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By checking the box below, I understand per F.S. 489.103(7)(a)(4)(c)(2), that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and is not hiring a licensed contractor to assume responsibility.

Application is hereby made to obtain a permit for the work as indicated above and I certify that no work has commenced and that all work will be performed to meet the standards of all laws regulating construction and zoning in this jurisdiction, whether specified herein or not. I understand: 1) Additional permits are required for Building, Mechanical, Electrical, Plumbing, Swimming Pools, Green Energy, Roofing, Fire Protection Systems, Signs, Fences, Driveways, Elevators, etc. and 2) Additional approvals may be required from other entities and 3) The right, title and interest of a person who has contracted for improvements may be subject to attachment under the Construction Lien Law and promise in good faith to provide a copy of the DBPR Construction Lien Law statement to any owner making improvements to real property. Issuance of a permit does not presume to give authority to violate or cancel the provisions of any other federal, state, or local laws. Unless owner builder exemption is elected, I certify the contracting firm listed above is authorized to act as my agent to obtain a permit for the work described herein. 

In lieu of signed, sworn and notarized signatures of the property owner, agent and/or contractor and under penalty of perjury, I declare that I have read and examined this application and all of the foregoing information is true and correct. Payment of required permit fees will make this application valid and binding to the same force and effect as handwritten signatures and that I may be required to provide traditional signatures at a later date. 

By checking the box below, I agree to conduct transactions with the City of Jacksonville Beach by electronic means. I agree that the electronic signature and date below serve as my signature authorization on permit applications and/or construction documents to be used for the review, approval, and issuance of building permits electronically. Furthermore, the electronic signature, date and payment of required fees will make this application valid and binding to the same terms, conditions, force and effect as handwritten signatures and that I may be required to provide traditional signatures at a later date.