Commercial Permit Application Form Page 2
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1
2COMMERCIAL WORKSHEET
(PLEASE TYPE OR PRINT CLEARLY)
ELECTRICAL INFORMATION: Electric Required? Yes______ No______ Existing Service?______ New Service?______ Upgrade Service?______
Limited Use?_______ Disconnect/Reconnect?______ Temporary Underground?_______ Temp Pole: Yes______ No______
Service Size: NEW Amps
Number New/Altered Circuits
______________
Electric Company
. __________________________________
_______________
Volts
Phase 1PH
3PH
OLD Amps
Volts
Phase 1PH
3PH
___________
________
________
______________
__________
_________
_________
MECHANICAL (HVAC): Required? Yes_____ No_____ Electric
Gas
Oil
Heat Pump
A/C
General?____
_____
_____
______
_____
______ Duct Work?______
Roof Top Equipment?______ Type of Equipment:________________________________ Equipment Location: Inside_____ Outside ______
Type of Heating System_______________________________ No. of BTU’s____________ Type of Cooling System____________________________
No. of Tons_______
.00
Declared HVAC Costs
PLUMBING INFORMATION: Plumbing Required? Yes_____ No_____ # of Plumbing Fixtures
Sewer/Septic Connection____
____
Utility Connection____ Well Connection____ Piping?____ Water Heater?____ Connection?____ Backflow Preventer?___ General? _____
Water Source____________________________ Water Company_____________________________________________
Sewer Source____________________________ Sewer Company____________________________________________
GAS INFORMATION: Gas Required? Yes_______ No_______ Type of Gas: (LP or Natural)____________________________
Tank Location: Above Ground
/Underground
Number of Gas Outlets
___________
___________
______________
ROOF INFORMATION: TYPE OF ROOF: Shingle
*Metal
*Tile
*Other
______
______
______
______________________________________________ Sloped_____
Low Sloped_____ Combination_____
* These roof types requires a licensed roofer (except for owner/builders)
FIRE INFORMATION: Fire Alarm Required?_______ Fire Protection Required?______ Sprinklers Required?______ Fire Alarm Provided?______
Sprinklers Provided?_______
Sprinkler Heads
Declared Fire Alarm Cost $
.00 Standpipes ________
____________
Siamese Connections_____ Roof Manifold Lines________
FLOOD ZONE: If the building is located in a 100 year Flood Hazard area (A, AE, AH, V), a FEMA Flood Certification form is required.
Flood Zone X_______ V_______ A_______ BASE FLOOD ELEV (A or V)__________Min Floor Elev___________.00
TREE CLEARING INFORMATION:
One Site Plan required showing the area to be cleared & location of tree protection barrier.
Tree Information: Lot size: Square Feet ________________________ Frontage __________________ft Depth ___________________ft
USE PERMIT INFORMATION:
One Site Plan required showing width of drive at property line & edge of road
***Pursuant to Chapter 556, Florida Statutes, as amended,
.
an excavator shall call 811, () before beginning excavation. The process takes 2 full business days. Day 1 starts the day after you call.***
Driveway? Yes_______ No________ Connected to Road Type: City _______
County _______ Private _______ State _______
Number of Culvert Pipes __________
Size ______________ Driveway approach to: Paved Rd ________ Unpaved Rd ________
CONSTRUCTION COSTS: DECLARED PROJECT COST: (Include labor & materials) $
.00
PERMIT INFORMATION: Permit to Complete? ________ After the Fact Permit? _______ Change of Use? ______ Additional Parking?_________
Primary Occupancy
Number of Dwelling Units
Number of Stories
Ground Floor Habitable?
_________________________________
_________
_________
________
Primary Use Area
Garage Area (Sq Ft)
Other
(Sq Ft)_________________________
___________________________
Area (Sq Ft)_________________________
Will the lowest floor level be 12” above any adjacent roads? Yes________ No________
TIED/RELATED PERMIT: TREE_________________________ USE__________________________ WETLAND____________________________
OTHER____________________________WELL PERMIT #_________________________________ SEPTIC PERMIT #_____________________________
ADDITIONAL STRUCTURES? Yes_____ No_____
Structure 1: ____________________________________________/__________________________sq ft
Structure 2: ____________________________________________/__________________________sq ft
Structure 3:____________________________________________/___________________________sq ft
Structure 4: ____________________________________________/__________________________sq ft
Structure 5: ____________________________________________/__________________________sq ft
Declared Construction Cost (Attached Structures Only
$
.00
): (include labor & materials)
PROPERTY ACCESS: Directions to property (Physical Location)
__________________________________________________________________________________
_______________________________________________________________________________GATE CODE________________________
Bonding Company Name______________________________________________ Address_________________________________________________________
Mortgage Lender’s Name______________________________________________ Address_________________________________________________________
Arch’s/Engr’s Name__________________________________________________ Address_________________________________________________________
July 2015
APPROVED BY _________________ (PERMIT OFFICER)
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