HomeMy WebLinkAbout800 Escambia Dr (2)CITY OF
h1N�� Building & Fire Prevention Division
tz RESIDENTIAL FENCE PERMIT APPLICATION
FIRE DEPARTMENT "P�
2 O
Application No:
Documented Construction Value: $ SO'
Job Address: �l% f.�(°lA W1 h� j , ')y Historic District: Yes [I No ❑
Parcel ID:
Plan Review Contact Person:
Phone• (yQ) CW—k /37 Fax:
Title: Email: �i ! s 4 t o o -e 3 eV-Qzbo r'o rvi
Residential Fence Information
Type of Fence: Wood ❑ Metal ❑ PVC/Vinyl ❑ Iron Other
Fence Height:
Additional Information:
Feet # Gates:
Total Linear Feet:
"Fences with a height of over 6 feet will require signed & sealed structural engineering"
Property Owner Information
(Name M a.be �P �e 5 Z.- Phone: (1�y '7) Y6 J — 7//3 -7
treet: Ss 66 /�5e-a' r t i �a �� ' Resident of property?
ity, State Zip: �o.r ko� J �� -3 7 7 /
Fence Contractor Information
me
Street:
City, State Zip:
Phone:
Fax:
Please Note: The Building Department does not perform site inspections on Residential Fence
permits. A signed and notarized Fence Affidavit is required to be submitted along with this
permit application. Please see the attached Fence Permit Submittal Guidelines.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
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 RECORDING YOUR NOTICE OF COMMENCEMENT.
Effective: August 1, 2017
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet standards of all laws regulating construction
in this jurisdiction. I understand that a separate permit must be secured for electrical work, plumbing, signs, wells, pools,
furnaces, boilers, heaters, tanks, and air conditioners, etc.
FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 5" Edition (2014) Florida Building Code
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be
found in the public records of this county, and there may be additional permits required from other governmental entities such as water
management districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will
be done in compliance with all applicable laws regulating construction and zoning.
Signt r ,..� (� 1�.�,c.�-vim 6
ature of Owner/Agent Date
f -, Se
Prin er/Agent's Name
Signature of Notary -State of Florida
.y C,�pPY PUBS, , ANNETTE BLAND
2. ",` Notary Public State of Florida
Commission # GG 060623
Jan 16, 2018
%;FOFe�cP' My Comm. Expires
110
Owner/Ag o__
Produced ID Type of ID
Signature of Contractor/Agent Date
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
PLAN REVIEWAPPROVAL: PLANNING:
COMMENTS:
HISTORIC:
Effective: August 1, 2017
PERMIT #: ('� — 2L( 0
L
Building & Fire Prevention Division
RESIDENTIAL FENCE AFFIDAVIT
(6 FEET OR LESS IN HEIGHT
ADDRESS: `,�tY
HEREBY AFFIRM THAT ALL OF THE FOREGOING
INFORMATION IS TRUE AND ACJRATE. THE FENCE WILL BE INSTALLED IN THE APPROVED LOCATION AS SHOWN ON THE APPROVED SITE
PLAN. THE FENCE WILL BE NO HIGHER THAN 6 FEET, MEASURED FROM GRADE. THE FINISHED SIDE OF THE FENCE IS REQUIRED TO FACE
OUT. IT IS THE HOMEOWNER'S RESPONSIBILITY TO VERIFY THE FENCE IS PLACED WITHIN THE PROPERTY LINES AND ANY DISPUTES
BETWEEN ADJACENT HOMEOWNERS WILL BE A CIVIL MATTER. I UNDERSTAND THAT FAILURE TO PROPERLY FOLLOW THESE GUIDELINES
AND ADHERE TO ALL CITY CODES (SANFORD LAND DEVELOPMENT REGULATIONS, SCHEDULE F) COULD RESULT IN THE FENCE HAVING
TO BE REPLACED, RELOCATED OR REMOVED AT THE OWNER'S EXPENSE.
El FENCE CONTRACTOR
BY SIGNING THIS AFFIDAVIT, YOU ARE ACKNOWLEDGING YOU HAVE MADE THE HOMEOWNER AWARE OF THE FENCE AFFIDAVIT
STIPULATIONS AS STATED ON THIS DOCUMENT.
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE:
El HOMEOWNER (OWNER/BUILDER)
OWNER/BUILDER NAME:` / b � `�C
OWNER / BUILDER SIGNATURE:
"PLEASE NOTE"
DATE: ^ l"6
DATE: S- �- l -IT
THE BUILDING DEPARTMENT WILL NOT CONDUCT ANY INSPECTIONS ON RESIDENTIAL FENCES. THIS
AFFIDAVIT MUST BE PROVIDED, SIGNED AND NOTARIZED, AT THE TIME OF PERMIT SUBMITTAL AND WILL
SUFFICE AS THE FINAL INSPECTION APPROVAL FOR THE FENCE.
STATE OF FLORIDA COUNTY OF a rx-N I aka te_
Sworn to and Subscribed before me this 044lday of /lei a 20 1'(0-3 by:
JA a)C�,k-e)�g ,. U. S Who is Personally Known to me or has ❑ Produced (type of
identification) L T_-b C-, (h as identification.
Signature of Notary Public
n
State of Florida r, . „ pi;v� I ` u to of Ftoridal
Print/Type/Stamp Name
of Notary Public
Noiaty Public #`GG 060623
GCOMMComm.
. �xP�tes Ja� MY
Effective: August 1, 2017
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