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:




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: 
First floor is currently occupied by an antique store. Second floor intended use will be office space.


Construction Cost:



6. Project Construction Cost (Provide cost for new construction, the addition, or the alteration):
Summary:
 $14,550



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


Cost of Construction:

Comments:
Replace electrical system (panels, rewiring). Replace both HVAC systems and ductwork


Building Official Recommendation upload:




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.
The cost of the platform lift is more than 20 percent of the total cost of the project


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
There is no existing vertical accessibility to first floor or second floor


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



 Provided 2 quotes for what it will cost to add a platform lift. The cost of the platform lift is more than 20 percent of the construction cost.
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.



Comments:
Please 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, or anything that will assist the Council and the Commission to determine the appropriate resolution of your request.