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PROCEDURE: Submit the completed 4 page application to (City of Pompano Beach)

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BROWSE CITY OF POMPANO BEACH (FL) FORMS

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City of Pompano Beach
Department of Development Services
Business Tax Receipt Division
License Year _____________
100 W. Atlantic Blvd Pompano Beach, FL 33060 Short-Term Rental Application
Phone: 954.786.4654 Fax: 954.786.4666 Email: linda.cebrian@copbfl.com
G:\Zoning 2009\Forms and documents\Website Documents\Word Documents\BTR\Applications\PDF\short-term_rental_app.doc Modified: 5.26.2020
PROCEDURE: Submit the completed 4 page application to the Business Tax Receipt Office, with the appropriate fee
or send the completed application to the Business Tax Receipt Division with the appropriate fee to the attention of
Linda Cebrian, Business Tax Receipt Inspector. When the application is processed, Inspections shall be made by
appointment with the 24-hr contact person. Applications must be submitted by the property owner or authorized
representative.
INITIAL APPLICATION FEE: Single Family and Duplex - $675.00; Triplex and Quadplex - $750.00
ANNUAL RENEWAL FEE: $375.00
APPLICATION CHECKLIST: The following copies shall be submitted with this completed application.
Submittal Requirement
Contact
A Copy of the Short Term Rental’s current
License as a Transient Public Lodging
Establishment with The Florida Department
of Business and Professional Regulation.
State of Florida Department of Business and Professional
Regulation
Address: 1940 North Monroe Street, Tallahassee, FL 32399-0783
Phone: 850-487-1395
Website: www.MyFloridaLicense.com
A Copy of the Short Term Rental’s current
certificate of registration with the Florida
Department of Revenue. Certificate must
be in the property owner’s name and list the
property address (if required).
Florida Department of Revenue, Coral Springs Center
Address: 3301 N University Drive Suite 200, Coral Springs, FL
33065
Phone: 954-346-3000
Website: http://dor.myflorida.com
A Copy of the Short Term Rental’s current
account with the Broward County Tax
Collector.
Tourist Development Tax Section Broward County Tax Collector
Address: 115 S Andrews Avenue Room A-110, Fort Lauderdale, FL
33301
Phone: 954-357-8455
Email: touristax@broward.org
A Copy of the Broward County Business
Tax Receipt.
Local Business Tax Receipt Section Broward County Tax Collector
Address: 115 S Andrews Avenue Room A-100, Fort Lauderdale, FL
33301
Phone: 954-831-4000
Email: businesstax@broward.org
A Copy of the current Pompano Beach
Business Tax Receipt
City of Pompano Beach, Business Tax Receipt Division, Attn: Linda
M. Cebrian
Address: 100 W Atlantic Blvd, 3
rd
Floor, Pompano Beach, FL 33060
Phone: 954-786-4654
Email: linda.cebrian@copbfl.com
Documentation demonstrating no Pending
Code violations and no unsatisfied liens for
property violations (for any property
within Pompano Beach owned by the
Property Owner).
City of Pompano Beach, Lien Search Division
Address: 100 W Atlantic Blvd, 3
rd
Floor, Pompano Beach, FL
33060
Phone: 954-545-7801
A Copy of the standard rental/lease agreement to be used when contracting with occupants.
Detailed exterior site plot plan identifying property lines, parking spaces, pools, spas, hot tubs, storage area
of garbage receptacles, screening if garbage receptacles, and fences.
Detailed interior floor plan identifying all bedroom, exits and location of fire extinguishers.
Authorization letter if the application is being submitted on behalf of the owner of the property or by his or her
authorized representative.
City of Pompano Beach
Department of Development Services
Business Tax Receipt Division
License Year _____________
100 W. Atlantic Blvd Pompano Beach, FL 33060 Short-Term Rental Application
Phone: 954.786.4654 Fax: 954.786.4666 Email: linda.cebrian@copbfl.com
G:\Zoning 2009\Forms and documents\Website Documents\Word Documents\BTR\Applications\PDF\short-term_rental_app.doc Modified: 5.26.2020
STREET ADDRESS (of the Short-Term Rental):
FOLIO #:
# of Dwelling Units
# of 32 Gallon Refuse/Garbage Cans
Yes
No
Is there a Hot Tub?
Yes
No
Responsible Party Contact Information
(If party is not the property owner)
Property Owner Contact Information
(Please Print)
Business Name (if applicable):
Business Name (if applicable):
Print Name and Title:
Print Name and Title:
Mailing Street Address:
Mailing Street Address:
Mailing Address City/ State/ Zip:
Mailing Address City/ State/ Zip:
Primary Phone Number:
Primary Phone Number:
Secondary/ Cell Phone Number:
Secondary/ Cell Phone Number:
Email:
Email:
24 Hour Contact
Must be within 25 miles of the short-term rental property
Property Owner
Responsible Party
Other (below)
Business Name (if applicable):
Print Name and Title:
Physical Street Address, of Home or Business:
Address City/ State/ Zip:
Primary Phone Number:
Secondary/ Cell Phone Number:
Email:
City of Pompano Beach
Department of Development Services
Business Tax Receipt Division
License Year _____________
100 W. Atlantic Blvd Pompano Beach, FL 33060 Short-Term Rental Application
Phone: 954.786.4654 Fax: 954.786.4666 Email: linda.cebrian@copbfl.com
G:\Zoning 2009\Forms and documents\Website Documents\Word Documents\BTR\Applications\PDF\short-term_rental_app.doc Modified: 5.26.2020
Owner/Responsible Party Affidavit for Short-Term Rental
I certify that I have received a copy of all provisions and regulations set forth in the City of Pompano Beach Code
of Ordinances, Chapter 153 Rental Housing and specifically those provisions for Short Term Rental recently
adopted by Ordinance 2017-50 shall be met.
I certify that I am familiar with the information contained in this application and applicable ordinances, and that
to the best of my knowledge such information is true, complete, and accurate.
The application shall bear the signature of all owner(s) and all authorized responsible party(ies) of the owner(s).
If necessary, please attach additional sheets with notarized signatures of all other authorized signatures of all
other authorized property owners and/or short term rental responsible party(ies).
The Development Service Director may refuse to issue or renew a license or may revoke a Short Term Rental
Permit issued, if the property owner has willfully withheld or falsified any information required for a Short Term
Rental Permit.
Failure to renew when applicable, shall constitute a code violation and shall subject the property
owner/responsible party to the revocation of the short-term rental permit. Moreover, the Director of Development
Services reserves the authority to require an inspection of the property for a permit renewal application.
I understand that this permit is nontransferable and expires on September 30 annually, with the option to renew.
Property Owner: _____________________________________________________________
(Print or Type Name)
Property Owner: ________________________________________ Date: ______________
(Signature)
Authorized Responsible Party: _____________________________________________________________
(Print or Type Name)
Authorized Responsible Party: ________________________________________ Date: ______________
(Signature)
SWORN TO AND SUBSCRIBED before me this _____ day of __________________________ 20_____, by
means of [ ] physical presence or [ ] online notarization.
Notary Public ____________________________________________
Seal of Office Notary Public, State of Florida
____________________________________________
(Print Name of Notary Public)
_________________________ Personally Known
_________________________ Produced Identification
Type of identification Produced:
____________________________________________
City of Pompano Beach
Department of Development Services
Business Tax Receipt Division
License Year _____________
100 W. Atlantic Blvd Pompano Beach, FL 33060 Short-Term Rental Application
Phone: 954.786.4654 Fax: 954.786.4666 Email: linda.cebrian@copbfl.com
G:\Zoning 2009\Forms and documents\Website Documents\Word Documents\BTR\Applications\PDF\short-term_rental_app.doc Modified: 5.26.2020
Local 24 Hour Contact Affidavit
In addition to the responsibilities required for a 24-hour contact person as provided for in § 153.33(F), the
additional responsibilities of the 24-hour contact person for Short Term Rental Housing are required to:
When the application is processed, an Inspection shall be made by appointment with the BTR Inspector.
Be available and have the authority to address or coordinate problems associated with the property 24
hours a day, 7 days a week;
Be situated within 25 miles of the short-term rental;
Maintain the entire property free of garbage and refuse; provided however, this provision shall not prohibit
the storage of garbage and litter in authorized receptacles for collection;
See that provisions of this section are complied with and promptly address any violations of this section
or any violations of law, which may come to the attention of the 24-hour contact person and
Inform all occupants prior to occupancy of the property regulations regarding parking, garbage and
refuse, noise, and outdoor musical performances.
I certify that I have read and understand the information contained on this affidavit, and that to the best of my
knowledge such information is true, complete, and accurate.
BEFORE ME, the undersigned authority, personally appeared __________________________ (PRINT NAME)
Who after being duly sworn, deposes and says: That I am the person whose signature appears below, and that
the information I have provided above in this document is true and correct.
Local 24 Hour Contact: _____________________________________________________________
(Print or Type Name)
Local 24 Hour Contact: ________________________________________ Date: ______________
(Signature)
SWORN TO AND SUBSCRIBED before me this _____ day of __________________________ 20_____, by
means of [ ] physical presence or [ ] online notarization.
Notary Public ____________________________________________
Seal of Office Notary Public, State of Florida
____________________________________________
(Print Name of Notary Public)
_________________________ Personally Known
_________________________ Produced Identification
Type of identification Produced:
____________________________________________
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PROCEDURE: Submit the completed 4 page application to (City of Pompano Beach)

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Completed 14 July 2020

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