City of Orange Beach Community Development Department
P.O. Box 2432 4101 Orange Beach Blvd. Orange Beach, AL 36561
www.OrangeBeachAL.gov/CDDportal 251.981.2610
2019-07
PERMIT REBATE APPLICATION
Property Owner Information
Name(s)
Mailing Address
Phone Number
Email Address
Property & Permit Information
Project Address
Contractor Name
Building Permit
Number and Date Issued
Certificate of Occupancy
Date Issued
Check Appropriate Rebate Program:
LEED ……………………………………………………….. 15 %
FORTIFIED HOME GOLD ………………………………... 25%
***** Attach a copy of (1) the permit, (2) the certificate of occupancy, and (3)
the program certification. Allow 4-6 weeks for processing. *****
Property Owner Signature: ___________________________________ Date: __________
St
aff Verification and Authorization:
Building Permit Fee: $__________________________
Authorized Rebate %: _________________________
Rebate Due: $________
________________________
Approved by: ________________________________