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City of Oldsmar Application for Mechanical Permit

2. 7th Edition (2020) FLORIDA MECHANICAL/ENERGY CONSERVATION CODE APPLIES

4. Permit #

5. NOC (if over $7,500)

7. Property Owner's Name*

8. Phone

9. Address

11. Contractor's Name*

12. Phone

13. Address

15. Email Address:*

16. Contractor's State License*

17. PCLLB No.*

19. Job Address*

20. Job Description*

22. Legal Description/Parcel ID

23. Area of improvement:

    (in sq ft)

24. Total job costs*

26. Bonding Company

27. Address

28. Architect/Engineer's Name

29. Address

31. Mechanical Fee Schedule
    

    Base Fee, Residential and Commercial: $50.00---Residential, New (per dwelling unit) Base Fee + $5.00 for each additional $1000 or fraction over $1,000 --- Residential AC Unit Replacement: $50.00 --- Commercial, New or replacement: Permit Fee is based on Total Value of project - See Fee Schedule Table

33. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENT TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT
    Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced 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. I understand that a separate permit must be secured for STRUCTURAL, ELECTRICAL WORK, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, ETC.

    Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced 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. I understand that a separate permit must be secured for STRUCTURAL, ELECTRICAL WORK, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, ETC.

35. OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning.
    OWNER'S ELECTRONIC SUBMISSION STATEMENT: Under penalty of perjury, I declare that all the information contained in this mechanical permit application is true and correct.

    OWNER'S ELECTRONIC SUBMISSION STATEMENT: Under penalty of perjury, I declare that all the information contained in this mechanical permit application is true and correct.

37. Permit Applications shall be submitted on paper and .PDF format, for review and contain all the items listed. In addition, building, plumbing, electrical, and environmental plans shall be submitted to secure this permit, when applicable. The construction permit fee is based on a $50.00 fee, plus additional fees according to value per thousand of valuation or fraction thereof. Application is valid for 180 days. Permit is extended for 6 months after each successful inspection. Permit expires after 1 year. Permit fee is non-refundable.
    Contractors must maintain, State License, General Liability and Workman's Compensation Insurance.

    Contractors must maintain, State License, General Liability and Workman's Compensation Insurance.

39. MECHANICAL INSTALLATION TO BE COMPLETED*

    Select Jobs Being Completed

    1. A/C Heat Pump (new)
    2. A/C Heat Pump (change out)

    1. Refrigeration Unit
    2. Clothes Dryer

    1. Range Hood
    2. Broiler

    1. Commercial Hood
    2. Other
41. Size and Seer

42. Other

    State the work being done

43. Select One

    1. Owner
    2. Authorized Agent
    3. Contractor

45. Print Name*

46. Signature:*

    By typing your name here, you are signing this form electronically. You agree you are submitting this application for processing and is the legal equivalent of your manual signature on this form. You must be the legal property owner/qualified license holder or authorized agent which match our registration records.

47. Date:
    Date:

49. Approved by:

Leave This Blank:


51. 1. Receive an email copy of this form.
52. Email address

    This field is not part of the form submission.

53. Submit

* indicates a required field