Fillable Credit Card Authorization (Broward County)

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Credit Card Authorization (Broward County)

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The Credit Card Authorization (Broward County) form is 1 page long and contains:

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  • 34 check-boxes
  • 19 other fields

Country of origin: US
File type: PDF

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BROWSE BROWARD COUNTY (FLORIDA) FORMS

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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
Credit Card Authorization
Card Information
Visa
MasterCard
Discover
American Express
Cardholder’s Name
Card #
Expiration Date
Card Verification Code (CVC)
Billing Address (PO Box not accepted)
City
Zip
Phone
Fax
Fee Description
Auto Body/ Paint / Repair
Chauffeur
Child Care Food Service Licensing
Contractor Licensing
Domestic Wastewater License
Elevator
Environmental Resource License
Hazardous Material Management Facility License
Kosher Food
Manatee Protection Slip Fees
Mover
Non-Domestic Wastewater License
Permitting
Property Foreclosure Certification
Property Foreclosure Registration
Solid Waste Management Facility License
Surface Water Management License
Towing
Tree Removal License
Tree Trimmer Licensing
Vehicle for Hire
Waste Transporter License
Zoning
License, Permit or Application #
Applicant, Facility or Project Name
Facility or Project Location
Building Records
Research Copies
Re-inspection(s)
Electrical Structural Mechanical Plumbing Zoning
(a) Elevator or Escalator BCID #
(b) Elevator or Escalator BCID #
(c) Elevator or Escalator BCID #
Notes/Other
I authorize Broward County to charge
to my credit card account, plus
Signature
Date
FAX this completed authorization form to 954-765-4410. Do
not upload this document to the ePermitting portal. Do not
email this document.
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Credit Card Authorization (Broward County)

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Completed 27 August 2020

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