Form Center • Temple Terrace, FL • CivicEngage

Step One

Contractor Information
Company Name *
Qualifier/License Holder Name *
State License Number*
Telephone Number*
Property Owner Information
Property Owner's First Name*
Property Owner's Last Name*
Property Owner's Address 1*
Address 2
City*
State*
Zip*
Property Owner's Telephone Number*
Applicant's First Name*
Applicant's Last Name*
Applicant's Telephone Number*
Applicant Email Address*
ADDRESS of Proposed Work *
Type of Property *
1. Residential
2. Commercial
Estimated Cost of Work *
Square Footage of Affected Area*
Number of Bedrooms*
For New Residence
Fl Product Approval Number
Please Provide For Window/Door Applications
Check All That Apply *
1. New Structure
2. Addition
3. Renovation
4. Repair
5. Other (Describe Below)
Detailed Description of Work *
Please Upload Any Additional Documentation If Applicable
Continue

Step Two

PERMIT APPLICATION (Chapter 713.135(6) Florida Statutes)
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, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and AIR CONDITIONERS, FIRE ALARM SYSTEMS,FIRE SPRINKLER SYSTEMS,ETC.
Applicant Initials*
NOTICE OF COMMENCEMENT (Chapter 713.135(1)(d) & 713.135(1)(a) Florida Statutes)
For any direct contract valued greater than $2,500 ($7,500 to repair or replace an existing heating or cooling system) a recorded NOTICE OF COMMENCEMENT is required prior to the first inspection. “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 RECORDING YOUR NOTICE OF COMMENCEMENT.”
Applicant Initials *
HOMEOWNER’S PROTECTION GUIDE (Chapter 713.135(1)(c) Florida Statutes)
Each applicant must promise in good faith to provide to the owner of the real property upon which improvements are to be constructed a printed statement stating that the right, title, and interest of the person who has contracted for the improvement may be subject to attachment under the Construction Lien Law.
Applicant Initials *
NOTICE OF DEED RESTRICTIONS
This permit may be subject to “deed” restrictions which may be more restrictive than the City regulations. The applicant assumes responsibility for compliance with applicable deed restrictions.
Applicant Initials *
WORK COMMENCING BEFORE PERMIT ISSUANCE (CHAPTER 8-28 (f) (2) City Code)
In the event that any work for which a permit is required is commenced or is in process prior to the issuance of a permit by the building department, the building official may impose a penalty fee. The fee for work commenced without a permit shall be assessed per discipline (building, electrical, mechanical, plumbing, etc.) according to the most recently adopted permit fee schedule.
Applicant Initials *
ADDITIONAL PERMITS REQUIRED (Florida Building Code 105.3.3)
“NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other govern- mental entities such as water management districts, state agencies, or federal agencies.”
Applicant Initials *
CONDITIONS OF THE PERMIT (Florida Building Code 105.4.1)
A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter or set aside any of the provisions of technical codes, nor shall issuance of a permit prevent the building official from thereafter requiring a correction of errors in plans, construction or violations of this code.
Applicant Initials *
Signature of Applicant:
UNDER PENALTY OF PERJURY, I DECLARE THAT ALL THE INFORMATION CONTAINED IN THIS BUILDING PERMIT APPLICATION IS TRUE AND CORRECT AND THAT ALL WORK WILL BE DONE IN COMPLIANCE WITH FLORIDA BUILDING CODE SIXTH EDITION (2017) AND ALL OTHER APPLICABLE LAWS REGULATING CONSTRUCTION, ZONING AND LAND DEVELOPMENT WHETHER OR NOT SHOWN OR INDICATED IN PLANS AND SPECIFICATIONS OF THIS PERMIT.
Signature of Applicant *
Date:*
Date:
Electronic Signature of Applicant *
1. By checking this box, I acknowledge that I am electronically signing this form and that the information above is true and correct to the best of my knowledge.
PERMIT #:
ZONING:
APPLICATION DATE:
FLOOD ZONE:
BASE FLOOD ELEVATION
FLOOD ELEV. CERT. REQ'D: Y / N
BUILDING:
_________________________________________________________________________________DATE: _________
ZONING/LANDSCAPING
_________________________________________________________________________________DATE: _________
ENGINEERING:
_________________________________________________________________________________DATE: _________
UTILITY BILLING:
_________________________________________________________________________________DATE: _________
COMMENTS
_________________________________________________________________________________DATE: _________
ADDITIONAL PERMITS REQUIRED:
ELECTRIC__MECHANICAL__PLUMBING__GAS____ROOF____HOOD___ALARM__SPRINKLER__VOLTAGE_____SPRINKLER________ OTHER__________________________________DATE:______________
INSPECTIONS REQUIRED:
FOOTER_________SLAB_____LINTEL______VERTICAL STEEL____FRAMING/FLOORING______FRAMING/STRIPPING___WALLSHTHNG ROOFSHTNHNG______INSULATION________FIREWALL/SHEERWALL___DRYWALL/SCREW____FINAL SURVEY_____________ FINAL/ ELEVATION CERT______BLOWER DOOR TEST______OTHER:________________FINAL BLDG.______DATE:____________

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