FORM B03
Page 2 of 2
Revised December 28, 2017
BONDING COMPANY:
Address:
City, State & Zip Code:
ARCHITECT’S/ENGINEER’S NAME:
Address:
City, State & Zip Code:
MORTGAGE LENDER’S NAME:
Address:
City, State & Zip Code:
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or
installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards
of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for
ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR
CONDITIONERS, and etc.
NOTICE: Bay County Builders’ Services Division does not have the authority to enforce deed restrictions or covenants
on properties. You are advised to check for any restrictions that may affect your property.
For improvements to real property with a construction cost of $2,500 or more, a certified copy of the Notice of
Commencement is required to be submitted to Builders’ Services when application is made for a permit or the
applicant may submit a copy of the Notice of Commencement along with an Affidavit attesting to its recording. A
certified copy of the Notice of Commencement must be provided to Builders’ Services and posted on the jobsite before
the first inspection can be performed.
The enforcing agency shall require each building permit for the demolition or renovation of an existing structure to
contain an asbestos notification statement which indicates the owner's or operator's responsibility to comply with the
provisions of Section 469.003, Florida Statutes, and to notify the Department of Environmental Protection of his or her
intentions to remove asbestos, when applicable, in accordance with state and federal law.
IMPORTANT: The building permit is valid as long as there is construction progress and an approved inspection is
recorded within each 180 days (6 months) period.
Owner/Agent/Contractor Affidavit
I certify that all statements, drawings, and other information submitted on and with this application are true and correct
and that all work will be done in compliance with all applicable laws. I further certify that I have reviewed the applicable
regulations associated with the proposed construction and intended use. I understand that the submittal of incorrect
information or any changes which vary from the approved plans will result in the revocation of this permit.
(Signature of Owner) Date (Signature of Contractor) Date
(Signature of Notary Public – Stamp or Seal) Date (Signature of Notary Public – Stamp or Seal)Date
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be
found in the public records of this county, and there may be additional permits required from other government entities such as
water management districts, state agencies, or federal agencies.
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