Date Received: Glades County Verification of Exemption from Florida Building Code & Zoning Review Fee Temporary structures associated with land development or construction projects - $300 for initial permit and $125 for renewal All others - $30 PLEASE NOTE that a building code exemption does not imply or grant an exemption from the Floodplain Management Ordinance or other Land Development Regulations. Owner Information Property Owner Name: Mailing Address: Phone Number: Email Address: Parcel Information Parcel ID #: Parcel Address: Exemption Requested Check the box next to the exemption(s) you are requesting. Buildings and structures specifically regulated and preempted by the Federal Government. Railroads and ancillary facilities associated with the railroad. Structures or facilities of electric utilities, as defined in s. 366.02, which are directly involved in the generation, transmission, or distribution of electricity. Exemption and Land Use Verification 1
Chickees constructed by the Miccosukee Tribe of Indians of Florida or the Seminole Tribe of Florida. As used in this paragraph, the term chickee means an open-sided wooden hut that has a thatched roof of palm or palmetto or other traditional materials, and that does not incorporate any electrical, plumbing, or other nonwood features. Family mausoleums not exceeding 250 square feet in area which are prefabricated and assembled on site or preassembled and delivered on site and have walls, roofs, and a floor constructed of granite, marble, or reinforced concrete. A building or structure having less than 1,000 square feet which is constructed and owned by a natural person for hunting and which is repaired or reconstructed to the same dimension and condition as existed on January 1, 2011, if the building or structure: 1. Is not rented or leased or used as a principal residence; 2. Is not located within the 100-year floodplain according to the Federal Emergency Management Agency s current Flood Insurance Rate Map; and 3. Is not connected to an offsite electric power or water supply. *Temporary sets, assemblies, or structures used in commercial motion picture or television production, or any sound-recording equipment used in such production, on or off the premises. *Temporary housing provided by the Department of Corrections to any prisoner in the state correctional system. *Temporary buildings or sheds used exclusively for construction purposes, other than mobile or modular structures used as temporary offices. *Mobile or modular structures used as temporary offices, except that the provisions of part II relating to accessibility by persons with disabilities apply to such mobile or modular structures. * Temporary means for the time of service or 180 days, whichever less. An extension may be granted for demonstrated cause. Attach the following: 1. Exemption Affidavit - A fully completed, signed and notarized Verification of Exemption Affidavit (form attached). 2. Site plan - A survey, sketch, or other legible drawing drawn to scale which shows: property boundaries and dimensions; any easements or rights-of way; any existing or proposed buildings with distances between buildings; setbacks from property lines for all existing or proposed buildings; any water bodies or jurisdictional wetlands on the property, right of way connection to public road and locations of flood zones. This is not required for Motion Picture or Television Production sets. Exemption and Land Use Verification 2
Exemption Affidavit This is to certify that the information given to the Community Development Department in support of this application is true and accurate. I understand that I am exempt from the requirements of the Florida Building Code as allowed by Florida Statute 553.73(10). I understand that if the structure is used for any other purpose than what is allowed by the exemption, it would constitute a zoning and building violation. I will assume full responsibility as Owner, and will personally be responsible. I hereby acknowledge that I have read and understand the above affidavit on this, 20. day of Signature of Owner Printed Name of Owner State of, County of The foregoing instrument was acknowledged before me this day of 20, by who is personally known to me or has produced as identification and who did did not take an oath. Signature of Notary Stamp Seal Below Printed Name of Notary Exemption and Land Use Verification 3
Glades County Community Development Department Date: To Whom It May Concern: EXEMPTION and ZONING VERIFICATION Official Use Only This letter is to verify that the Glades County Community Development Department has determined that the following described use: At the following described location: Parcel ID #: Parcel Address: Meets the criteria specified in Florida Statute 553.73(10) and is exempt from the Florida Building Code. Meets the Comprehensive Plan and Land Development Regulations. Requirements: 1. If the structure is used for any other purpose than what is allowed by the exemption, it may constitute a zoning and building violation. 2. Temporary buildings, sheds, offices, or other items shall be removed upon conclusion of the operation for which they were needed or within six months of this approval, whichever comes first, unless an extension is requested. 3. Structure(s) shall be placed as indicated on the site plan. Staff Signature Staff Printed Name Exemption and Land Use Verification 4
Glades County Community Development Department Date: To Whom It May Concern: POWER RELEASE ON BUILDING EXEMPT FROM BUILDING CODE Official Use Only This letter is to verify that the Glades County Community Development Department has determined that the improvements located at: Parcel ID # Meet the criteria specified in Florida Statute 553.73(10) to qualify as an exemption from the Florida Building Code. Proposed Use Property Owner s Name Mailing Address Phone # No permit is required for any structural/ electrical/ plumbing/ gas or mechanical work being performed on this structure. Staff Signature Staff Printed Name Exemption and Land Use Verification 5