Fence Checklist. Permit application and supporting documents. 2. Notarized, Owner/Builder Affidavit (if applicable).

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Village of Royal Palm Beach, Florida Community Development Department, Building Division 1050 Royal Palm Beach Boulevard Royal Palm Beach, Florida 33411 Telephone (561) 790-5128 Fax (561) 790-5129 Fence Checklist This plan submittal checklist is designed to ensure that all information required to complete the review process is contained in the plans thereby providing for a more efficient review and permitting process. Any misstatement or inaccuracy will be cause for denial or revocation of the permit. Place a checkmark in the blank before each item to verify your acknowledgement of the requirement. for office use only 1. 2. 3. 4 5. 6 7. 8. Permit application and supporting documents 1. Permit application must be completed in its entirety including original, notarized signatures. (Qualifier must sign application) 2. Notarized, Owner/Builder Affidavit (if applicable). 3. Proof of Homestead (If fence installation is by Owner/Builder) 4. Notarized Easement Agreement. 5. HOA Acknowledgement Affidavit, if applicable. 6. Indicate if fence is to be used as pool barrier; if so, must comply with current FBC and Florida Statute 515.29. If only a portion of the fence is being repaired or replaced but it is part of the primary pool barrier, entire fence must comply with FBC and Florida Statute 515.29. 7. 1 (one) complete set of plans required if size does not exceed 12 x 18 with minimum scale of 1/8 = 1 otherwise 2 (two) complete sets of plans are required. 8. Address must be clearly marked on each document submitted NOTE: Prior to 1 st inspection, this office must be supplied with the original recorded Notice of Commencement or a certified copy. Rev03 092815

Construction Drawings Residential and commercial sites require one (1) complete set of plans if size does not exceed 12 x 18 with minimum scale of 1/8 = 1 otherwise two (2) sets of plans are required. 1. Site plan or current survey showing: A. all property lines and applicable easements B. all streets bounding the property C. location of all buildings on the property D. location of proposed fence with length and height indicated, (indicate if fence is to be constructed in the easement) E. show existing fences (types and heights) on the property F. setbacks of fence to property lines G. fence shall not obstruct access to fire hydrants 2. If fence exceeds six (6) foot in height, plans must be submitted providing: A. construction elevation drawings showing height, design, and footing details. Design details must provide information regarding the materials B. a statement of compliance paraphrasing: " To the best of my knowledge, these plans were prepared and shall comply with current edition Florida Building Code Florida Building Code requires pedestrian egress to a public way. You may not lock people within a site, nor require keys, special tools or knowledge (such as pass codes) to egress to a public way. NOTE: The Village of Royal Palm Beach reserves the right to require additional information and/ or documentation as it deems necessary to complete the review and permitting process as provided for in Florida Statute 553.79.

V i l l a g e o f R o y a l P a l m B e a c h, F l o r i d a Community Development 1050 Royal Palm Beach Boulevard Royal Palm Beach, Florida 33411 Telephone (561) 790-5128 Fax (561) 790-5129 FENCE PERMIT APPLICATION Permit No Date GENERAL INSTRUCTIONS Applicant must fill in all information relative to the work. The checklist of requirements for this permit, if any, must be completed and included with this application submittal. Note: Separate applications will be required for multiple structures or items on same parcel. PROPOSTED IMPROVEMENT LOCATION PCN Subdivision Address Is this application related to a Code Enforcement Case? Provide Case No. Does this application have a companion application (i.e., pool, structure, etc)? Permit No. Has this Project had Zoning approval? Yes No Project No. Date Approved / / APPLICANT INFORMATION Owner Address City State Zip Home Phone CONTRACTOR INFORMATION Work Phone Qualifier_ Title Company Address City_ State Zip Contact Person Phone Contractor License # APPLICATION TYPE (CHECK ONLY ONE PER APPLICATION) Fence Height: Number of gates: Type: Chain Link Wood (Shadow Box or Board on Board) PVC Other Will this fence be replacing an existing fence? YES NO Is there an existing pool at this location? YES NO DESCRIPTION OF WORK Single Family Townhouse Condo Commercial Further Description of work: Estimated Value $ Permit Fee $ Deposit $ Cash or Check # STATE STATUTE REQUIRES ALL PERMITS OVER $2,500.00 HAVE A NOTICE OF COMMENCEMENT RECORDED WITH THE CLERK OF COURT PRIOR TO 1 ST INSPECTION. IN ORDER TO OBTAIN 1 ST INSPECTION, THE ORIGINAL NOC OR CERTIFIED COPY MUST BE SUPPLIED TO OUR OFFICE. FORMS ARE AVAILABLE IN OUR OFFICE OR ONLINE AT www.royalpalmbeach.com.

APPLICATION CERTIFICATION AND ACKNOWLEDGEMENT Application is herby made to obtain a permit to do the work and installations as indicated. I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I certify that all the foregoing information is accurate. I further acknowledge the following: Issuance of a permit may be subject to conditions and setbacks Issuance of a permit is not authorized to violate public or private restrictions Failure to comply with applicable construction regulations may result in the withholding of future permits Submission of any false information or misrepresentation is a violation of law and may result in permit revocation. Warning to Owner: Your failure to record a Notice of Commencement may result in you paying twice for improvements to your property. If you intend to obtain financing, consult with your lender or attorney before recording your Notice of Commencement. If work is being conducted by contractor, this application must be signed by qualifier. _ Qualifier/Contractor (if applicable) or Owner/Builder Date STATE OF FLORIDA COUNTY OF PALM BEACH ******************* NOTARY ******************** The foregoing instrument was acknowledged before me this day,20 by and who is personally known to me or who has produced (type of identification) as identification and who did/did not take an oath. Notary Public (SEAL ABOVE) Name of Notary (typed, printed or stamped) STAFF COMMENTS STAFF APPROVAL Building Date

Record & Return To: Diane DiSanto, Village Clerk Village of Royal Palm Beach 1050 Royal Palm Beach Boulevard Royal Palm Beach, Florida 33411 AGREEMENT FOR CONSTRUCTION WITHIN UTILITY/DRAINAGE/CANAL EASEMENT The undersigned hereby applies for permission to construct within a utility/drainage/canal (circle one) easement ( Easement ) of the Village of Royal Palm Beach, Florida ( Village ), and requests permission from the Village to do so, and in support states as follows: 1. I am the Owner of the real property with legal description as follows: 2. The real property address is: 3. The real property parcel control number is: 4. The real property permit number is: 5. The Village has an Easement on said real property, the location of which is shown on the survey attached hereto as Exhibit A. 6. I am applying for permission to construct/install a ( Structure ) within said Easement in the location identified on Exhibit A. NOW, THEREFORE, in consideration of the mutual covenants, considerations, representation, warranties and promises herein contained and other good and valuable consideration, the sufficiency of which is hereby acknowledged by each party, the parties agree as follows: The Village agrees to allow the Structure described in paragraph 6 above under the following conditions: A. The Owner agrees that the structure will be constructed/installed and maintained in accordance with the Village Code of Ordinances. B. The Owner agrees to remove or relocate the Structure at his/her own expense upon request of the Village. Upon such removal or relocation, Owner agrees to restore the Easement to its previous condition. If Owner fails to do any of the above within five (5) days of such request, the Village may remove or relocate the Structure and restore the Easement to its previous condition, and Owner agrees to reimburse the Village for any expenses it incurs in connection therewith. Owner understands and acknowledges that the Village will not be responsible in any way for repairs to, or replacement of the Structure or any portion thereof. C. The Owner agrees that the Structure shall be as depicted on Exhibit A filed with the Village Planning, Zoning & Building Department and that no other construction by Owner shall take place in the Easement, unless this Agreement is amended to so provide. D. This Agreement shall be recorded at the Owner s expense (Standard fees by the Clerk of the Circuit Court and the Owner will be billed by the Village Clerk) in the public records of Palm Beach County, Florida and shall be a covenant running with the Property, and shall be binding on the Owner, his/her heirs, successors and assigns. 1 of 2

E. Upon the vacation, abandonment or discontinuance of the Easement, this Agreement shall immediately and automatically terminate and be of no further force and effect. F. The Owner understands and acknowledges that prior to Village approval of the construction/installation within the Easement, the Village must determine if the Easement is for utility, drainage or canals. The undersigned Owner, therefore, authorizes the Village to designate on the Agreement for Construction Within Utility/Drainage/Canal Easement the type or types of Easements affected by the Agreement. G. The Owner hereby agrees that he/she will indemnify and hold the Village harmless from and against any and all claims, demands, lawsuits, settlements, damages, costs and expenses, including attorney s fees, suffered or incurred by the Village and arising out of or in connection with the subject matter of this instrument. Executed this day of, 20. WITNESSES: WITNESSES: One (1) Owner One (1) Owner THE STATE OF FLORIDA COUNTY OF PALM BEACH The foregoing instrument was acknowledged before me this date by (Name of person acknowledging) _, who is personally known to me or who produced as identification and who did/did not take an oath, and acknowledged before me is that he/she executed said instrument, for the purposes therein expressed. Notary Public, State of Florida (SEAL) THE STATE OF FLORIDA COUNTY OF PALM BEACH The foregoing instrument was acknowledged before me this date by (Name of person acknowledging) _, who is personally known to me or who produced as identification and who did/did not take an oath, and acknowledged before me is that he/she executed said instrument, for the purposes therein expressed. Notary Public, State of Florida (SEAL) The Village consents to the construction/installation of the Structure, subject to the requirements set forth above. BY: Village Planning and Zoning BY: Village Building Official (VILLAGE SEAL) 2 of 2