Building Permit Application

CITY OF LAKE MARY
BUILDING PERMIT APPLICATION
911 Wallace Court
(407) 585-1360/1449      Fax: (407) 585-1346

FAILURE TO COMPLY WITH THE MECHANIC’S LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING
TWICE FOR BUILDING IMPROVEMENTS.

DATE SUBMITTED:______________  RECV’D BY:___________  PERMIT #:________________

Project Name:______________________________________________________________________

Project Address:________________________________________________ Suite #:___________

(Fee Simple) Owner:____________________________________________________
 
City, State, Zip:___________________________________________________

Parcel #:__________________________ Lot #:_______ Block #:_______ Flood Zone:_______

SFD [     ] COMMERCIAL [     ] # OF STORIES___________ # OF UNITS__________
ROOF TYPE______________________

CONTRACTOR:                                                                                        
ADDRESS:                                                                                        
CITY, STATE, ZIP:______________________________________________________            
PHONE #:_______________________________ FAX#:______________________________             
E-MAIL:                                                                                        
 
LICENSE HOLDER:                                                                                        
STATE LICENSE#:_____________________________EXPIRES:_____________
CITY, STATE, ZIP:______________________________________________________            
PHONE #:_______________________________ FAX#:______________________________             
E-MAIL:                                                                                        

ARCHITECT:                                                                                       
STATE LICENSE#:_____________________________EXPIRES:_____________
CITY, STATE, ZIP:______________________________________________________            
PHONE #:_______________________________ FAX#:______________________________             
E-MAIL:                                                                                        
 
ENGINEER:___________________________________________________
STATE LICENSE#:_____________________________EXPIRES:_____________
CITY, STATE, ZIP:______________________________________________________            
PHONE #:_______________________________ FAX#:______________________________             
E-MAIL:                                                                                        
 
SQ. FT. OF COND. SPACE:__________________     
$_________________________________________
CONTRACT AMOUNT OF CONSTRUCTION
OTHER SPACE SQ. FT.:______________________________                                             
TOTAL SQ. FT.:_____________________________________

DESCRIPTION OF WORK:____________________________________________________________
 
                                                                                                                                                                    
 
                                                                                                                                                                    
 
                                                                                                                                                                    
 
                                                                                                                                                                    
 
 
(check all that apply)

_____  Commercial Building Shell                                   
_____  Commercial Interior Build Out                             
_____  Commercial Interior Alteration/Renovation       
_____  Single Family Dwelling                                           
_____  Multi-Family Dwelling                                           
_____  Residential Addition                                               
_____  Residential Pool                                                       
_____  Commercial Pool                                                                   
_____  Residential Roofing/Re-roofing                             
_____  Commercial Roofing/Re-roofing                           
_____  Fence (height _______ type _______)                       
_____  Commercial Electric
_____  Commercial Mechanical 
_____  Commercial Plumbing 
_____  Residential Electric
_____  Residential Mechanical
_____  Residential Plumbing
_____  Low Voltage   
_____  Shed   
_____  Irrigation
_____  Screen Enclosure
_____  Other
 
 

 

OFFICIAL USE ONLY
 

 

Department                                  Date        Initial                         Comments

Community Development ____________ _________ ____________________________________
 
                                                                                                                                                        


Fire Department                  ____________ _________ ____________________________________

                                                                                                                                                        

Building Department         ____________ _________ ____________________________________                                                                                                                                                  
                                                                                                                                                        
 
Public Works                       ____________ _________ _____________________________________                                                                                                                                                  
                                                                                                                                                        
      
Constrtion Type per FBC:_______________________________________________
Occupancy Type per FBC:_______________________________________________                                                                                 
Fire Sprinkler System Required? _______ YES ________ NO    SQUARE FOOTAGE:___________
Apply 50% Reduction to Fire Impact Fee? ________ YES ________NO

 
Are trees to be removed?_______ YES _______ NO
If yes, a separate arbor permit application must be submitted.

Is the proposed development parcel in the Special Flood Hazard Area (SFHA)? ____Yes ____ No
If yes, a floodplain determination must be submitted.
 

________________________________________________
                 Owner/Agent (Please Print)                   

________________________________________________
                 Owner/Agent (Please Sign)                     
 

The foregoing instrument was acknowledged before Me This ______ Day of
__________________ 20____ By___________________________________ Who is personally
known to me and/or has produced ______________________________________ as
identification and who did (did not) take an oath. 

Notary _______________________________________

(Seal)
 
 

________________________________________________
                 Contractor (Please Print)                   

________________________________________________
                 Contractor (Please Sign)                     
 

The foregoing instrument was acknowledged before Me This ______ Day of
__________________ 20____ By___________________________________ Who is personally
known to me and/or has produced ______________________________________ as
identification and who did (did not) take an oath. 

Notary _______________________________________

(Seal)

 
NOTICE 
COPY OF CONSTRUCTION CONTRACT IS REQUIRED AT TIME OF PERMIT APPLICATION
 

Application is hereby made to obtain a permit to do work and installations as indicated. (State Law requires construction to be performed by licensed contractors. Exemptions to that law may apply). I certify no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for other work to be performed.
 

NOTE: Any commercial or residential building undergoing a change of use of the property will require a site plan review and approval prior to issuance of a Building Permit. Agencies that enforce building codes are required to state, additional permits may be required from other governmental entities, such as Water Management Districts, State Agencies or Federal Agencies as required by State and Federal law.

NOTE: This application becomes null and void 180 days after the date of filing, unless such application has been pursued in good faith or a permit has been issued. Extensions may be granted by the Building Official if requested in writing and justifiable cause is shown.