Building Permit Application PDF Details

Application is hereby made to obtain a permit to do the work and installations as indicated.

Notice of commencement: A notice of commencement must be recorded and posted on the job site before the first inspection.

Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your property.

Separate permits: A separate permit may be required for electrical work, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, air conditioners, etc.

Certification: I certify that no work or installation has commenced prior to the issuance of a permit, OR this is an after-the-fact permit.

QuestionAnswer
Form NameBuilding Permit Application
Form Length2 pages
Fillable?Yes
Fillable fields59
Avg. time to fill out10 min
Issuing agencyCity of Daytona Beach Shores Building Department
Matches the agency's fileYes, checked November 3, 2026
Other namesBuilding Permit Application
Official sourceBuilding Permit Application, City of Daytona Beach Shores Building Department

How to Fill Out Building Permit Application

Building Permit Application at a glance

What it is: The Building Permit Application of the City of Daytona Beach Shores Building Department: application is hereby made to obtain a permit to do the work and installations as indicated.

Who signs: Both the owner and the contractor must sign the application.

A filled-in Building Permit Application example: an owner roofs a house

Building Permit Application example filled out, example: an owner roofs a house
Jane Ann Sample owns a house and applies for a building permit. She hires a contractor to replace the roof at a building cost of 9,500 with no change of use. The picture shows the form filled in; every value in it is made up. The building cost is 9,500 in all, so TOTAL COST equals the BUILDING amount. Nothing goes in ELECTRIC, PLUMBING, MECHANICAL or OTHER under cost of job because the whole job is roofing. Only RESIDENTIAL is ticked under current use because the house is lived in, and NO is ticked for the fire systems because the roof work does not affect them. No architect or engineer is hired, so the architect/engineer information stays empty. Nobody has started work, so the after-the-fact permit box stays empty. Both sign by hand before a notary public, so the sworn blocks of signing before a notary public stay empty in the picture.

How to fill out Building Permit Application, box by box

Date and property identification

Building Permit Application example filled out, date and property identification

Enter the DATE.

Under PROPERTY IDENTIFICATION, enter the BUSINESS NAME OR PROPERTY OWNER'S LAST NAME, the CONSTRUCTION ADDRESS and the PARCEL #.

Property owner information

Building Permit Application example filled out, property owner information

Under PROPERTY OWNER INFORMATION, enter the NAME, ADDRESS, PHONE #, CITY, STATE, ZIP and E-MAIL.

Under PROPERTY OWNER INFORMATION, the E-MAIL line is marked (Req).

Contractor information

Building Permit Application example filled out, contractor information

Under CONTRACTOR INFORMATION, enter the BUSINESS NAME, PHONE #, CONTACT NAME and CELL #.

Under CONTRACTOR INFORMATION, enter the ADDRESS, FAX #, CITY, STATE, ZIP and E-MAIL.

Enter the LICENSE HOLDER'S NAME and the FL LICENSE #.

Fire systems, current use and change of use

Building Permit Application example filled out, fire systems, current use and change of use

Mark No or Yes for "Will this work affect either the fire sprinkler or fire alarm systems in any way?"

Mark the CURRENT USE OF STRUCTURE: RESIDENTIAL, BUSINESS, STORAGE or ASSEMBLY.

Mark NO or YES for IS THIS A CHANGE OF USE?

Cost of job and description of work

Building Permit Application example filled out, cost of job and description of work

Under COST OF JOB, enter the BUILDING, ELECTRIC, PLUMBING, MECHANICAL and OTHER.

Enter the TOTAL COST.

Describe the GENERAL DESCRIPTION OF WORK TO BE DONE.

Architect/engineer information (if applicable)

Building Permit Application example filled out, architect/engineer information (if applicable)

Under ARCHITECT/ENGINEER INFORMATION (if applicable), enter the NAME, PHONE #, ADDRESS, FAX #, CITY, STATE, ZIP and FL LICENSE #.

Certification or after-the-fact permit

Building Permit Application example filled out, certification or after-the-fact permit

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 standard of all laws regulating construction in this jurisdiction, OR mark THIS IS AN AFTER-THE-FACT PERMIT (Additional permit fees will apply).

Signing before a notary public

Building Permit Application example filled out, signing before a notary public

Sign on the OWNER/AGENT SIGNATURE line and enter the OWNER/AGENT'S NAME (PRINTED).

Before a Notary Public, under the OWNER/AGENT SIGNATURE, at STATE OF and COUNTY OF: Sworn to and subscribed before me this day of 20, by who is personally known to me or has produced, and who did (did not) take an oath. My Commission Expires:

Sign on the CONTRACTOR'S SIGNATURE line and enter the CONTRACTOR'S NAME (PRINTED).

Before a Notary Public, under the CONTRACTOR'S SIGNATURE, at STATE OF and COUNTY OF: Sworn to and subscribed before me this day of 20, by who is personally known to me or has produced, and who did (did not) take an oath. My Commission Expires:

More rules for Building Permit Application

A separate permit may be required for electrical work, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, air conditioners, etc.

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 commencing work or recording your notice of commencement.

Common questions about Building Permit Application

What am I certifying when I sign?

By signing you certify that all the information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning.

Sources

[1] Building Permit Application, City of Daytona Beach Shores Building Department (the Official source link on this page).

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