1. Name and address of project for which the waiver is requested:

Name:

Street:

City:

Zip Code:






Local Building Department Contact Information

















Applicant Information:


2. Name of Applicant. If other than the owner, please indicate relationship of applicant to owner in space provided:


First Name:

Last Name:

Street:

City:



Zip code:

Phone:

Fax:

Email:

Relationship to owner:


Owner Information:


3. Please enter the owner information below. If the owner and the applicant are not the same person, please upload a written authorization by owner in space provided:




Owner First Name:

Owner Last Name:

Street:

City:



Zip code:

Phone:

Fax:

Email:



Written Authorization:
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Project and Facility Type:



4. Please check one of the following:



5. Type of facility. Please describe the building (square footage, number of floors). Define the use of the building (i.e., restaurant, office, retail, recreation, hotel/motel, etc.)







Description:

SCOPE OF WORK
ARCHITECTURE - DEMO OF EXIST MEZZANINE, NOTED WALLS & THE ADDITION OF NEW RAMP. NEW LIFE SAFETY PLAN & ADDITION OF NEW EGRESS LIGHTING & FIRE EXTINGUISHERS.
ELECTRICAL - ADDITION OF NEW EGRESS LIGHTING TO TIE INTO EXIST. EMERGENCY CIRCUIT ONLY.
MECHANICAL - NO MECHANICAL SCOPE, EXISTING TO REMAIN.
PLUMBING - REMOVAL AND CAPPING OF EXCESS PIPE ONLY.

 


Construction Cost:



6. Project Construction Cost (Provide cost for new construction, the addition, or the alteration):


Summary:

$25,000, + OVER $40,000 FOR VERTICAL LIFT


Construction Cost upload:
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7. Has there been any construction activity on this building during the past three years?


Cost of Construction:

Comments:
Building Official Recommendation upload:
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Construction Status:




8. Project Status: Please check the phase of construction that best describes your project at the time of this application. Describe status.



*Briefly explain why the request has now been referred to the Commission.

BUILDING DEPARTMENT HAS TOLD US TO COMPLY OR PROVIDE ACCESSIBILITY WAIVER BEFORE A PERMIT WILL BE ISSUED




Requirements to be Waived.




9. Requirements requested to be waived. Please reference the applicable section of Florida law. Only Florida-specific accessibility requirements may be waived.

Issue 1: Florida-specific hotel/motel rooms Minimum height in parking structures Accessible parking
Vertical accessibility Toilet rooms
Private Other
Issue 2: Florida-specific hotel/motel rooms Minimum height in parking structures Accessible parking
Vertical accessibility Toilet rooms
Private Other Need Additional Space
Issue 3: Florida-specific hotel/motel rooms Minimum height in parking structures Accessible parking
Vertical accessibility Toilet rooms
Private Other Need Additional Space

Grounds for waiver.


10. Grounds for Waiver: The Florida Building Commission may grant waivers of Florida-specific accessibility requirements upon a determination of unnecessary, unreasonable or extreme hardship. Please describe how this project meets the following hardship criteria. Explain all that would apply for consideration of granting the waiver.


NOTE:**


Need Additional Space


TOTAL JOB COST INCLUDING RAMPING FROM GRADE TO FIRST FLOORS (WITHOUT VERTICAL ACCESS TO SECOND FLOOR)IS $25,000, TO PROVIDE VERTICAL ACCESS TO SECOND FLOOR WILL BE AN ADDITION OF ALMOST 200% OF CURRENT JOB COST ESTIMATE.


Cost Estimates For Compliance:










Licensed Design Professional Comments.


11. Licensed Design Professional: Where a licensed design professional has designed the project, his or her comments including his or her signature and professional seal MUST be uploaded.



Professional Comments
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Comments: See attached Letter.

Design Professional First Name: Design Professional Last Name: Street Address: City: State:

Zip: Email Address: Phone:



Additional Documentation.


12. Upload Additional Documentation: Please upload any documentation such as plans, photographs and anything that will assist the Council and the Commission to determine the appropriate resolution of your request.