509 W 11 St - BR18-004360 - FENCEY .OF
S NFORD Building & Fire Prevention Division
J RESIDENTIAL FENCE PERMIT APPLICATION
FIRE DEPARTMENT
Application No: / J3
Documented Construction Value: $ _/
Job Address: Historic District: Yes No 0--
Parcel ID:
Plan Review Contact Person:
Phone:/i7—
Type of Fence: Wood Metal
Fence Height: Feet
Additional Information:
Title:
idential-Fence-Information
PVC/Vinyl Iron Other
Gates: / Total Linear Feet:
Fences with a height of over 6 feet will require signed & sealed structural engineering"
Property Owner Information
Name / J a' c' Phone: t
Street: / CC C" /l %C v Resident of property?
City, State Zip:
Fence Contractor Information
Name
J
Street:
City, State Zip:
Phone:
Fax:
Please Note: The Building Department does notperform 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 ANDPOSTED 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
a
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 ofthis 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 ofthe property ofthe requirements of Florida Lien Law, FS 713.
OWNER'S—AFFIDAVIT: I certifythat -allof theforegoing informationisaccurateand -that -all -work -will ----
be done in -compliance with all applicable laws regulating construction and zoning.
ure ofOwner/ t Date Signature of Contractor/Agent Date
Print Owner/Agent's Name
iv a. i Y
ignature of otary-State of FI
EE C, 11; BLANTON
MY OOMMISSION # Fr 178648
EXPIPF S: February 25, 2019
Bond4 Tivu Notary Public Underwriters
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
Print Contractor/Agent's Name
Signature ofNotary -State of Florida Date
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Sad)a,
PLAN REVIEWAPPROVAL: PLANNING: O -HISTORIC:
COMMENTS: ()Ic- 4t7 vi t,-
nllnc e- On cCboer4r 0, a(z, VJI
Effective: August 1, 2017
S.x
Y Cs
Building & Fire Prevention DivisionO
FIRE DEPARTMENT
3
RESIDENTIAL FENCE AFFIDAVIT
1 `7 (6 FEET OR LESS IN HEIGHT)
PERMIT #: % 7 CEO li GJ 7E` ADDRESS: 7 i _6 —i —o/ 1 P
HEREBY AFFIRM THAT ALL OF THE FOREGOING
IN ORMATION IS TRUE ANDKCCURATE. 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.
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:
HOMEOWNE
OWNER/BUILDER
OWNER / BUILDER SIGNATURE:
PLEASE NOTE""
DATE:
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 INSPECTION APPROVAL FOR THE FENCE.
STATE OF FLORIDA COUNTY OF
n
Sworn to and Subscribed before me day of 20 / q:
rWho.i " erso ally Known to me or has 0 Produced (type of
r
I d ntifleation) as identification.
Sigiiature of Notary Public
State of Florida
Print/Type/Stamp Name
of Notary Public
Effective: August 1, 2017