Date:
Permit Application Number:
Orange County Division of Building Safety
201 South Rosalind Avenue
Post Office Box 2687, Orlando, Florida 32802-2687
Phone: 407-836-5550
www.ocfl.net/building
Para más información en español, por favor llame al Division of Building Safety al número 407-836-5550.
Version 2.1 – 6/25/2021
PERMIT APPLICATION “Page 2”
To be completed as required by Florida Statute Section 713 and other applicable sections.
Owner’s Name:
Owner’s Address:
Fee Simple Titleholder’s Name (If differs from owner):
Fee Simple Titleholder’s Address:
Contractor Name:
Contractor Address:
Job Name:
Job Address:
Bonding Company Name:
Bonding Company Address:
Architect/Engineer Name:
Architect/Engineer Address:
Mortgage Lender Name:
Mortgage Lender Address:
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, PLUMBING, GAS,
MECHANICAL, ROOFING, SIGNS, POOLS, ETC.
OWNER AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be
done in compliance with all applicable laws regulating construction and zoning.
Owner Affidavit Signature:
WARNING TO OWNER: Your failure to record a Notice of Commencement may result in
your paying twice for improvements to your property. A Notice of Commencement must
be recorded and posted on the job site before the first inspection. If you intend to obtain
financing, consult with your lender or an attorney before recording your Notice of
Commencement.
Owner Name:
Signature:
Notary Public, State of Florida, County of
The foregoing instrument was acknowledged before
me on by
by means of physical presence or online
notarization, who is personally known to me or has
produced as identification.
Notary Name:
Notary Signature:
Contractor Name:
Signature:
Notary Public, State of Florida, County of
The foregoing instrument was acknowledged before
me on by
by means of physical presence or online
notarization, who is personally known to me or has
produced as identification.
Notary Name:
Notary Signature:
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