BLDG1406-0001-ApplicationPERMIT NO
SUB -PERMIT
SUB -PERMIT
SUB -PERMIT
BLDG1406-0001')
ea+e-4
PERrrs FEES CI1ARG
1
$309.15
'• PERMIT TYP . DESCRIPTION •
STATUS APPUED ISSUED
FEES CHARGED • ,t • FEES PAID BA D'
' • JOSVALUE • OWNER
ST MISC
APPROVED
$309.15
$7,900.00
PERGOLA & TAVERTINE PAVERS IN BACKYARD
06/02/2014
$92.00
JOTAL of ALL FEES ' :*".;
FEES PAID ,.
$92.00
$217.15
PATEL,BINITA & JAYESH
BALANCE DUE JOBVALUE
$217.15
0 (ion Pa4 edk
Drintorl• Tliocrin‘i 17 Irci 1(11A
1 nf 1
$7,900.00
0111,11141
Contact Person:
ifiefe5r1 t i 1 -
City of Parkland
Building Permit Application
www.cityofparkland.orl; p,�,� � rJ1nr{
Phone #: Ct Sy- 7' 365'( GAO E-mail: J tl
ALL OF THE FOLLOWING MUST BE FILLED IN BY APPLICANT, ACCORDING TO F.S. 713.135
Company Name � Master Permit Number e3r✓P' � yob . DOD/
Business Address Date 4./a//
City Stat- Zip Phone # Construction Value •75aD
Engineer's Name
Engineer's License #
Phone #
City State Zip Phone # u, Gell Architect's Name
w
4st-323-2-010/111173-3451 Architect's License #
Property Owner's Name k' Aydei tr
Owner's Street Address I 2335 KW $01= PL
Job Site Address perice4Elm scarp RAT 2 Lot j+1 Block F Phone #
Work Description:
ntasi PePtrDIA / nt." s' i N- 'iAvlgTit'E QFWb114 ,QA'O-YAM).
LA -49 44-4 Acooe1D vu siv C * ($e& -
Application
$ Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of permit
and that all work will be performed to meet the standards of all laws regulating construction in the City of Parkland, Florida. I understand that a separate permit may be
secured for ELECTRICAL, PLUMBING, SIGNS, WELLS, POOLS, BOILERS, TANKS, AIR CONDITIONERS, ROOFING, SHUTTERS, ETC.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CCMMENCMENT MAY RESULT !N YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT
Contractor Property Owner
Notification E-mail: Notification E-mail:,.h .. 70. a a' C
*O.O4i
Print Name of Qualifier/Builder: Print Name of Proper Owner:
3 Aic31t ?PrreL—
License number:
Signature of Qualifier:
Owner's Address:
12335 N vd tt' PL eikim PP►, Pt, 33D-7(.0.
Signature of Pro
On this day of , 20 , before me, the undersigned On this Z day of JUVt , 20 L'1 , before me, the undersigned
Notary Public of the State of Florida, personally appeared Notary Public of the 5Sate�pf Florida, personally appeared
and whose name is subscribed to and within j C�r ' f 2 f{ Y and whose name is subscribed to and within the
the instrument, and he/she acknowledges that he/she executed it. .instrument, and he/she acknove es that he/she eecuted it.
NOTARY PUBLIC, STATE OF FLORIDA
PRINTED NAME OF NOTARY PUBLIC
Personally known to me CI Produced identification
Ci Oath taken C3 Oath not taken
NOTARY PUBLIC SEAL OF
OFFICE:
Application Approved By:
Permit Officer
l Alt
NOTARY q1.1B ic, STAT
F FLORIDA
elfNICAMIE QF NOTARY PUBLIC
0 Personally known to me
0 Oath taken
f4:t. e e =t
RIN
roduced identification
0 Oath not taken
NOTARY PUBLICS — •
MARILYN BLANCETT
\• Notary Public - State of Florida
OF OFFICE: /c•` My Comm. Expires Oct 30, 2015
Commissipn
EE 132703
Date:
bonded Through Nations! Nntary Assn -
� _ _
Electrical Contractor:
Business Address:
License #: 4 Estimated Construction Value:
Phone #: Notification E-mail:
Qualifier Signature: Print Name:
The foregoing instrument was acknowledged before me thus day of
who is personally known to me or who produced
Notary Public: My Commission Expires:
Plumbing Contractor:
Business Address:
License #:
Phone #:
Qualifier Signature:
,20 ,by the above named person
as identification who did/did not take an oath
Estimated Construction Value:
Notification E-mail:
Print Name:
The foregoing instrument was acknowledged before me thus day of
who is personally known to me or who produced
Notary Public: My Commission Expires:
Mechanical Contractor:
Business Address:
License #:
Phone #:
Qualifier Signature:
,20 ,by the above named person
as identification who did/did not take an oath
Estimated Construction Value:
Notification E-mail:
Print Name:
The foregoing instrument was acknowledged before me thus day of
who is personally known to me or who produced
Notary Public: My Commission Expires:
,20 ,by the above named person
as identification who did/did not take an oath
Landscaping Contractor:
Business Address:
License #: Estimated Construction Value:
Phone #: Notification E-mail:
Qualifier Signature: Print Name:
The foregoing instrument was acknowledged before me thus day of ,20 ,by the above named person
who is personally known to me or who produced as identification who did/did not take an oath
Notary Public: My Commission Expires:
Other Contractor:
Business Address:
License #: Estimated Construction Value:
Phone #: Notification E-mail:
Qualifier Signature: Print Name:
The foregoing instrument was acknowledged before me thus day of ,20 ,by the above named person
who is personally known to me or who produced as identification who did/did not take an oath
Notary Public: My Commission Expires:
FS 489.103 Owner / Builder Exemption
ENTALA-
The following Disclosure Statement is required to be read and signed by a property owner who is applying for a permit for
construction on their own property, and intends to act as their own contractor under the Owner / Builder Exemption provided by
Florida Law, as described in the following excerpt. Please sign two copies.
489.103 Exemptions. --This part (regarding licensed contractors) does not apply to:
(7) Owners of property when acting as their own contractor and providing direct, onsite supervision themselves of all
work not performed by licensed contractors:
(a) When building or improving farm outbuildings or one -family or two-family residences on such property for the
occupancy or use of such owners and not offered for sate or lease, or building or improving commercial buildings, at a
cost not to exceed $75,000, on such property for the occupancy or use of such owners and not offered for sale or
lease. In an action brought under this part, proof of the sale or lease, or offering for sale or lease, of any such
structure by the owner -builder within 1 year after completion of same creates a presumption that the construction
was undertaken for purposes of sale or lease.
(b) When repairing or replacing wood shakes or asphalt or fiberglass shingles on one -family, two-family,or three-
family residences for the occupancy or use of such owner or tenant of the owner and not offered for sate within 1 year
after completion of the work and when the property has been damaged by natural causes from an event recognized as
an emergency situation designated by executive order issued by the Governor declaring the existence of a state of
emergency as a result and consequence of a serious threat posed to the public health, safety, and property in this
state.
This subsection does not exempt any person who is employed by or has a contract with such owner and who acts in the
capacity of a contractor. The owner may not delegate the owner's responsibility to directly supervise all work to any
other person unless that person is registered or certified under this part and the work being performed is within the
scope of that person's license. For the purposes of this subsection, the term "owners of property" includes the owner
of a mobile home situated on a leased lot. To qualify for exemption under this subsection, an owner must personally
appear and sign the building permit application and must satisfy local permitting agency requirements, if any, proving
that the owner has a complete understanding of the owner's obligations under the law as specified in the disclosure
statement in this section. If any person violates the requirements of this subsection, the local permitting agency shall
withhold final approval, revoke the permit, or pursue any action or remedy for unlicensed activity against the owner
and any person performing work that requires Licensure under the permit issued. The local permitting agency shall
provide the person with a disclosure statement in substantially the following form:
DISCLOSURE STATEMENT
City of Parkland
Development Services Department
Building Division
6600 University Drive, Parkland, FL 33067
Building Permits & Inspections for your Safety!
Phone: 954 753-5447 Fax: 954 753-8838
Website: www.citvofoarkland.org
1. 1 understand that state law requires construction to be done by a licensed contractor and have applied
for an owner -builder permit under an exemption from the law. The exemption specifies that 1, as the
owner of the property listed, may act as my own contractor with certain restrictions even though I do not
have a license.
2. I understand that building permits are not required to be signed by a property owner unless he or she is
responsible for the construction and is not hiring a licensed contractor to assume responsibility.
3. I understand that, as an owner -builder, 1 am the responsible party of record on a permit. I understand
that I may protect myself from potential financial risk by hiring a licensed contractor and having the
permit filed in his or her name instead of my own name. I also understand that a contractor is required by
law to be licensed in Florida and to list his or her license numbers on permits and contracts.
4. 1 understand that I may build or improve a one -family or two-family residence or a farm outbuilding. I
may also build or improve a commercial building if the costs do not exceed $75,000. The building or
residence must be for my own use or occupancy. It may not be built or substantially improved for sale or
lease. If a building or residence that I have built or substantially improved myself is sold or leased within 1
Rev. Aug 2009
Page 1 of 2
FS 489.103 Owner / Builder Exemption
year after the construction is complete, the law will presume that I built or substantially improved it for
sale or lease, which violates the exemption.
5. I understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
6. I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons
working on my building or residence. It is my responsibility to ensure that the persons whom I employ have
the licenses required by law and by county or municipal ordinance.
7. I understand that it is a frequent practice of unlicensed persons to have the property owner obtain an
owner -builder permit that erroneously implies that the property owner is providing his or her own labor
and materials. I, as an owner -builder, may be held liable and subjected to serious financial risk for any
injuries sustained by an unlicensed person or his or her employees while working on my property. My
homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner -
builder and am aware of the limits of my insurance coverage for injuries to workers on my property.
8. I understand that I may not delegate the responsibility for supervising work to a licensed contractor
who is not licensed to perform the work being done. Any person working on my building who is not
licensed must work under my direct supervision and must be employed by me, which means that I must
comply with laws requiring the withholding of federal income tax and social security contributions under
the Federal Insurance Contributions Act (FICA) and must provide workers' compensation for the employee.
I understand that my failure to follow these laws may subject me to serious financial risk.
9. I agree that, as the party legally and financially responsible for this proposed construction activity, I
will abide by all applicable laws and requirements that govern owner -builders as well as employers. I also
understand that the construction must comply with all applicable laws, ordinances, building codes, and
zoning regulations.
10. I understand that I may obtain more information regarding my obligations as an employer from the
Internal Revenue Service, the United States Small Business Administration, the Florida Department of
Financial Services, and the Florida Department of Revenue. I also understand that I may contact the
Florida Construction Industry Licensing Board at 850-487-1395 or
htto://www.mvflorida.com/dbor/consumers.html for more information about licensed contractors.
11. I am aware of, and consent to, an owner -builder building permit applied for in my name and
understand that I am the party legally and financially responsible for the proposed construction activity at
the following address:
12335 KW to— Q( Par klarJ , R 3307 4o
tAddress of property
12. I agree to notify The Citv of Parkland Buildine Division immediately of any additions, deletions, or
changes to any of the information that I have provided on this disclosure.
Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not
have a license, the Construction Industry Licensing Board and Department of Business and Professional Regulation may
be unable to assist you with any financial loss that you sustain as a result of a complaint. Your only remedy against an
unlicensed contractor may be in civil court. It is also important for you to understand that, if an unlicensed contractor
or employee of an individual or firm is injured white working on your property, you may be held liable for damages. If
you obtain an owner -builder permit and wish to hire a licensed contractor, you will be responsible for verifying
whether the contractor is properly licensed and the status of the contractors workers' compensation coverage.
Before a building permit can be issued, this disclosure statement must be completed and signed by the property
owner and returned to the local permitting agency responsible for issuing the permit. A copy of the property owner's
driver license, the not.: • - of the property owner, or other type of verification acceptable to the local
permitting agency is - • hen the p- it is issued. y
Signature: - Date: (o ! 1 ) ) 1
Signature of property owner
Rev. Aug 2009
Page 2 of 2
INSTR # 112403575, OR BK 50928 PG 1114, Page 1 of 1, Recorded 07/14/2014 at
08:57 AM, Broward County Commission, Deputy Clerk 4060
Permit # gLD(r1 `06 --0091 Folio #
NOTICE OF COMMENCEMENT
The undersigned hereby gives notice that Improvement will be made to certain real
property and in accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice of Commencement :
nn space reserved for recorder
1. Legal Description of Property. Lot 14 Block Unit # 8tdg # "'Lengthy legal attached
Subdivision I Condominium:
Street Address if available: 1 2.33g: N W RC"` f V YkF.la.U►M0 R. 3.307�,
2. General description of Improvement : T]eiAgn..
3. a. Owner name and address: 77 JJ
b. Interest in property.
c. Name and address of fee simple
titleholder (If other than Owner):
4. a. Contractor name and address:
b. Contractor's phone number:
5. a. Surety name and address:
b. Surety's phone number.
c. Amount of bond:
6. a. Lender name and address:
b. Lender's phone number:
Jcwesk fkk.l
NW `Ocie` t' I i;ev klctN J r --l. 3.30(..
S
414.1
12�t5 uw $ors fyi . VA -Lk-) rave .
7. a Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1Ha)7., Florida Statutes:
Name:
Address:
b. Phone number.
6. a. In addition to himself or herself, the Owner designates
b. Phone number of person or entity designated by owner
9. Expiration date o/ notice of commencement :
to receive a copy of Llama's Notice per Sectlon 713.13(1)(b), Florida
(the etpwation date it 1 year from the date of reaordmg unbq a dieerant date a tp.uted)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 71313,
FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A
NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Signatures) of Ow s)' Authorized Officer/Director/Partner/Manager
By + By
v
Print Name �a,yGi `0.lrn Name
TitI.IO race
STATE OF FLORIDA
COUNTY OF BROWARD
The fore agynsWmpnt watackp/orwled ed 4eforr a i;:,
by
f�i d� ���h 11llJJr�'//'�11`...t((a,�� I�j'1 itii,'r
v ally, fl as
Personally known, or [ roduced the following type of Identification:
Title/Office
q
day of
for
Signature of Notary Public:
Print Name:
(SEAL)
VERIFICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES,
Under penalties of perjury, 1 declare that I have read the foregoing and
that the facts stated in it are true, to the best of my knowledge and belief.
Signatur
By
F16Y talk_ DL--
' Authorized OfficerlDirectorlPartnerIManager wh
By
kik
Notary PubliC Stab of Fonda
• Misty B Delhierm
▪ My Commission FF 103660
K a Expires 03/19/2016
g 'ecordingwams1nac - nabae d arnmencement revises 71 07 doc