100 Edgewater Cir - BR17-003143 - FENCEIFSJY
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j,) D Building & Fire Prevention Division VIiL
RESIDENTIAL FENCE PERMIT APPLICATIONFIR [
r>€PAlsTMsNr Application
No: /' — 3/ L 3 Documented
Construction Value: $ Job
Address: 160 T dap wa4ey C ( C Historic District: Yes No `i Parcel
ID: H - ao-36 •Sin r)n 42c) kFsnr> Plan
Review Contact Person: t Q Etna & t 0 Title: Phone:
3 6(o - (o ga -r) (n 3- Fax: Email: CA0nv 1iEP-Ag'rnebvix1LLd d.Cd vn Residential Fence
Information Type of
Fence: Wood P Metal PVC/Vinyl Iron Other Fence Height:
Feet # Gates: Total Linear Feet: ( S Additional Information:
Fences with
a height of over 6 feet will require signed & sealed structural engineering** Property Owner
Information Name Ao'
n i I? fnlDorc' Phone: I • Y U .19 7 Street: 1
OU GcWa-f-r C t rResident of property? City, State
Zip: SoLAED3 a-7? Fence Contractor Information
Name MAD P"
Y)j2l , c-DQt )Lr- UnS}V' LVJi6n Phone: 3S(o• 10S9--0(Q 3 Street: l l
S . C lam, Q" a.,rA 3c!5 l l 9-Ly d Fax: City, State Zip:cear
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 I, 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 105.3Shall be inscribed: with the date of application and the code in effect as of thatdate: 511 Edition (2014) Florida Building Code NOTICE:
In addition to the requirements of thispermit, 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. Signature
of Owner/Agent Date Print
Owner/Agent's Name Signature
of Notary -State of Florida Date Owner/
Agent is Personally Known to Me or Produced
ID Type of ID Z->
14 -b - !7 gnatuie
of Contract&/Jkgent Date L1
helot t tno,1-a PriyCtractor/
Agent's Name 7MC4" pm1-7 SignatureofNotary-
State of FloridaDate Contractor/
Agent is Personally Known to Me or Produced
ID Type of ID M1K
hA "
Ol F.i[S. 1 14 r _? tt `-a. a
i. BELOW
IS FOR OFFICE USE ONLY Job
PLAN
REVIEWAPPROVAL: PLANNING: 2' HISTORIC: COMMENTS:
Ok
to install approx. linear feet of 6' high privacy
fence and n, gate(s) as shown on plan.
Fence shall be constructed with finished
side facing outward. Effective:
August 1, 2017
871 S Chirles Richard Beah Bivd.
Debary, FT-32713
386-313-03111
T(')-. Melanie Sambursky
100 Edgewater Cir
Sanford, FL 32713
SALESPERSON JOB
QTY DESCRIPTION
Install 65' of 6' wood fence
To accept this quotation, sign here and
PAYMENT TERMS
Due on receipt
Thank you for your business!
DATE: 10/6/17
I DUE DATE
UNIT PRICE, LINE TOTAL
1,396.00
SUBTOTAL
SALES TAX
Building & Fire Prevention Division
RESIDENTIAL FENCE AFFIDAVIT
G FEET OR LESS IN HEIGHT
PERMIT##:
r
ADDRESS: O O EA Cy- (—W
St=.)EorA EL. -,S D-77 3
I L14 ZX' r C'k 6 (\ HEREBY AFFIRM THAT ALL OF THE FOREGOING' INFORMATION
IS TRUE AND ACCURA THE FFNCE.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. 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: tr 11 CONTRACTOR
SIGNATURE: ` DATE: Q / HOMEOWNER (
OWNER/BUILDER) OWNER/
BUILDER NAME: OWNER /
BUILDER SIGNATURE: PLEASE
NOTE** DATE:
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 IN, APPROVAL FOR THE FENCE; STATE
OF FLORIDA COUNTY OF u0j%1&-' fC `
j Sworn
to and Subscribed before me this day of U 20 4 t by: IIDL
Who is C-Personally Known to me or has 0 Produced (type of idea '
aton) as identification. e--
T Sign
lure of Notary Public State
of:Florida Print/
Type/Stamp Name 05 2019 of
NotaryPublic Effective:
August L 2017
10/23/2017
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Ok to install approx. linear feet of 6' high
privacy fence and gates) as shown on
plan. Fence shall be constructed with
finished side facing outward.
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