Residential Application
Town of Fort Myers Beach 2525 Estero Blvd. Fort Myers Beach, FL 33931
Phone # (239) 765 -0202 Permits@fmbgov.com Fax # (239) 765-0909
Job Information: Flood Zone:___________BFE_________
Owner Name: _________________________________________ Phone # _________________________
Owner Mailing Address (if different):_______________________________________________________
STRAP #: _____________________________________________________________________________
Job Address: ________________________________________ Fort Myers Beach, FL 33931 Lee County
Contractor’s Information:
Contractor Business Name :__________________________State Cert/CC Comp Card #:______________
Qualifiers Name: ________________ Email: _____________________________ Phone# _____________
Address:_________________________ City______________ State_______________________________
Scope of work:_________________________________________________________________________
Estimated cost value:__________________*if over $2500 a NOC and Building Addendum is required.
Are you using Private Provider services for Plan Review? YES NO Inspections? YES NO
Construction Details Mastered? NO YES MASTER #:_________________________
SELECT CONSTRUCTION TYPE
NEW SINGLE FAMILY/DUPLEX____ ADDITION/ALTERATION____ ACCESSORY STRUCTURE_____
Lot Data: Type of Lot Check One Vacant Existing Home demolished Demo Permit#____
Setbacks:
Front
ft
Right Side
Ft.
Rear
Ft.
Left Side
Ft.
Building Data:
Footprint under roof
Ft.
A/C Sq. Ft
Ft.
Bldg. Width
Ft.
Total Sq. Ft under roof
Ft.
Bldg. Depth
Ft.
Bldg. Height
Ft.
Number of Bedrooms:___ Number of Bathrooms:____ Number of Floors:____
Sub Information:
Plumbing: NO YES
A/C: Seer:____________ KW:___________ Tons:___________
F. Sprinklers / F. Alarm / Monitor: YES NO
Shutters: YES NO Impact windows: YES NO
Width
Ft.
Area
Ft.
Depth
Ft.
Street frontage
Ft.
June 22, 2020
Residential Application
Town of Fort Myers Beach 2525 Estero Blvd. Fort Myers Beach, FL 33931
Phone # (239) 765 -0202 Permits@fmbgov.com Fax # (239) 765-0909
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT
MAY RESULT IN YOURPAYING 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.
June 22, 2020
Town of Fort Myers Beach
2525 Estero Blvd. Fort Myers Beach, FL 33931
Phone : 239 765-0202 Permits @fmbgov.com Fax: 239 765-0909
This page is required for ALL Building Permit Applications
ACKNOWLEDGEMENT OF TOWN OF FORT MYERS BEACH REGULATIONS BY OWNER OR AGENT OF OWNER
NOTICE OF ADDITIONAL RESTRICTIONS: In addition to the requirements of this permit, there may be additional restrictions applicable to this property
that maybe found in the public records of this County, and there may be additional permits required from other governmental entities such as the Water
Management District, State agencies, or Federal agencies.
WARNING OF WORK IN THE COUNTY RIGHT-OF-WAYS: This permit does not authorize construction or installation of any structure or utility, above or below
ground, within any right of way or easement reserved for access, drainage or utility purposes. This restriction specifically prohibits fencing, sprinkler systems,
landscaping other than sod, signs, water, sewer, cable and drainage work therein. If such improvements are necessary, a separate permit for that purpose
must be obtained from the Building Department.
NOTICE OF CLEARING RESTRICTIONS: Issuance of a Demolition Permit for a structure does not authorize removal of vegetation beyond the footprint of the
structure. A Demo Permit is not a clearing permit.
INSPECTIONS This permit is void if the first inspection is not made within six (6) months from the date issued or if no inspection has been made for a period
of six (6) months from the most recently passed inspection. The permit is void if the zoning classification is violated. Applicant agrees to comply with the
sanitary regulations and understands that the proposed structure may not be used or occupied until an approved certificate of occupancy is issued.
Applicant further understands that failure to obtain permit or misrepresentation of the improvements is a misdemeanor and upon conviction, applicant can
be punished as provided by the law. Failure to comply with the mechanics lien law can result in the property owner paying twice for improvements
WORK IN THE SPECIAL FLOOD HAZARD AREA: Be advised that Substantial Damage/Substantial Improvement requirements will apply to structures located
in the Special Flood Hazard Area with Finished Floor Elevations below the Base Flood Elevation.
CERTIFICATION: Application is hereby made to obtain a permit to do the work and installations as indicated. I, THE OWNER OR AGENT OF OWNER, certify
that I have not performed any work or installation 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. The permit or application fee may have additional fees imposed for failing to obtain permits prior to
commencement of construction. The permit application or approved permit expires if work is not commenced within 180 days from the date of issuance. I,
THE OWNER OR AGENT OF OWNER understand that the structure cannot be used or occupied until a certificate of occupancy is issued. By signing this permit
application, I, THE OWNER OR AGENT OF OWNER, agree that I have been retained by the property owner to provide contracting services for the trade for
which I am listed. Furthermore, it is my responsibility to notify the Building Plan Review and Inspection Division should I no longer be THE OWNER OR AGENT
OF OWNER responsible for providing said contracting services. I, THE OWNER OR AGENT OF OWNER , agree that I understand the review and issuing of this
permit does not exempt me from complying with all State and local County Codes and Ordinances.
Job Street Address:______________________________________________________________________________________________
I, _____ (Property Owner), hereby certify that
_______________________________________ is my authorized agent/representative of the property described
herein. All answers to the questions in this registration and any supplementary information attached
to and made part of this registration is honest and true.
Signature of Property Owner
Typed or printed name of Property Owner
STATE OF _____ _____ COUNTY OF ________________
The foregoing instrument was certified and subscribed before me
by means of _____ physical presence
OR_____online notarization,
this ______day of ___________________, 20______, by ______________________, _____ who
is personally known to me OR _____ who has produced ______________________ as identification.
Notary Public Signature
(SEAL)
June 22, 2020
click to sign
signature
click to edit
click to sign
signature
click to edit
Town of Fort Myers Beach
2525 Estero Blvd. Fort Myers Beach, FL 33931
Phone : 239 765-0202 Permits @fmbgov.com Fax: 239 765-0909
NOTICE OF COMMENCEMENT INFORMATION
Per Florida Statutes 713.135 a Notice of Commencement (NOC) is required for construction of improvements totaling more than $2,500, with
certain exceptions. For A/C Repairs or Replacements a notice of commencement is required for improvements more than or equal to $7,500. The
applicant shall file with the issuing authority prior to the first inspection either a certified copy of the recorded NOC or a notarized statement that
the NOC has been filed for recording, along with a copy thereof. In order to comply with the state requirement, permits will be placed in
inspection hold until proof of the NOC is filed with the building permitting and inspection department. The issuing authority shall not perform or
approve subsequent inspections until the applicant files by mail, facsimile, hand delivery, email or any other means such as certified copy with
the issuing authority.
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.
June 22, 2020
Town of Fort Myers Beach
2525 Estero Blvd. Fort Myers Beach, FL 33931
Phone : 239 765-0202 Permits @fmbgov.com Fax: 239 765-0909
This page is required for ALL Building Permit Applications
ACKNOWLEDGEMENT OF TOWN OF FORT MYERS BEACH REGULATIONS BY THE QUALIFIER
NOTICE OF ADDITIONAL RESTRICTIONS: In addition to the requirements of this permit, there may be additional restrictions applicable to this property
that maybe found in the public records of this County, and there may be additional permits required from other governmental entities such as the Water
Management District, State agencies, or Federal agencies.
WARNING OF WORK IN THE COUNTY RIGHT-OF-WAYS: This permit does not authorize construction or installation of any structure or utility, above or below
ground, within any right of way or easement reserved for access, drainage or utility purposes. This restriction specifically prohibits fencing, sprinkler systems,
landscaping other than sod, signs, water, sewer, cable and drainage work therein. If such improvements are necessary, a separate permit for that purpose
must be obtained from the Building Department.
INSPECTIONS: This permit is void if the first inspection is not made within six (6) months from the date issued or if no inspection has been made for a
period of six (6) months from the most recently passed inspection. The permit is void if the zoning classification is violated. Applicant agrees to comply with
the sanitary regulations and understands that the proposed structure may not be used or occupied until an approved certificate of occupancy is issued.
Applicant further understands that failure to obtain permit or misrepresentation of the improvements is a misdemeanor and upon conviction, applicant can
be punished as provided by the law. Failure to comply with the mechanics lien law can result in the property owner paying twice for improvements
NOTICE OF CLEARING RESTRICTIONS: Issuance of a Demolition Permit for a structure does not authorize removal of vegetation beyond the footprint of the
structure. A Demo Permit is not a clearing permit.
WORK IN THE SPECIAL FLOOD HAZARD AREA: Be advised that Substantial Damage/Substantial Improvement requirements will apply to structures located in
the Special Flood Hazard Area with Finished Floor Elevations below the Base Flood Elevation.
CERTIFICATION: Application is hereby made to obtain a permit to do the work and installations as indicated. I, THE QUALIFIER, certify that I have not
performed any work or installation 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. The permit or application fee may have additional fees imposed for failing to obtain permits prior to commencement of
construction. The permit application or approved permit expires if work is not commenced within 180 days from the date of issuance. I, THE QUALIFIER
understand that the structure cannot be used or occupied until a certificate of occupancy is issued. By signing this permit application, I, THE QUALIFIER, agree
that I have been retained by the property owner to provide contracting services for the trade for which I am listed. Furthermore, it is my responsibility to
notify the Building Plan Review and Inspection Division should I no longer be THE QUALIFIER responsible for providing said contracting services. I, THE
QUALIFIER , agree that I understand the review and issuing of this permit does not exempt me from complying with all County Codes and Ordinances.
Job Street Address:_________________________________________________________________________________________
I, _____ (Qualifier ), hereby certify that all answers to the questions
in this registration and any supplementary information attached to and made part of this registration
is honest and true.
Signature of Qualifier
Typed or printed name of Qualifier
STATE OF _____ _____ COUNTY OF ________________
The foregoing instrument was certified and subscribed before me
by means of ______ physical presence
OR______online notarization,
this ______day of ___________________, 20_______, by _______________________________,
____ who is personally known to me OR _____ who has produced ______________________ as identification.
Notary Public Signature
(SEAL)
June 22, 2020
click to sign
signature
click to edit
click to sign
signature
click to edit
Town of Fort Myers Beach
2525 Estero Blvd. Fort Myers Beach, FL 33931
Phone : 239 765-0202 Permits @fmbgov.com Fax: 239 765-0909
NOTICE OF COMMENCEMENT INFORMATION
Per Florida Statutes 713.135 a Notice of Commencement (NOC) is required for construction of improvements totaling more than $2,500, with
certain exceptions. For A/C Repairs or Replacements a notice of commencement is required for improvements more than or equal to $7,500. The
applicant shall file with the issuing authority prior to the first inspection either a certified copy of the recorded NOC or a notarized statement that
the NOC has been filed for recording, along with a copy thereof. In order to comply with the state requirement, permits will be placed in inspection
hold until proof of the NOC is filed with the building permitting and inspection department. The issuing authority shall not perform or approve
subsequent inspections until the applicant files by mail, facsimile, hand delivery, email or any other means such as certified copy with the issuing
authority
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.
June 22, 2020