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:
 This ADA compliant structure is where the Zippers receive instruction, are weighed and trained and outfitted before going out on the course. ADA bathrooms, deck, parking, all attached.


Construction Cost:



6. Project Construction Cost (Provide cost for new construction, the addition, or the alteration):
Summary:
 We estimate the total construction cost to be $800,000.


Construction Cost upload:


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


Cost of Construction:

Comments:
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.
We received a deficiency notice from The City of Newberry, while under construction.


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
The Topography of the site makes vertical accessibility on all the lines, technically infeasible.

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:**



The Topography of the site makes vertical accessibility on all the lines, technically infeasible.



Need Additional Space
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:
See Letters.

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.