City
Email
City
Email
First License #
Address # Street
Phone # Email
OWNER’S INFORMATION
Name(s)
Address # Street
State Zip Phone #
Fee Simple Titleholder’s Name (if other than owner)
Address # Street
State Zip Phone #
CONTRACTOR’S INFORMATION
Qualifier Name: Last
Company Name
City State Zip
1. All Building Permit submittals for new home or new commercial building must be in digital format.
2. Submit digital permit applications to PERMITTING@GROVELAND-FL.GOV
3. Re-inspection fees must be paid prior to scheduling a re-inspection.
4. Incomplete permit applications will not be processed until complete.
5. To schedule an inspection email request to: inspectionrequest@alpha-inspections.net
City of Groveland, Building Services Department, 156 S. Lake
Avenue, Groveland, FL 34736
E-
mail: permitting@groveland-fl.gov
Phone (352) 429-2141 Fax (352) 429-3852 (revised 3/12/20)
CONTRACTOR’S SIGNATURE
STATE OF FLORIDA
COUNTY OF LAKE
I DO HEREBY S SWEAR THAT THE INFORMATATION CONTAINED HEREIN AND THE ATTTACHMENTS
HERETO ARE TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE AND THAT NO WORK OR
INSTALLATION HAS COMMENCED PRIOR TO ISSUANCE OF A PERMIT.
OWNER’S SIGNATURE
STATE OF FLORIDA
COUNTY OF LAKE
Sworn to (or affirmed) and subscribed before me this ____ day of _____ by _________________
(owner)
(Seal) ________________________________
Signature of Notary Public
Personally Known:______
OR Produced Identification:_____
Type of Identification Produced:____________
Sworn to (or affirmed) and subscribed before me this ____ day of _____ by _________________
(Seal)
(contractor)
________________________________
Signature of Notary Public
Personally Known:______
OR Produced Identification:_____
Type of Identification Produced:____________
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