Dbpr Hr 7025 Form PDF Details

In the State of Florida, the proper operation and maintenance of elevators are regulated to ensure public safety and compliance with established standards. The Division of Hotels and Restaurants, Bureau of Elevator Safety, facilitates these regulations through various forms, with the DBPR HR-7025 form playing a crucial role in the process. This particular form serves as an Application for Certificate of Operation, a necessary step for anyone seeking authorization to operate an elevator within the state. It covers essential details, including the elevator's serial number, building information, the responsible elevator maintenance company's details, and the applicant's signature to attest to understanding their obligations towards the elevator's safe operation and upkeep. Additionally, it mentions the legal ramifications for failing to adhere to these responsibilities, including the requirement to disclose a social security number for the purpose of assuring compliance with child support obligations, shedding light on the intertwining of public safety and social responsibilities. The form is available through the Department of Business and Professional Regulation, highlighting the procedural steps and contact information for applicants seeking further assistance.

QuestionAnswer
Form NameDbpr Hr 7025 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesE-mail, dhr, dhr elevators myfloridalicense, myfloridalicence com

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DBPR HR-7025– Division of Hotels and Restaurants, Bureau of Elevator Safety

Application for Certificate of Operation

STATE OF FLORIDA

DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION

1940 North Monroe Street

Tallahassee, FL 32399-0783

Phone: 850.487.1395 – E-mail: dhr.elevators@dbpr.state.fl.us

www.MyFloridaLicense.com/dbpr/hr

Please direct questions about this application to the Department of Business and Professional Regulation’s Customer Contact Center at 850.487.1395. Information is also available online at www.MyFloridaLicense.com/dbpr/hr/.

SECTION 1 - ELEVATOR SERIAL NUMBER

As provided on the Permit to Install, Alter or Relocate or the previous Certificate of Operation

Serial Number

Note: The serial number must be present or the application will be returned.

 

 

SECTION 2 – BUILDING INFORMATION

Note: If the information below has changed since the

Permit to Install, Alter or Relocate was issued, please provide the updated information.

Primary Name (enter name of the building owner)

Main Address (enter building address)

City

County

State

Zip Code

D/B/A Name (enter Business Name or Doing Business As Name of the building)

MAILING INFORMATION

Name

Mailing Address

City

State

Zip Code

 

 

CONTACT INFORMATION

 

 

Contact Name

Primary Business Phone Number

 

Primary E-Mail Address

Alternate Phone Number or Fax Number

SECTION 3 – ELEVATOR COMPANY INFORMATION (FOR SERVICE MAINTENANCE CONTRACT HOLDERS)

Organization Name

Address

License Number

(Registered Elevator Company)

City

State

Zip Code

SECTION 4 – APPLICANT SIGNATURE

Pursuant to Sections 399.03 and 399.07, Florida Statutes, the undersigned hereby applies for Certificate of Operation for an elevator in the building located at the address indicated. I understand the elevator owner is responsible for the safe operation, proper maintenance, fees, and annual inspection and prompt correction of code deficiencies of the elevator.

Authorized Signature of Applicant

 

Date Signed

 

 

 

 

 

 

Social Security Number*

Date Submitted

Fee Amount Enclosed

Application Update

 

 

$

Yes

No

*Under the Federal Privacy Act, disclosure of Social Security Numbers is voluntary unless specifically required by Federal statute. In this instance, disclosure of social security numbers is mandatory pursuant to Title 42 United States Code, Sections 653 and 654; and sections 409.2577, 409.2598, and 559.79, Florida Statutes. Social Security numbers are used to allow efficient screening of applicants and licensees by a Title IV-D child support agency to assure compliance with child support obligations.

2009 October 14

Page 1 of 1

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