Fence Information & Checklist**
Provide 2 copies of survey indicating location of fence and gates.
Provide a complete application, applications shall be completely filled out or
indicate N/A if not applicable.
Provide utility easement consents and removal forms if applicable.
Provide completed land survey affidavit if survey not up-to-date.
Provide completed fence permit affidavit.
Provide photos of proposed location of fence.
Permit fee
Fencing in side and rear yard may not exceed 8 feet in height.
Fencing forward of the front building line (including corner lots) shall not exceed four (4)
feet in height.
Height shall be measured from the finished grade to the top of the fence (columns/posts
excluded). Consideration shall be given to the adjoining property grade during
installation.
Photos of the site prior to installation shall be submitted with the application. Photos of
the site after installation (in the same orientation as the “before” photos) shall be
submitted.
Indicate type of material; length of fence; height of fence; location of gates, if any;
Indicate in red “xxxxxx” on survey or site plan where fence will be placed. “ / ” shall
indicate a gate location.
It is advisable to notify/request approval from Homeowners Association prior to
applying for a permit as the restrictions may be more stringent than that of the City.
Please retain any approvals you receive for your records.
** Submittal requirements will include, but may not be limited to, the
above listed documents.
Additional information regarding fence regulations are located at:
http://library.amlegal.com/nxt/gateway.dll/Florida/boynton/partiiilanddevelopmentregulations*?f=template
s$fn=default.htm$3.0$vid=amlegal:boyntonbeach_fl
(Part III Land Development Regulations, Ch. 3 Zoning, Art. V Supplemental Regulations, Sec. 2 Walls and Fences)
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UNIVERSAL COUNTY-WIDE/MUNICIPAL
BUILDING PERMIT APPLICATION FORM
July 2013 Edition
Approved for use throughout Palm Beach County and Municipalities
FOR OFFICE USE ONLY
FBC Version:______________ Permit Type: _______________
Accepted By:____________ Application Date: _____________
Application #:________________________________________
1
KIND of PERMIT (CHECK ONE):
PRIMARY PERMI
T
S
UB-PERMIT -
If Fee & Value of a Sub-Permit are
covered under a Primary Permit, complete boxes 1, 3, 4, 5, 6 &
8 only to apply. If not covered under a Primary Permit,
complete the entire application to apply.
2
PROPERTY OWNER:_______________________________________
TENANT:________________________________________________
ADDRESS: ____________________________________UNIT:______
CITY: __________________________STATE: ______ZIP:__________
PHONE: __________________________FAX:___________________
EMAIL:__________________________________________________
3
TRADE (CHECK ONE):
STRUCTURAL ROOFING ELECTRICAL
M
ECHANICAL PLUMBIN
G FIRE
GAS
OTHER: _______________________________
PRIMARY PERMIT #: _____________________
4
PROJECT NAME: _____________________________________________
PCN: __ __- __ __- __ __- __ __- __ __- __ __ __- __ __ __ __
LEGAL DESCRIPTION:__________________________________________
ADDRESS: ___________________________________________________
CITY: _______________________________________________________
5
FURTHER WORK DESCRIPTION : ____________________________________________________________________________
Type of Work: New Addition Alteration Repair Demo Temporary Other
V
ALUE: _____________ PERMIT FEE: ____________ NET S.F (for SFD’s): ____________
(SEE FEE SCHEDULE) (AS APPLIES) (AS APPLIES)
6
OWNER BUILDER PER FL. ST. 489 (AS NAMED ABOVE, FOR CONTACT INFORMATION SEE BOX 2)
CONTRACTOR (CERT. HOLDER): _______________________________________________ License #: ________________________
DB
A (COMPANY NAME): _______________________________________ Contact Person: ___________________
_____________
ADDR
ESS: _____________________________________STE:______ CITY: ____________________STATE: ________ ZIP:____
____
PHONE: ____________________________ FAX: _______________________ EMAIL: ________________________________________
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 the 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.
OWNER’S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance
with all applicable laws regulating construction and zoning.
7
________________________________________________________________________________
(Signature of Owner or Agent) (including contractor)
Print Name
: _______________________________________
NOTARY REQUIRED IF $ 2,500 OR MORE, OR FOR ALL OWNER /
BUILDERS REGARDLESS OF $ VALUE STATE OF FLORIDA
COUNTY OF _______________________________________
Sworn to (or affirmed) and subscribed before me this _______
day of __________________,
20 , by
8
________________________________________________________________________________
(Signature of Owner or Agent) (including contractor)
Print Name
: ________________________________________
NOTARY REQUIRED IF $ 2,500 OR MORE, OR FOR ALL OWNER /
BUILDERS REGARDLESS OF $ VALUE STATE OF FLORIDA
COUNTY OF ________________________________________
Sworn to (or affirmed) and subscribed before me this _______
day of _____________________,
20_ , by
____________________________________________________
(Name of person making statement)
_________________________________________________
(Signature of Notary Public - State of Florida)
(Print, Type, or Stamp Commissioned Name of Notary Public)
Personally Known ____ OR Produced Identification ______
Type of Identification Produced_______________________
____________________________________________________
(Name of person making statement)
_________________________________________________
(
Signature of Notary Public - State of Florida)
(Print, Type, or Stamp Commissioned Name of Notary Public)
Personally Known ____ OR Produced Identification _______
Type of Identification Produced_______________________
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FEE SIMPLE TITLEHOLDER, BONDING COMPANY, ARCHITECT/ENGINEER AND MORTGAGE LENDER INFO IS REQUIRED WHEN THE
AGGREGATE VALUE (TOTAL COST OF ALL IMPROVEMENTS & NOT JUST WORK AUTHORIZED BY THE INDIVIDUAL PERMIT) IS $2,500 OR
MORE (EXCEPT HVAC REPAIR /REPLACEMENT < $7500). PLEASE ADDRESS ALL ITEMS.
9
10
Fee Simple Titleholder’s Name (If other than owner): ____________ Bonding Company : ________________________________
__________________________________________________________________ ________________________________________________
Fee Simple Titleholder’s Address
(If other than owner): _______ Bonding Company Address: _________________________
________________________________________________ ________________________________________________
City: ___________________ State:
_____ Zip: __________ City: _____________________ State:_____ Zip: __________
Same as Owner Not Applicable
11
12
Architect/Engineer’s Name : ________________________ Mortgage Lender’s Name : ___________________________
________________________________________________ __________________________________________________
Architect/Engineer’s Name Address: _________________ Mortgage Lender’s Address: __________________________
________________________________________________ __________________________________________________
City: ______________________ State:
_____ Zip: __________ City: ________________________ State:_____ Zip: __________
Not Applicable
Not Applicable
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.
NOTICE TO CONTRACTOR: FOR A DIRECT CONTRACT GREATER THAN $2,500 (EXCEPT FOR HVAC SYSTEM REPAIR OR
REPLACEMENT LESS THAN $7500), FLORIDA STATUTES REQUIRE THE APPLICANT TO FILE WITH THE ISSUING AUTHORITY,
PRIOR TO THE FIRST INSPECTION, EITHER A CERTIFIED COPY OF THE RECORDED (BY OWNER) NOTICE OF COMMENCEMENT
OR A NOTARIZED STATEMENT (BY OWNER) THAT THE NOTICE OF COMMENCEMENT HAS BEEN FILED FOR RECORDING,
ALONG WITH A COPY THEREOF. IN THE ABSENCE OF A CERTIFIED COPY OF THE RECORDED NOTICE OF COMMENCEMENT,
NO SUBSEQUENT INSPECTIONS CAN BE PERFORMED UNTIL THE APPLICANT FILES SUCH CERTIFIED COPY WITH THE ISSUING
AUTHORITY. THE CERTIFIED COPY OF THE NOTICE OF COMMENCEMENT MUST CONTAIN THE NAME AND ADDRESS OF THE
OWNER, THE NAME AND ADDRESS OF THE CONTRACTOR, AND THE LOCATION OR ADDRESS OF THE PROPERTY BEING
IMPROVED.
IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR
RECORDING YOUR NOTICE OF COMMENCEMENT.
OFFICE USE ONLY BELOW THIS LINE
13
CODE EDITION/NOTES : ______________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
14
USE (CHECK ONE):
1 & 2 FAMILY TOWNHOUSE CONDOMINIUM
MULTI-FAMILY COMMERCIAL INDUSTRIAL
AGRICULTURAL - BLDG CODE EXEMPT OTHER: _____
_________________________________________________
USE CHANGE: ___________________________________
________________________________________________
15
APPROVED BY:________________________________________________________________ DATE:_____________________________
Permit Officer
AUTHORIZED FOR CERTIFICATE OF OCCUPANCY: _________________________________________________________DATE:___________________
Building Official or Designee
AUTHORIZED FOR CERTIFICATE OF COMPLETION: ________________________________________________________ DATE:___________________
Building Official or Designee
Page 2 of 2
City of Boynton Beach
Planning & Zoning Division
FENCE PERMIT AFFIDAVIT
(SUBMIT SURVEY)
Address:____________________________________________________________________
Owner:_____________________________________________________________________
Subdivision:__________________________________ Lot:__________________________
Block:______________ Valuation:___________________________
Type of Fence:_________________________ Height:__________ Length: ______________
Type of Posts: (1) Corner________ (2) Line________ Depth in Ground*:_____________
Distance between Posts:_______ Top Rail Size:________ In concrete**: Yes____ No ____
*Minimum depth of direct burial of posts in ground: 30 inches.
**Minimum depth of posts in concrete: 24 inches by 10 inch diameter.
AFFIDAVIT
I, the contractor/owner, have signed for a permit to construct a fence as shown on the survey.
If, at any time, the fence is found not to be on said property, it will be removed and reinstalled
at my expense.
___________________________
Signature of Contractor/Owner
__________
Date
________________________________
Address
State of Florida
Palm Beach County
Before me personally appeared ______________________________, who is personally
known to me, or has produced _________________________________(type of identification)
as identification and who did (did not) take an oath, and acknowledged to and before me that
he/she executed said instrument for the purposes therein expressed. Witness my hand and
official seal this _____ day of _________________, ________. (SEAL)
Notary Public ____________________________ My commission expires: ______________
100 East Boynton Beach Blvd, PO Box 310, Boynton Beach FL 33425-0310 Phone: (561) 742-6260 Fax: (561) 742-6259
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City of Boynton Beach
Planning & Zoning Division
LAND SURVEY AFFIDAVIT
BEFORE me, the undersigned authority, personally appeared, _______________________
(print name),
and states:
1. The affiant is over 18 years of age and makes this Affidavit upon his/her own personal knowledge.
2. The affiant is the owner of the property located at
_____________________________________________________________
(insert address).
3. The attached survey depicts conditions as they currently exist on the Property as of the date of this
affidavit. The survey shall be clean, legible and clear in detail. Survey shall not bear any previous City
stamps.
4. The Affiant warrants to the City of Boynton Beach that there are no other structures existing on the
Property other than those indicated on the attached survey.
5. The Affiant hereby releases and holds the City of Boynton Beach harmless from any liability, claim,
suits, and/or damages associated with the installation of any improvements on the Property based
upon the submission of the attached survey.
6. The Affiant further warrants and affirms that in the event there are any errors in the survey, or the
conditions of the Property are not as indicated on the survey, and additional permits and/or costs are
required, that the Affiant shall assume the obligation to pay for and incur any of the expenses or costs
associated with obtaining a new survey or removing any of the structures on the Property. The Affiant
hereby releases the City of Boynton Beach from any responsibility or obligation for any of the costs and
expenses associated with the removal or construction of any structures that are located on the
Property which are not indicated on the attached survey or permit.
FURTHER AFFIANT SAYETH NAUGHT.
_______________________________ STATE OF________________________________
Signature
_______________________________ COUNTY OF______________________________
Print Name
THE FOREGOING INSTRUMENT was acknowledged before me this _ day of ____________ ,
_______, by _______ , who is personally known to me or has produced ____
as identification.
_______ _____ My Commission Expires: ___________________________
NOTARY PUBLIC
100 East Boynton Beach Blvd, PO Box 310, Boynton Beach FL 33425-0310 Phone: (561) 742-6260 Fax: (561) 742-6259
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_____________________________________________
_____________________________________________
____________________________________________________________________________
___________________________________
_________________________
_________________________
________________________________________________________
City of Boynton Beach
Planning & Zoning Division
EASEMENT CONSENT
To: _____________________________________________
Name of easement holder
Address: _____________________________________________
Gentlemen:
I am the record titleholder of property located at ____________________________________. I propose to
apply for a permit from the City of Boynton Beach to construct or install a ______________________________
in the ____________________ easement on my property, legally described as:
Lot _______________ Block _____________ Subdivision ____________________________ or Metes &
Bounds ____________________________________________________________
Please complete the section below indicating your approval or disapproval of this work.
I understand that you will not be responsible for repairs to, or replacement of, any portion of the above
referenced improvement and that any removal or replacement of this improvement necessary for your use or
access to this easement will be performed at my expense or my successors in interest.
Owner's Signature & Date
Owner’s Phone #
___________________________________
Owner's Signature & Date
ACKNOWLEDGEMENT:
I/We (agree) (do not agree) to the proposed improvement under the circumstances described on pages 3
and 4 of this document.
Name of easement holder(s)
By: ____________________________________ Title: ______________________________
Date: __________________________________
(1 of 4)
3301 Quantum Blvd, Suite 101, Boynton Beach, FL 33426 Phone: (561) 742-6260 Fax: (561) 742-6357
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EASEMENT HOLDERS
To assist you in identifying potential easement holders, the following list is being provided. THIS LIST
IS NOT INCLUSIVE AND OTHER ENTITIES MAY HAVE EASEMENT RIGHTS. It is the applicant’s
responsibility to identify all easement holders.
NOTE: A copy of a survey must be provided with each consent form when submitting to the
easement holder.
CABLE: GAS:
Comcast Florida Public Utilities
M-F 8AM-5:30PM, Sa 9AM-1PM M-F 8AM-5PM
3960 RCA Blvd., Suite 6002 Phone: 561-832-0872
Palm Beach Gardens, FL 33410 Fax: 855-212-5011
Email: Daniel_Tiburcio@comcast.com Attn: Engineering
Attn: Daniel Tiburcio Email: Engineering-wpb@fpuc.com
Comcast PBC Construction Dept. 401 S Dixie Hwy.
(Allow 1 week for return email) West Palm Beach FL 33401
*Do NOT send request via U.S. mail (Mailing: PO Box 3395, W P B FL 33402-3395
include self-addressed, stamped envelope)
ELECTRIC: TELEPHONE:
Florida Power & Light Company BellSouth Telephone / AT&T
M-F 7:30AM-4PM M-F 8AM-5PM
Phone: 561-616-1601 AT&T Engineering Department
Fax: 561-616-1625 321 SE 2
nd
Street, Delray Beach, FL 33483
9329 S Military Trail Fax: 561-272-8695
Boynton Beach FL 33436 -2901 Email: g30576@att.com
(www.fpl.com) Attn: Cassandra Hendrix
Note: No longer accepting walk-ins requests
WATER/SEWAGE:
M-F 7:00AM-4:00PM
City of Boynton Beach Utilities Dept.
Phone: 561-742-6400
Email: easementconsent@bbfl.us
124 E Woolbright Road
Boynton Beach FL 33426-6040
(2 of 4)
3301 Quantum Blvd, Suite 101, Boynton Beach, FL 33426 Phone: (561) 742-6260 Fax: (561) 742-6357
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________________________________________________________________________
_________________________________________________________________________
City of Boynton Beach
Planning & Zoning Division
REMOVAL AGREEMENT
DATE: PERMIT NO:________________
WHEREAS, _______________________________ (hereinafter referred to as “Owner(s)”
(Print)
is/are desirous of construction or installing a ____________________________________in a portion of
the ________________________________ easement on my/our property, the legal description of this
property being as follows:
Lot _______________ Block ______________ Subdivision ________________________ or Metes &
Bounds ________________________________________________________
WHEREAS, the Owner(s) does/do covenant that they are the fee simple owner(s) of the property; and
WHEREAS, the above is to be erected for the use and enjoyment or proper functioning of the property
and special aesthetics;
NOW, THEREFORE, in the consideration of the City of Boynton Beach (“City”) not immediately enforcing
its rights or the rights of any others, now existing or which may in the future exist, against the Owner(s) or
the property, the Owner(s) hereby agree(s) with the City to remove, at no expense to the City, the
Easement holders, or the beneficiaries of the easement, the above described improvement from the
property, within thirty (30) days of written notice addressed to them or their successors in interest, at:
ADDRESS: _______________________________________________________________
notifying them that said improvement is inconsistent with the use of the Easement. It is agreed by the
Owner(s) that the improvement shall be as depicted on Exhibit “A” and filed with the City of Boynton
Beach Planning and Zoning Division, and that no other construction shall be in effect in said Easement.
It is agreed by the parties, hereto, that this Declaration will be recorded at the expense of the
Owner(s) in the Official Records of Palm Beach County, Florida and that this Declaration shall be a
covenant running with the land and be binding upon the heirs, personal representatives, grantees,
assigns and successors in interest of the Owner(s).
Owner(s) shall immediately remove the improvement permitted herein in the event that the City or
Owner(s), or both, are challenged with respect to the City’s authority to authorize the placement of said
improvement in the Easement or a claim of damages is made as a result of the placement of said
3301 Quantum Blvd, Suite 101, Boynton Beach, FL 33426 Phone: (561) 742-6260 Fax: (561) 742-6357
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improvement in the Easement. In the event that the City and/or Owner(s) are challenged with respect to
the placement of said improvement in the Easement, or a claim for damages is made as a result of the
placement of said improvement in the Easement, Owner(s) shall indemnify, defend, and save the City
harmless against and from said challenge.
Upon the vacation, abandonment or discontinuance of the Easement, this Declaration shall immediately
and automatically terminate and be of no further force and effect.
SIGNED, SEALED, EXECUTED AND ACKNOWLEDGED on this _________________ day of
___________________, ________.
WITNESS:
________________________________ ___________________________________
Owner’s Signature
________________________________ ___________________________________
Owner’s Signature
________________________________
Owner’s Phone #
STATE OF FLORIDA
COUNTY OF PALM BEACH
The foregoing instrument was acknowledged before me this ___________________ day of
_________________________, ________, by ___________________________________
(Name of Person Acknowledging)
who is personally known to me or who has produced ______________________________
(Type of ID)
as identification and who did/did not take an oath.
(Signature of person taking
acknowledgement)
(Title or rank)
(4 of 4)
(Name of Officer taking acknowledgement
typed, printed or stamped)
(Serial number, if any)
SEAL
3301 Quantum Blvd, Suite 101, Boynton Beach, FL 33426 Phone: (561) 742-6260 Fax: (561) 742-6357
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