Environmental Protection and Growth Management Department
BUILDING CODE SERVICES DIVISION
1 North University Drive, Box #302 Plantation, Florida 33324 • 954-765-4400 • broward.org/building
(Rev. 01/20) PC201249002
FLORIDA
Certificate of Completion
Permit #: ___________________________ Date: ______________________________________
Folio#: ____________________________ Jurisdiction: __________________________________
This Certificate of Completion is requested for: _________________________________________________
Change of Occupancy: Yes · No
Contractor Name: ___________________________________________________________________________
Property Owner(s) Name: ____________________________________________________________________
Job Address: _____________________________________________________________________________
City: ______________________________ State: ___________ Zip Code: ______________________
Phone #: _______________ Cell #: _____________________ E-mail: ________________________
Job Value: $________________ NOC Recorded Yes No
For office use only
Necessary Documents (check all that apply)
Finals
Date
Highway Construction & Engineering
Building
Final Survey
Electric
Soil Treatment
Mechanical
Insulation Certificate
Plumbing
Special/Threshold Inspector Certificate
NOTES: ______________________________________________________________________________________________
_____________________________________________________________________________________________________
CC Issued by: ____________________________ Date Issued: ___________________________________________
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signature
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