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 AIIORNEY BEFORE RECORDING
Y01~R~EfflCE OF COMMENCEMENT." Date,N31::)lied:
I NOTICE I Prepared By:
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. J
Permit Type: Permit No.:
ROOFING PERMIT
INSPECTIONS ARE REQUIRED: SEE BACK OF PERMIT CARD FOR REQUIRED INSPECTION.
I
08 43 45 33 08 006 0190
Property Address
1Zi SE ZSTH CT
8/17/0!
GUIFARROC
8/17/01
0100003372
Rat/Book/Page
Zoning Reviewed by
RA
Subd~v~bn Nome Legal Address
SEACREST ESTATES LT 19 BLE 6
Owner's Name/Address/Telephone Contractor's Name/Address/Ucense/Telephone
LEGAGNEUR, MONIQUE &
BEAUCIQUOT, FRITO
BOYNTON BEACH FL
33435
LEGAGNEUR, MONIQUE &
BEAUCIQUOT, FRITO
BOYNTON BEACH FL
Additbnal~scri~ion Ge~ral/Amhit~t/Engi~er
TENANT: 36 SQS 5/11 SLOPE
33435
Construction
Schedule of Fees
BFE FFE FLZ
Sq. Ft.
Valuation
THIS FERMi
Improvements
T FEE I$ NOT REFUNDABLE
35.00 DATE- 8/17/01 RECEIPT#- 0000010573 000000000
NOTICE:
CALL 7~Z-6355 FOR
INSPECTIONS Z4 HOURS IN ADVANCJE (BEFG~REL,5:00 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 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.
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
Pennit No.
(Contractor)
(Contractor's Address)
~_'(Owner/s Name)
(Property Address)
CERTIFICATION SELECTION:
~71 Certification of roof metal installation, flashing, underlayment.
[~] Certification of're-nailing roof` sheathing, and removal and replacement of damaged or rotted wood.
~] Other
I,/~/./t'3'~,..oo 4_ff-tO'(j~,,OT~'.g [i~3/amanOwner/Builder, [] am certified as a roofing contractor
(Li~e~.~'~o."- L4..----- ) anc~ do hereby certify that all roof` work (as indicated above) has been
perforated at the above address in accordance with Chapter 15 of the 1997 Standard Building Code. I understand that
the City of Boynton Beach of,f,ers progressive reroof inspections.
affidavit.
'S,'gh~aiad of, O~w,~e~ ¢..7'aer or C~ua"iiner
I have notified the owner of the property of this
STATE OF FLORIDA, COUNTY OF PALM BEACH .'/ ' , .
The foregoing instrument was acknoxvledged, before me this (~/.-~)~)/ (date) by ~q0~l~'l/~ ~~o~ is pe~so~ny
knoxwl to me or xvho has m'oduced~~O ~ ~¢~ - (type of identification) as i~entificat~n ~d who dkd (did no~u
oath. ~ ~ ~
Name of officer takina acknowledeement--typed, printed or stamped ~
Title or rank Serial number
DJ :rah 10/6/95, Rev WV H:mh I 1/27/95, 1/12/96 2/5/96, Rev DJ :bg I 1129/9% 8t31 ~2000
~[CH~MAIN/SHRDATA~DEVELOPMENT~POLICY MANUAL.WPkPOLICYMHkSPECCONkROOFCERT.WPD
DEPARTMENT OF DEVELOPMENT
BUILDING DIVISION
(ONE & TWO FAMILY DWELLINGS ONLY)
ROOFING CERTIFICATION
DECEMBER 1999
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.
II. 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.
III. 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/RoofMetal, 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 job site.
When a Final is the only scheduled inspection and an affidavit is 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\MAINXSHRDATA\DEVELOPMENT\POLICY MANUAL.WP\POLICYMH~SPECCON\ROOFCERT.WPD
Permit Application No.
Owner: pg~t)~(~
DEPARTMENT OF DEVELOPMENT
BUILDING DIVISION
OWNER-BUILDER AFFIDAVIT
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.
(12) months.
I, THE OWNER OF PROPERTY DESCRIBED AS
(legal description) ~.',,4 i~$47~3 /-04' [~
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 la;v 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 o~vn contractor with certain restrictions
even thougJa I do not have a license. I must supervise the construction myself. I may build or improve a one-family or
t~vo-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 own~~¢r?~!r,!v.~thin, tlie past t~velve
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 THE IMPOSITION OF OTHER PENALTIES AS PRESCRIBED BY LAW.
6w~e~' - / .... ~//' ,(.~ .... Date '
STATE OF FLORIDA, COUNTY OF P.&LM BEACH / / ,,
The foregoing instrument ~vas acknowledged before me this ~,//(i/O ! (date)by
who is personally known_t~ produced~C L2Z,3--Kqo-5'g'-66a-O (type of identification) ks identification
an d wh~Ko.~].A~.~?yD~m44/
Name oP'dY'fl~ff~k3ng ackno~vledgement--~ped, printed or stamped
Title
Revised 6/00, 3/01 * J:\SHRDATA~DevelopmentWORMS.docXOwner-Builder Affidavit.doc- REX/'. 5-24)