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City of Oldsmar Application for Roofing Permit

2. FLORIDA BUILDING AND ACCESSIBILITY CODE, 7th EDITION (2020) APPLIES

4. Permit No.

6. Property Owner Name

7. Address1

8. Phone

10. Email Address:

11. Project to be completed by licensed contractor?*

    1. Yes
    2. No (Owner/Builder)

13. Owner/Builder Affidavit
    Owner/Builder Affidavit

    Owner will be required to submit affidavit if acting as contractor for permit.

14. Owner/Builder Affidavit

16. Contractor's Name

17. Name of business:

18. Phone

20. Address1

21. Email Address:

22. Contractor’s State Registration No.

24. PCCLB No.

26. Job Address*

27. Legal Description

28. Area of improvement*

    (in sq ft)

30. Job Description*

32. Valuation*

33. Contract/Proposal

    Contract/Proposal must display total job valuation listed on the application.

35. Bonding Company

36. Address

38. Architect/Engineer’s Name

39. Address

41. Please complete the product approval spec sheet
    Product Approval Specifications Sheet

42. Upload Product Approval Specifications Sheet*

    Product approval sheet must be completed fully for permit to be processed.

46. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS 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.
    Notice of Commencement Form

    Must provide a duly recorded notice of commencement for construction projects valued in excess of $2,500.00

48. Upload Recorded NOC

50. ROOFING MUST BE SECURED WITH SIX (6) NAILS PER SHINGLE
    LOOSE LAID BALLASTED ROOF PERMITTED ONLY UPON RECEIPT OF REGISTERED ENGINEER CERTIFICATION THAT IT MEETS REQUIREMENTS OF FLORIDA BUILDING CODE CHAPTER 15. ALL ROOF COVERINGS NOT COVERED IN ROOFING CODE SHALL HAVE BUILDING DEPARTMENT APPROVAL PRIOR TO INSTALLATION. NOTICE OF COMMENCEMENT REQUIRED FOR CONTRACTORS ON JOBS OVER $2500.

    LOOSE LAID BALLASTED ROOF PERMITTED ONLY UPON RECEIPT OF REGISTERED ENGINEER CERTIFICATION THAT IT MEETS REQUIREMENTS OF FLORIDA BUILDING CODE CHAPTER 15. ALL ROOF COVERINGS NOT COVERED IN ROOFING CODE SHALL HAVE BUILDING DEPARTMENT APPROVAL PRIOR TO INSTALLATION. NOTICE OF COMMENCEMENT REQUIRED FOR CONTRACTORS ON JOBS OVER $2500.

52. 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, KITCHEN HOODS, FIRE SPRINKLERS, ALARM SYSTEMS, AND SHEDS, ETC.

    I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, KITCHEN HOODS, FIRE SPRINKLERS, ALARM SYSTEMS, AND SHEDS, ETC.

54. 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 roofing permit application is true and correct.

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

56. Building Permit Applications shall be submitted on paper and PDF format / CD, for review and contain all the items listed in the Residential or Commercial Application Packet. The construction permit fee is based on a $40.00 Base Fee, plus an additional $4.00 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 nonrefundable. Contractors must maintain, State License, PCCLB License, General Liability and Workman’s Compensation Insurance.

58. Print Name*

59. Check the one that applies to you*

    1. Owner
    2. Authorized Agent
    3. Contractor

61. 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.

62. Inspection Affidavit
    Inspection Affidavit

    Required to be completed and onsite for final roof inspection.

64. APPLICATION APPROVED BY:

    Permit Specialist / Building Official

65. Date:
    Date:

Leave This Blank:


67. 1. Receive an email copy of this form.
68. Email address

    This field is not part of the form submission.

69. Submit

* indicates a required field