Fillable Building-permit-refund-request Building Permit Refund Request

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Building-permit-refund-request Building Permit Refund Request

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04/2020
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
BUILDING PERMIT
REFUND REQUEST
Wrien refund requests must be submied within 60 days of permit issuance and construcon must not have
commenced. The applicant will receive a refund of 50% of the original permit fees (not including radon and
landscaping fees, which are non-refundable). Refunds are not issued for fees $100 or less, with the excepon
of clerical errors resulng in overpayment. Clerical errors are eligible for a refund of 100% of the overpayment
amount. Wrien request must submied within one year from the date of the occurrence. Please send an
email to kindredl@HCFLGov.net if you have quesons concerning permit refunds.
If you are requesng refund of impact fees, please call: 813-276-8305.
A copy of the receipt (plus credit card receipt if paid by credit card, copy of check/money order if paid by
cashier’s check or money order, or copy of canceled check if paid by personal or business check) must be
aached to this form to receive a refund. The refund will only be issued to the business or person that issued
the original check (or the authorized user named on the credit card).
Name of Business or Individual Account on which Check was Drawn or Authorized Credit Card User:
Business Address _____________________________________________________________________________________________
City ____________________________________________________ State ________________________ ZIP____________________
Business Phone_______________________________________________________________________________________________
Reason for requesng the refund: ____________________________________________________________________________
Permit Number _____________________________________________ Receipt Number _______________________________
Examinaon Fee_____________________________________________ License Fee ____________________________________
Signature of Applicant _______________________________________ Date ___________________________________________
FOR BSD OFFICE USE ONLY
Accounng String: ________________________________________________________________Amount: ______________
Accounng String: ________________________________________________________________Amount: ______________
Accounng String: ________________________________________________________________Amount: ______________
Accounng String: ________________________________________________________________Amount: ______________
Accounng String: ________________________________________________________________Amount: ______________
Total Refund: ______________
Secon Manager Approval: _______________________________________________________Date: _________________
Department Director Approval: ___________________________________________________Date: __________________
cc: Team Leader, Structural Review Intake Team, Pa English
Building Services | 19th Floor | P.O. Box 1110 | Tampa, FL 33601
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Building-permit-refund-request Building Permit Refund Request

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Completed 23 April 2020

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