Community Development Department
Building Construction Division
18400 Murdock Circle | Port Charlotte FL 33948
Building Phone: 941.743.1201 | Building Fax: 941.764.4907
Zoning Phone: 941.743.1964 | Zoning Fax: 941.743.1598
BuildingConstruction@CharlotteCountyFL.gov
www.CharlotteCountyFL.gov
”To exceed expectations in the delivery of public services”
A recorded Notice of Commencement is required in the Permitting Office prior to the first inspection.
Application Date
Permit Number
2
For Office Use Only
0
CSR
1
INSPECTION AFFIDAVIT
CERTIFICATE OF COMPLIANCE
Date
Engineer/Architect Signature
Street Name
Unit #
Street Number
Street Type
Contractor Name
Contractor Phone #
I, the undersigned, have read the above statement and agree to abide by it.
Permit Number
Engineer/Architect Firm
Engineer/Architect Name
Engineer/Architect Address
Telephone #
Fax # E-mail
Florida Registration or License Number
I hereby certify that to the best of my knowledge and belief, the building components and site improvements outlined herein and
inspected under my authority have been completed in conformance with the approved plans and the applicable codes by the
following affiant, who is duly authorized to perform inspections pursuant to Florida Building Code, Sections 105.14 and 107.6
I certify that the construction was inspected as outlined by the Charlotte County Building Construction Services inspection
requirements and take fully responsibility for the inspections listed below:
Inspection:
Inspection:
Inspection:
Seal required below
10/2019 DJ
Inspection: Inspection:
Inspection:
Inspection:
Inspection:
Inspection:
Inspection:
Inspection:
Inspection:
If additional inspections, please provide them in a separate form
