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PERMITWARNING TO OWNER: CITYOF BOYN~T~)N I~(}~~ "YOUR FAILURE TO RECORD A NOTICE OF COM- 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~I~OTICE OF COMMENCEMENT." Date Applied: 8/g0/01 CONKL INC Prepared By: NOTICE '1 ITHE REQUIREMENTS OF THIS PERMIT THERE MAY BE ADDITIONAL RESTRICTIONS APPLICABLE| IN ADDITION TO ' LIC RECORDS OF THIS COUNTY AND THERE MAY PERTY THAT MAY BE FOUND IN THE PUB RE ADI)rrlONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTI ~ TO THIS PRO TIES SUCH AS WATER MANAGEMENT ~ ~I~STRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. · D~elssued: 8/Z0/01 0100003380 Permit No.: Pmparty Address 110 SE ZZND AVE ~ Legal Address CRESTVIEW - BOYNTON BEACH ne 110 SE ZZND AVE ROYNTON BEACH 561 Z54-31ZZ Additional .Descri tion FL 33435 Contractor'sName/~dress/IJcense/~phone 2900 N DIXIE HWY STE Z0Z FORT LAUDERDALE FL 954 3Z1-5550 General/Architect/Engineer 33334 Construction BFE FFE FLZ Occupancy Sq. Ft. Valuation_ ~hedu~ofF~s PAID 4~.80 DATE- B/Z0/01RECEIPT~- 000001058Z 000000000 PAID 4~,80CR DATE- 8/Z0/01 RECEIPT#- 000001058Z 000000000 CREDITED ~4.80 DATE- 8/'Z0/01 RECEiPT~- 32079 000000000 ncc is in the file AUTHORIZED SIGNATUR - NOTICE: CALL 7~Z-6355 FOR INSPECT 0 Y (' ' ~SSUANOE, OR THIS ~ER~LL BE-=~ NULL AND VOID 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. ,n consideration of the granting of this permit, the owner and buitder 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 To: Re: From: AFFIDAVIT (ONE & TWO FAMILY DWELLINGS ONLY) City of Boynton Beach, Florida Department of Development - Building Division Field Inspection Section 100 East Boynton Beach Blvd., P.O. Box 310 Boynton Beach, FL 33425-0310 01-111180 (Contractor) (Contractor's Address) (Owner/s Name) (Property Address) CERTIFICATION SELECTION: ~"Certification of roof metal installation, flashing, underlayment. ~-~Certification of re-nailing roo£sheathing, and removal and replacement of damaged or rotted wood. ~-~ Other I, ~'ZOC'~&~' /'~. d~,a~'.t~' , [-l am an Owner/Builder, ~g- am ce,ified as a roofing contractor (License No. ~.,~ lDt. l"~d.~[O ) and do hereby certify that all roof work (as indicated above) has been performed at the above address in accordance with Chapter 15 of the 1997 Standard Building Code. I understand that the City of Boynton Beach offers progressive retool inspections. I have notified the owner of the property of this affidavit. ~S~gnature of Owner/Buqld~r,~ Qualifier ~D"ate STATE OF FLORIDA, COUNTY OF PALM BEACII The foregoing instrument was ackno,vledged before me this ~/22/C~ ~ (date)by ~~/~, ~t/G,AjF_q' ,who is personally r who has produced (type of identification) as identification and who did (did not) take an oath. (SEAL) Siunature of erson takin acknowled ement P~"~ ~/~ Name of officer takln~ acknowled~emeut--typed, printed or stamped Title or rank Serial number ~.. ~g ~L MAT ~,ZUOZ DJ:mb 10/6/95, Rev WV} t:mh 11/27/95, 1/12/96 2/5/96, Rev DJ :bg 11/29~99, 8/31/2000 ~CH~MAIH~SHRDATA~DEVELOPMENT[POLICY MJZHUAL.WP~POLICYMH\SPECCON\ROOFCERT.WPD DEPARTMENT OF DEVELOPMENT BUILDING DIVISION (ONE & TWO FAMILY DWELLINGS ONLY) ROOFING CERTIFICATION DECEMBER 1999 II. III. I. PURPOSE The purpose of this Policy is to provide a method for certifying installation of roof metal, roof underlayment and re-nailing of roof sheathing on occupied or finished one and two family dwellings. AUTHORIZATION Section 103.6 of the 1997 Standard Building Code and Boynton Beach Amendments, as adopted by the City of Boynton Beach, provides that requirements necessary for the public safety, health and general welfare not specifically covered by the standard or other technical codes shall be determined by the Building Official. APPLICATION Qualified applicants may certify the roof metal installation and re-nailing of roof sheathing by preparing an affidavit certifying that the installation of the roof metal and re-nailing of roof sheathing complies with all codes, ordinances, rules and regulations; that the qualifier or designee personally inspected the specific job; and that the roof was installed according to the 1997 Standard Building Code, as amended, and the manufacturer's installation instruction. This affidavit must be presented to the inspector at the next scheduled inspection on-site or sent to the inspection office. When the roof metal and roof sheathing are not inspected at either a Sheathing, Tintag/Roof Metal, or Final Inspection, the Structural Building Inspector will either fail the inspection until certified by the applicant or pass the inspection if the signed affidavit is present at the j ob site. When a Final is the orily scheduled inspection and an affidavit ]s SupPlied, the Inspector shall' add the comment, "CERTIFIED," and pass the inspection. Progressive reroof inspections may still be requested by calling the inspection clerk 24 hours prior to reroof at (561) 742-6355. E-4 \\CH~MAIN~SHRDATA\DEVELOPMENT\POLICY MANUAL.WP\POLICYMH~SPECCON~ROOFCERT.WPD Permit*# PCN fl State of: cou.ty City of Boynton Beach f~--" Development Department Building Division F NOTICE OF COMMENCEMENT A~-20-2001 08:27am 0 1--35cj 1 27 ORB 1 ~:>8~2 P§ <:_ac_aS DORD1HY H. WILI~EN, CLERK PB COUNTY, FL IIIII I1 III II III II III II III II III II III II III II III II III I IIII 03. 01-3380 THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property, and in accordance wiit~ Chapter 713, Florida Statutes, the following information is provided in ti]is Notice of Commencement: 1. Legal description of property: (or attach legal description) 2. Street Address Lot Block 3.General description of improvement: 4. Owner Information: Phone Number: ~ '- ~ 5q -- ~/ Z7 ] Fax Number: Interest in properly: ~~/' Name & Address of Fee simple titleholder (if offmr than Owner ) 5. Contractor Information: 6.Surety Information: tif requir~ d) Name: Address: PboneNumber . [ BondAmount 1 $ 7. Lender Information: Lender Name: Address: 8. Persons within the'State of Florida, designated by Owner upon whom notices or other documents may be served as provided by Section 7!3.13(1){a)(71, Flor.!da Statutes: Name: Address: Phone Number: ' [ Fax Number: 9. In addition to himself or herself, owner designates: Name: Address: Phon,e Number: I Fax Number: to receive.s3_~opy of tbeLienor's I~oti~le i~ provided in Section 713.13(a)(b), Florida Statutes. EXPIRATION D/~ O~ TIHI~"~' I\ /[ / F1 (expiresl year/rom date ofre~ordin.q unless a different date is~si~ecified) Signalure of Owner: ~~~~ ~ /~ PrinledName: I~L.~"~--~J~J ~'~.~"('-'~/('~ o_is.pe~sonally know to me.br who has produced identification '~. Type of Ide~ti~icaJJBni Signature of Notary: ~.~ V ~f~'/-~b' /3 T~ O' 'G-' ....... ~\CI I\M A IN\SI II~.l)Al'A\l)cvclolm~Cut\FO R M S.d.c\Notice tff ('ommenccmcnl da'  I certify this_document to be a tru~.'~.~of the record in ,,