This subsection does not apply to a direct contract to repair or replace an existing heating or air-conditioning system in an amount less than $15,000.
Tax Folio No.
BUILDING PERMIT APPLICATION
Owner's Name
Owner's Address
Fee Simple Titleholder's Name (If other than owner)
Fee Simple Titleholder's Address (If other than owner)
City
State Zip
Contractor's Name
Contractor's Address
City
State Zip
Job Name
Job Address
City County
Legal Description
Bonding Company
Bonding Company Address
City State
Architect/Engineer's Name
Architect/Engineer's Address
Mortgage Lender's Name
Mortgage Lender's Address
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.
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.
IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
(Signature of Owner or Agent)
(including contractor)
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me this day of, (year) , 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
(Signature of Contractor)
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me this day of, (year) , 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
(Certificate of Competency Holder)
Contractor's State Certification or Registration No.
Contractor's Certificate of Competency No.
APPLICATION APPROVED BY
Permit Officer
OWNER'S ELECTRONIC SUBMISSION STATEMENT: Under penalty of perjury, I declare that all the information contained in this building permit application is true and correct.
Fla. Stat. § 713.135