Fillable SWIMMING POOL & SPA PERMIT APPLICATION CHECKLIST

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SWIMMING POOL & SPA PERMIT APPLICATION CHECKLIST

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Building Department - 5399 N. Dixie Hwy Ste #3 Oakland Park, FL 33334 – www.oaklandparkfl.gov/166/building-permitting
Hours: Monday – Friday 8am to 4pm | Phone: 954-630-4350 | Fax: 954-229-0487 | Email: building@oaklandparkfl.gov Online
permit access: https://oaklandparkfl-energovweb.tylerhost.net/apps/SelfService#/home
SWIMMING POOL & SPA PERMIT APPLICATION CHECKLIST
Required Permit Applications:
Broward County Uniform Building Permit Application (filled out and notarized for each applicable trade
building, plumbing, electrical and mechanical)
Permit Review Stops:
Electrical Engineering Flood
Mechanical (if commercial) Plumbing Structural
Zoning Fire Marshall (for commercial & multi-family dwellings)
Minimum Plan Submittal:
Documented proof of cost, including all trades (signed contract)
Two (2) sets of signed and sealed plans showing location of pool, setbacks, elevation, grading, soil conditions,
flood zone – BFE & DFE, child protection requirements…etc.
Two (2) copies of current, signed and sealed, survey showing the scope of work and easements
Plans must indicate the elevation of equipment pads
Two (2) sets, completed, signed & notarized, of Residential Swimming Pool, Spa and Hot Tub Safety Act –
Notice of Requirements forms
Impervious and Pervious Space Calculations form filled out
Grading plan must show retention of rainwater as required by ordinance
Other Requirements & Information:
Contractor registration requirements (if contractor is not registered with the City)
Owner Builder Disclosure Statement (if owner intends to perform the work)
Notice of commencement (if job value is over $2,500)
Easement agreement (if installing in an easement)
Fence permit or screen permit (as required)
Please note that this checklist is not intended to be all-inclusive.
Due to changes in the codes, regulations, ordinances and job conditions, other requirements may apply.
RESIDENTIAL SWIMMING POOL, SPA AND HOT TUB SAFETY ACT
NOTICE OF REQUIREMENTS
I (We) acknowledge that a new swimming pool, spa or hot tub will be constructed or installed at
________________________________________________, and hereby affirm that one of the following methods will
(Please Print Job Address)
be used to meet the requirement of Chapter 515, Florida Statutes and Florida Building Code Section 424.2.
Please initial the method(s) to be used for your pool or spa:
__________ The
pool will be equipped with an approved safety pool cover that complies with ASTM F1346-91.
(Submit Manufacturer’s Specifications).
__________ A continuous, one-piece (child) barrier meeting the requirements of Florida Building Code 424.2.17 will
protect the pool perimeter. The plans shall show the fence location and method of attachment, including
one end that shall not be removable without the aid of tools. (Submit Manufacturer’s Specifications).
__________ A
combination of non-dwelling walls and fences (screen enclosure, child fence, masonry fence walls,
chain link or wood fence, etc.) will protect pool perimeter. The plans must specify the type and location
of all non-dwelling walls.
__________ An
y combination of protection which incorporates dwelling walls with openings directly into pool
perimeter and all windows and doors will be equipped with exit alarms complying with Florida
Building Code, 424.2.17.1.9 (Submit Manufacturer’s Specifications).
__________ A
ny combination of protection which incorporates dwelling walls with openings directly into the pool
perimeter and all doors will be equipped with a self-latching device with positive mechanical
latching/locking installed a minimum 54" above the threshold. If this option is selected, submit plans
showing all types and location of all perimeter protection. The plans must also show the location and type
of all openings, and hardware type for each location. (Submit Manufacturer’s Specifications).
In accor
dance with the Code, a final inspection of the pool project will not be approved without compliance with the
Private Swimming Pool Safety Requirements, and upon expiration of the permit, the pool shall be presumed to be
unsafe.
I understand that not having one of the above installed will constitute a violation of Chapter 515, F.S. and will be
considered as committing a misdemeanor of the second degree, punishable as provided in Section 775.082 or Section
775.083 F.S. this form must be signed by the owner/agent and the prime contractor.
__________
_____________________ ____________________________________
Owner/Agent Printed Name Signature & Date
_______________________________ ____________________________________
Prime Contractor Printed Name Signature & Date
________________
_______________ ____________________________________
Notary Signature & Date Commission Expires
(This form contains all information from approved form by Broward County Board of Rules and Appeals- 11/15/02)
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THE PERMIT APPLICATION WILL NOT BE ACCEPTED WITHOUT THE ABOVE MINIMUM DOCUMENTATION
OTHER DOCUMENTS MAY BE REQUIRED DEPENDING UPON THE JOB CONDITIONS
IMPERVIOUS & PERVIOUS SPACE CALCULATIONS
DATE
PERMIT #
OWNER
CONTRACTOR
TOTAL LOT
AREA (SQ.FT.)
BUILDING FOOTPRINT AREA
PORCH/PATIOS/WALKWAYS/SLABS
DRIVEWAY AREA
POOL/PATIO AREA
TOTAL IMPERVIOUS AREA TOTAL
PERVIOUS AREA
I CERTIFY THAT ALL THE FOREGOING INFORMATION IS ACCURATE AND THAT ALL WORK
WILL BE DONE IN COMPLIANCE WITH THE APPLICABLE LAWS REGULATION CONSTRUCTION
AND ZONING.
Owner Date
Contractor Date
WE RESERVE THE RIGHT TO HAVE THIS DOCUMENT PREPARED SIGNED AND
SEALED BY AN ARCHITECT OPR ENGINEER
SEAL
Architect/Engineer DATE
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
CONTRACTOR REGISTRATION REQUIREMENTS
Signed Contractor Registration Form must be completed in its entirety
Following documents required for registration
• State License or Broward County Central Board of Examiners and State Registration
• County Business Tax Receipt in county business is located
• City Business Tax Receipt in the city Where the business is located
• Workman’s Compensation Insurance identify, City of Oakland Park as Certificate Holder
5399 N. Dixie Highway Suite 3 Oakland Park, Florida 33334
• General Liability Insurance, Identify City of Oakland Park as Certificate Holder
5399 N. Dixie Highway Suite 3 Oakland Park, Florida 33334
• Copy of Qualifier’s State Driver’s License
All documents shall be current and legible. Any missing information will delay registration/permitting
All information shall be updated annually and upon renewal of license and insurance policies.
CONTRACTOR REGISTRATION FORM
COMPANY NAME:
COMPANY ADDRESS:
CITY: STATE: ZIP:
BUSINESS PHONE: EXT: OTHER:
COMPANY EMAIL
QUALIFIERS NAME:
STATE CERTIFICATE OF COMPETENCY NO.:
BROWARD COUNTY CERTIFICATE OF COMPETENCY NO.:
STATE REGISTRATION NO.:
LIABILITY INSURANCE
INSURANCE COMPANY NAME:
POLICY NO.:
EFFECTIVE DATE: EXPIRATION DATE:
WORKERS COMPENSATION INSURANCE
INSURANCE COMPANY NAME:
POLICY NO
EFFECTIVE DATE: EXPIRATION DATE:
Qualifiers Signature Date:
Sworn and subscribed before me this Day of , 20
Personally Known Produced Identification
Type of Identification
Print Notary Name Notary Signature
Seal
***ALL OF THE ABOVE INFORMATION IS MANDATORY***
Owner-Builder Disclosure Statement
Provide property address under Statement #11.
Provide copy of property owner’s Florida Driver License.
Provide notarized property owner signature at end of Disclosure Statement.
1. I understand that state law requires construction to be done by a licensed contractor and have applied for
an owner-builder permit under an exemption from the law. The exemption specifies that I, as the owner
of the property listed, may act as my own contractor with certain restrictions even though I do not have a
license.
2. I understand that building permits are not required to be signed by a property owner unless he or she is
responsible for the construction and is not hiring a licensed contractor to assume responsibility.
3. I understand that, as an owner-builder, I am the responsible party of record on a permit. I understand that
I may protect myself from potential financial risk by hiring a licensed contractor and having the permit
filed in his or her name instead of my own name. I also understand that a contractor is required by law to
be licensed in Florida and to list his or her license numbers on permits and contracts.
4. I understand that I may build or improve a one-family or two-family residence or a farm outbuilding. I
may also build or improve a commercial building if the costs do not exceed $75,000. The building or
residence must be for my own use or occupancy. It may not be built or substantially improved for sale or
lease. If a building or residence that I have built or substantially improved myself is sold or leased
within 1 year after the construction is complete, the law will presume that I built or substantially
improved it for sale or lease, which violates the exemption.
5. I understand that, as the owner-builder, I must provide direct, onsite supervision of the construction.
6. I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons
working on my building or residence. It is my responsibility to ensure that the persons whom I employ
have the licenses required by law and by county or municipal ordinance.
7. I understand that it is a frequent practice of unlicensed persons to have the property owner obtain an
owner-builder permit that erroneously implies that the property owner is providing his or her own labor
and materials. I, as an owner-builder, may be held liable and subjected to serious financial risk for any
injuries sustained by an unlicensed person or his or her employees while working on my property. My
homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner-
builder and am aware of the limits of my insurance coverage for injuries to workers on my property.
8. I understand that I may not delegate the responsibility for supervising work to a licensed contractor who
is not licensed to perform the work being done. Any person working on my building who is not licensed
must work under my direct supervision and must be employed by me, which means that I must comply
with laws requiring the withholding of federal income tax and social security contributions under the
Federal Insurance Contributions Act (FICA) and must provide workers' compensation for the employee.
I understand that my failure to follow these laws may be subject me to serious financial risk.
9. I agree that, as the party legally and financially responsible for this proposed construction activity, I will
abide by all applicable laws and requirements that govern owner-builders as well as employers. I also
understand that the construction must comply with all applicable laws, ordinances, building codes, and
zoning regulations.
10. I understand that I may obtain more information regarding my obligations as an employer from the
Internal Revenue Service, the United States Small Business Administration, the Florida Department of
Financial Services, and the Florida Department of Revenue. I also understand that I may contact the
Florida Construction Industry Licensing Board at (850)487-1395 or call.center@dbpr.state.fl.us for
more information about licensed contractors.
11. I am aware of, and consent to, an owner-builder building permit applied for in my name and understand
that I am the party legally and financially responsible for the proposed construction activity at the
following address:_________________________________________________________________
12. I agree to notify the City Of Oakland Park immediately of any additions, deletions, or changes to any of
the information that I have provided on this disclosure.
Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who
does not have a license, the Construction Industry Licensing Board and Department of Business and
Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of a
complaint. Your only remedy against an unlicensed contractor may be in civil court. It is also important for you
to understand that, if an unlicensed contractor or employee of an individual or firm is injured while working on
your property, you may be held liable for damages. If you obtain an owner-builder permit and wish to hire a
licensed contractor, you will be responsible for verifying whether the contractor is properly licensed and the
status of the contractor's workers' compensation coverage.
Before a building permit can be issued, this disclosure statement must be completed and signed by the property
owner and returned to the local permitting agency responsible for issuing the permit. A copy of the property
owner's driver license, the notarized signature of the property owner, or other type of verification acceptable to
the local permitting agency is required when the permit is issued.
Property Owner Signature: ______________________________________
STATE OF FLORIDA
COUNTY OF BROWARD
The foregoing instrument was acknowledged before me this _____ day of ________________, 20____ by
_____________________________________________ who is personally known to me or who has produced
_____________________________________ (Type of I.D.) as identification and who did (did not) take and
oath.
__________________________________________
Signature of Notary
__________________________________________
SEAL ABOVE Name of Notary typed, printed or stamped
NOTICE OF COMMENCEMENT INSTRUCTIONS
In accordance with Section 713.13 (1) (h) of the Florida Statutes, a Notice of
Commencement is required for the construction of, improvements to, alteration of or
repair of real property. The Notice of Commencement must be recorded with Broward
County Records, Taxes and Treasury Division, or in the office of the clerk where the real
property is located.
E-Recording or In-Person Recording a Notice of Commencement
1. Complete the Notice of Commencement Form.
o All information must be typewritten or legibly printed.
o Lines 1, 2 and 3 must always be filled in. Items 4 through 9 are
completed as applicable. For lengthy legal descriptions, attach a
separate page and indicate on the form that the legal description is
attached.
o If line 5 applies, a copy of the Payment Bond must be attached to the
instrument when it is recorded.
o Be sure to read the Warning to Owner. The owner (of the property)
must sign in two places on the Notice of Commencement, or the
Owner’s Authorized Officer/Director/Partner/Manager.
o The owner or the person who signed must also sign under the
Verification Pursuant to Section 92.525 of the Florida Statues,
indicating that they have read the foregoing instrument and declare
that the facts stated in it are true. At the bottom of the form please
type or print the name and address of the party to whom the
recorded Notice is to be returned.
2. The owner or person who signed must appear with the completed form
before a Notary Public, who must complete the acknowledgment portion of
the form and affix his or her seal. You can get the form notarized at the
offices of the Broward County Records, Taxes and Treasury Division. The
owner must appear in person, and present official photo ID, such as a
current driver's license or other current government-issued photo
identification, to the Notary. The fee is $10 per acknowledgement.
3. To calculate recording fees due, count the total number of pages in the
document. The fee is $10 for the first page and $8.50 for each additional
page of the same document. If you require a certified copy to post on the
job site, include an additional $1 for each page of the document and $2 for
certification of each document. If you are unsure of the fees and wish to
record your document in person, wait until you get to the recording office to
complete your check. If you need the certified copy right away, you should
go in person to the recording office. If you mail in your Notice of
Commencement, please include a self-addressed, stamped envelope for the
return of your recorded documents.
4. Make checks payable to "Board of County Commissioners."
5. Electronically record the documents within minutes at:
Governmental Center West
1 N. University Drive
Plantation, FL 33324
Notice of Commencement Services are available Monday through Friday
from 8AM to 1PM and 2 to 4PM.
Or mail to:
Broward County Records, Taxes and Treasury Division
ATTN: Recording Section
P.O. Box 14668
Fort Lauderdale, FL 33302
Or deliver in person to either our Fort Lauderdale or Plantation location:
6. Broward County Records, Taxes and Treasury Division
Broward County Governmental Center Room 114
115 S. Andrews Ave.
Fort Lauderdale, FL 33301
Open Monday through Friday, 7:30 a.m. to 5:00 p.m.
AFTER RECORDING – RETURN TO:
PERMIT NUMBER:
NOTICE OF COMMENCEMENT
The undersigned hereby given notice that improvement will be made to certain real property, and in accordance with Chapter 713,
Florida Statues the following information is provided in the Notice of Commencement.
1.
DESCRIPTION OF PROPERTY (Legal description & street address, if available) TAX FOLIO NO.:
S
UBDIVISION BLOCK TRACT LOT BLDG UNIT
2. GENERAL DESCRIPTION OF IMPROVEMENT:
3. OWNER INFORMATION: a. Name
b
. Address
c. I
nterest in property
d
.
N
ame and address of fee simple titleholder (if other than Owner)
4. CONTRACTOR’S NAME, ADDRESS AND PHONE NUMBER:
5. SURETY’S NAME, ADDRESS AND PHONE NUMBER AND BOND AMOUNT:
6. LENDER’S NAME, ADDRESS AND PHONE NUMBER:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13 (1) (a) 7.,
Florida Statutes:
NAME, ADDRESS AND PHONE NUMBER:
8. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor’s Notice as provided in Section
713.13 (1) (b), Florida Statutes:
NAME, ADDRESS AND PHONE NUMBER:
9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is specified): , 20
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN
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. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Si
gnature of Owner or Print Name and Provide Signatory’s Title/Office
Owner’s Authorized Officer/Director/Partner/Manager
State of Florida
County of Broward
T
he foregoing instrument was acknowledged before me this day of , 20
By
, as
(name of person) (type of authority,…e.g. officer, trustee, attorney in fact)
For . (name of party on behalf of whom instrument was executed)
Personally known or produced the following type of identification:
Notary
(Signature of Notary Public)
U
nder Penalties of perjury, I declare that I have read the foregoing and that the facts in it are true to the best of my knowledge and belief (Section 92.525, Florida
Statutes).
S
ignature(s) of Owner(s) or Owner(s)’ Authorized Officer/ Director / Partner/Manager who signed above:
By
By
R
ev .08-09-07 (S.Recording)
□
□
□
□
□
Date: Attention:
I, propose to apply for a building permit to construct a
In the Utility Easement, Drainage Easement, Canal Maintenance
Easement, at my property located at
Legal Description: Lot Block Subdivision
City of Oakland Park (SEE ATTACHED SURVEY)
A BRIEF DESCRIPTION OF THE TYPE OF CONSTRUCTION AND LOCATION OF THE PROPOSED CONSTRUCTION AS FOLLOWS:
I understand that your company will not be responsible in any way for repairs to, or replacement of, any portion of this
And that any removal or replacement of this construction necessary for the use of this
easement will be done at my expense, I further understand that I will assume full responsibility for any damage incurred to the utility
facilities during construction.
This is to certify that I am the lawful owner(s)
Signature of Owner
Contact Phone Number
Address
Return Fax Number
City State
Zip
Email Address
Note: This agreement shall be attached to the permit application when completed.
We Agree Disagree with the comments noted with the proposed construction based upon the circumstances stated herein:
Name of Utility Company:
Representative:
Title and Date:
Utility companies:
AT&T Southeast (Bell South)
8601 W. Sunrise Boulevard. Plantation, Florida 33324 (Fax) Attn: Lisa Goltiz, Engineering
954-423-6108
Comcast Cable
2601 SW 145
th
Avenue, Suite 100 Miramar, Florida 33027
(Fax Juan Arivello 954-447-8445
Oakland Park Utilities
3650 NE 12TH AVENUE OAKLAND PARK, FL 33334 954-630-4280
FP&L Customer Service Department
330 S.W. 12 Avenue Pompano Beach, Florida (Fax) Attn: Mike Engineering 954-956-2019
TECO (People’s Gas) Engineering Department
16101 W. Dixie Highway North Miami Beach, Florida 33162 (Fax) Attn: Yolanda,
Engineering 1-305-945-0171
EASEMENT AGREEMENT
BUILDING DEPARTMENT
DURING A HURRICANE WATCH & BEFORE THE ONSET OF HURRICANE
VELOCITY WINDS YOU ARE REQUIRED TO
SECURE THIS SITE
IN ACCORDANCE WITH THE BROWARD COUNTY ADMINISTRATIVE PROVISIONS
OF THE FLORIDA BUILDING CODE SECTION 110.13
All loose objects in exposed outdoor locations shall be
lashed to rigid construction or shall be stored inside an
enclosed structure.
Florida Building Code Broward County Administrative Provisions Section
110.13.2.4
NOTICES ISSUED BY THE NATIONAL WEATHER SERVICE OF A HURRICANE WATCH ARE
DEEMED SUFFICIENT NOTICE TO THE OWNER OF REAL PROPERTY UPON WHICH
CONSTRUCTION IS OCCURRING, OR ANY CONTRACTOR RESPONSIBLE FOR SAID
CONSTRUCTION, TO SECURE LOOSE CONSTRUCTION DEBRIS AND LOOSE CONSTRUCTION
MATERIALS AGAINST EFFECTS OF HURRICANE FORCE WINDS
This includes but not limited to:
•
110.13.2.1 Road Right-of-Way shall remain clear of construction waste and trash
•
110.13.2.2 Waste and Trash Enclosures Temporary Toilets
•
110.13.2.3 Loose Construction Debris Forms and Construction Materials
•
110.13.2.5 Roofing Tile and Materials Construction Shacks
•
110.13.2.5 (1) Loading of Roof Tile
•
110.13.2.5 (4) Store the construction materials inside an enclosed structure.
•
110.13.3 Building materials shall be loaded on a roof no earlier than (20) working days
prior to permanent installation.
•
Temporary Electric Service Poles
AND PROTECT ALL GLASS AREAS
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SWIMMING POOL & SPA PERMIT APPLICATION CHECKLIST

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Completed 1 July 2022

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