN APPROVED INSPECTION FOR A PERIOD OI~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.
DEPARTMENT OF DEVELOPMENT
BUILDING DIVISION
Building
Planning ,6 Zoning
OccttloationM l. icense$
CotntnttniO, Redevelopment
Neighborhood SpeciMh't
OVCNER-BUILDER AFFIDAVIT "' 0 l ' 0 9 7 1
I hereby apply for a Building Pe~it in the City of Boston Beach, FloNda, and will personally
supe~ise and control the pe~itted construction and will obse~e all the requirements of the
Building, ElectNcal, Plumbing, Mechanical, Zoning and other technical codes as adopted and
enforced by the City of Bo~ton 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 myselfi 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 for sale or lease. IfI sell or lease more than one
building I have built myself within one (I) year after 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 nnder an owner-builder permit within
the past twelve (12) months.
I, THE OWNER OF PROPERTY DESCB.1BED,~~
(legal description) ~_ffq~ {L~'//~ ~
/¢o-/¢/
(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, D/-MAY RESULT IN CANCELLATION OF THIS PERMIT
AND~D~Y~IE I]~dPOSIT~ON O]/OTHER PENALTIES AS P~RESCRIBED BY LAW.
' 7/O~r ' ' "- '"'k, Date
STATE OF FLORIDA, COUNTY OF PALM BEACIt ~ t
il
The foregoing instrument .was o, cknowledged before me this ~,,/7//(~/' (date)
by _?_ ~"{#vl ~ ~ (Jig4'o~l , who is personall~ lmown to me or~a~ produced~
~r'~ m ,,Cb 3'-' ,~ "7 -qS'.~O~' OItype of identification) as identification and who~t~ake an oath.
~edgement
~~l~wledtement--typed, p 'nted or stamPed
Revised WOO -J:~SHRDATAXDevelopment~ORMS.doc\Owner-Buildcr Affidavit. doc. 8t'24/2000
America's Gateway to the Gulfstream
100 East Boynton Beach Blvd., P.O. Box 310 Boynton Beach, Florida 33425-0310 Phone: (561) 7424350 Fax: (561) 7424357