City of Eustis Building Permit Application
City of Eustis Building Permit Application
111 E. Orange Avenue, P.O. Drawer 68, Eustis, FL 32727-0068
Telephone: 352-483-5462 – Fax: 352-589-2651
Code in Effect: Florida Building Code 2023, 8th Edition
BUILDING PERMIT APPLICATION PAGE 2
CONTRACTOR PLEASE COMPLETE INFORMATION AND SIGN IN APPROPRIATE BLOCK BELOW. BY SIGNING BELOW, I HEREBY SWEAR THAT I AM IN COMPLIANCE WITH FLORIDA'S WORKER'S COMPENSATION LAW AND THAT I HAVE SECURED COVERAGE OR HAVE A VALID CERTIFICATE OF EXEMPTION.
Permit Number:
Important!
Yes No (Check one) I am filling and/or excavating the property. If yes, provide the Finish Floor Elevation (FFE), lot corner elevations, and drainage plan for the site. Depending on the type of development, not all information will be required. Note: Failure to respond correctly will make you personally liable for future damages.
Yes No (Check one) I am filling and/or excavating the property. If yes, provide the Finish Floor Elevation (FFE), lot corner elevations and drainage plan for the site. Depending on the type of development, not all information will be required. Note: Failure to respond correctly will make you personally liable for future damages:
Important!
OWNER OR LESSEE
FAX NO.
NAME
MAILING ADDRESS
CITY
STATE
ZIP CODE
BONDING COMPANY
FEE SIMPLE TITLEHOLDERS (IF OTHER THAN OWNER)
NOT APPLICABLE
SAME AS OWNER
SAME AS OWNER
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NOT APPLICABLE
MORTGAGE LENDERS
NOT APPLICABLE
NOT APPLICABLE
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NOT APPLICABLE
DESIGN PROFESSIONAL
DESIGN PROFESSIONAL
LICENSE #
LICENSE #
LICENSE #
PRIMARY CONTACT EMAIL ADDRESS
PRIMARY CONTACT EMAIL ADDRESS
PRIMARY CONTACT EMAIL ADDRESS
PRIMARY CONTACT EMAIL ADDRESS
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PRIMARY CONTACT CELL PHONE NO.
PRIMARY CONTACT CELL PHONE NO.
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