PERMITWARNING TO OWNER:
"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
YOL~R~q'ICE OFCOMMENCEMENT." Oate Applied:
NOTICE I
IN ADDITION TO THE REQUIREMENTS OF THIS PERMIT, THERE MAY BE ADDmONAL RESTRICTIONS APPLICAM~yE I Prepared By:
TO THIS PROPERTY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY AND THERE
BE ADDFrlONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT~ Date Issued:
DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.
Permit Type: Permit No.:
BUILDING PERMIT
INSPECTIONS ARE REQUIRED: SEE BACK OF PERMIT CARD FOR REQUIRED INSPECTION.
Property Address Zoning
409 NE ilTH AVE
6/Z6/01
010000Z638
Revmwed by
RA
SubdMsion Name Legal Address
MEEKS & ANDREWS ADD
Owne¢sName/A~mss/~lep~ne
BALLARD, KEVIN
Z46 NW 14TH AVE
DELRA¥ BEACH
Additional~scd~ion
TENANT: 6 FT WOOD W/1
Construction
Schedule of Fees
BFE
Sq. Ft.
FL 33444
GATE
FFE
FLZ
Valuation
SoU
THIS MW. EM
Contracto~sName/A~mss/Li~n~/~iephone
BALLARD, KEVIN
Z46 NW 14TH AVE
DELRA¥ BEACH FL
General/Architect/Engineer
Improvements
~ENu~.
FEE IS NOT RF. FUNDABLE '
33444
PAID 35.00 DATE- 6/Z6/01 RECEIPT#- 0000009719 000000000
/,-/0, oo
TYPE- PENALTY FEE 105,00
AUTHORIZED SIGNATURE --
NOTICE: CALL
THIS PERMIT SHALL BECOME NULL AND VOID UNLESS THE WORK AUTHORIZED IS COMMENCED WITHIN ONE HUNDRED AND EIGHTY (180) DAYS AI-~t=H 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.
DEPARTMENT OF DEVELOPMENT
BUILDING DIVISION
FENCE PERMIT AFFIDAVIT
Indicate
North Arrow
Indicate fence with
Small xxxxxxxxxx's
(PLEASE DRAW IN LOT LAYOUT)
FILE COPY
PERMIT NO. 0
Address
ALL WORK INVOLVED' ON THIS PERMI1~ SHALL CONFORM',
WITH ALL CITY OF BOYNTON BEACH BUILDING CODES.
Owner
Subdivision
'Aialuation
Type ofFence
Type of Posts (1) Comer ~,/.,~'~/
Distance b/t Posts
Lot Blk
~"~"-~ Length
(2) Line Depth in Ground ~.~
~'-~c~,,.c Top Rail Size In concrete Yes .,)(' No __
AFFIDAVIT
I, the contractor/owner, have signed for a permit to construct a fence as shown above. I have not provided a survey
by a qualified surveyor to the City of Boynton Beach. Therefore, it is my responsibility to place this fence on the
property referenced above. If, at any time, the fence is found not to be on said property, it will be removed and
reinstalled at my expense.
Signature of Contractor'/Owner Date Address
State of Florida
County of
Before me personally appeared , to me well known to be the person described
in and who executed the foregoing instrument, and acknowledged to and before me that he/she executed said
instrument for the purposes therein expressed. Witness my hand and official seal this day of
., A.D. __
Notary Public, State of Florida at Large
My commission expires:
Permit App. li~afior) No.
DEPARTMENT OF DEVELOPMENT
BUILDING DIVISION
O~VNER-BUILDER AFFIDAVIT
o
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 UNDERSTAlND THAT THIS PERMIT IS FOR CONSTRUCTION OF
IMPROVENIENTS EXEMPT UNDER 489.103 (7) OF THE FLORIDA STATUTES, AlND 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 o~vner 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
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 t~velve
(12) months.
· bi, THE OWNER OF PROPERTY DESCRIBED AS
~ (legal description)
(Address) qo'~
L: JUN 2§ 2001 ,.
BUILDING DEPARTMENt
DO HEREBY CERTIFY THAT I HAVE READ THE FOREGOING, AND AIM AWARE OF
RESPONSIBILITIES AlND 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
A. BOVE STATEMENTS CONSTITUTES FRAUD AND MAY RESULT IN CAINCELLATION OF THIS
OF OTHER PENALTIES AS PRESCRIBED BY LAW.
STATE OF, ~FI~ORIDA, COUkNTY OF PA.I. xM BEACH
The foregoino.-.instrument ~vas acknmvledged before me tl~s
who is personally known to me or who has produc.ed U~.-
and ~vho ~
Signaturq q ~l~,¢~?~c~~mer~t I tr/'l
Name oral--typed} p~rint~d or staml~ed
Title
Date
(date) by
(~,~pe of identification) as identification
Revised 6/00, 3/01 - J:\SHRDATA\DeveloprnenthCORMS.doc\Owner-Builder Al:~davit. doc- REV. 5-2-01