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SEMBLUEINC COT ONLINE PERMITTING INFORMATION
SemBlueInc Online Permitting Pricing As the City of Tallahassee moves to an online permitting process, the procedure to obtain a permit has become
both easier and more difficult at the same time. While you can now file for a permit from virtually anywhere at any
time from your computer, the requirements to do so have become more rigid and require a certain degree of
computer skill and knowledge. Below is our prices for the different services we provide.
Full Set Packages
Individual Sheets
Residential - $100
Commercial 1 - $150 (up to 20 plan pages)
Commercial 2 - $250 (21 – 60 plan pages)
Commercial 3 - $350 (61 plan pages and above)
$10 per document
Price includes:
• Scanning documents for submittal
• Renaming pages per COT’s Naming Convention
• Attaching Digital Notarization Affidavit
• Required forms such as Owner Affidavit are FREE
with the initial upload
• Dedicated computer to upload project at our office
• Support staff to assist with any questions that may
arise while using the permitting website
• Informational packet with a step by step guide to
using the ProjectDox website
• Traditional Notary Services
• After your initial upload, resubmittals are $5.00 per
scan
Price includes:
• Scanning documents for submittal
• Renaming pages per COT’s Naming Convention
• Attaching Digital Notarization Affidavit
• All scans, including forms and plans, are considered
individual documents
If you have any questions, please contact us at [email protected], call 850-671-2714 or visit
www.semblueinc.com\permitting to find useful forms and videos.
SemBlueInc / City of Tallahassee Online Permitting Information and Helpful Documents
The purpose of this packet is to guide you through the COT’s Online Permitting Process. All of these forms, instructions, helpful documents and videos can be located on the City of Tallahassee’s website or at www.semblueinc.com/permitting. Our employees can assist you with the permitting process, including:
• scanning your paper copies • naming the digital files according to the city’s naming convention • applying a traditional Notary Seal • applying a digital Notary Seal • submitting your documents
Who needs to use the online permitting website? As of now, any commercial project over $25,000 must use this method. Projects under $25,000 and residential projects still use the traditional paper method. By late 2014 or 2015, all projects will need to go through the online permitting process.
For projects submitted digitally, the architect, engineer, consultant, etc. MUST sign the document with a digital signature AND a digital seal. If you do not have a digital seal, SemBlueInc can create an image that you can use to sign your documents.
Should you need assistance or help with your permitting needs, please contact SemBlueInc directly at:
[email protected] or 850-671-2714
We will gladly assist you and answer any questions you have or directly you to the person best suited to your particular question.
Important Contact Information
City of Tallahassee Growth Management Website http://www.talgov.com/growth/GrowthHome.aspx • There you will find a live chat portal to answer any questions
City of Tallahassee Growth Management Phone Number 850-891-7001
SemBlueInc Website http://www.semblueinc.com
SemBlueInc Email [email protected]
SemBlueInc Phone Number 850-671-2714
City of Tallahassee Account Setup
To begin the permitting process, you will log into the COT’s Online Permitting page:
https://cityprojects.talgov.net/OP/Login.aspx
If this is your first time permitting with the city, you must first create an account. To do so, you will need the following
information.
• Full Name *
• Business Name (optional)
• Professional License Number (if applicable)
• Telephone Number *
• Security Question *
• Answer *
• Email Address * (This will be your username. All official email correspondence will be sent to this email.)
• Password *
o 8-10 Characters o At least 1 uppercase letter o At least 1 lowercase letter o At least 1 digit o At least 1 special character o Example: Hello12#
* Denotes Required Field
City Of Tallahassee Online Permit Requirements
To permit through the city’s new online permitting process, there are certain pieces of information you must have.
If you would like for SemBlueInc to submit your documents directly, we will also need your username and password to the Account Setup website as well as the information below and all of your required documents. As part of our service, we can notarize any required documents.
TYPE OF PERMIT – Please Circle 1 • Land Use & Environmental Service Application
o Land Use Compliance Certificate o Zoning Verification
• Site Plan/Subdivision
o Pre-Submittal o Limited Partition o Preliminary Plat o Type A Site Plan Review o Type B Site Plan o Major Modification o Minor Modification
• Building Inspection Division
o Commercial Building Permit – If nothing is circled, we will choose this by default
STEP 1 – PROJECT INFORMATION • Parcel # - This can be found on the Leon County Property Appraisers website www.leonpa.org
o Parcel Identification Number
o Address
o Building Number / Unit Number (if applicable)
o Project Name
o Land Use Compliance Certificate Number LUCC (if applicable)
o Site Plan Approval Number (if applicable)
o Environmental Permit Number (if applicable)
o Concurrency Certificate Number (if applicable)
STEP 2 – CONTACT INFORMATION
Applicant Information – Applicant will be the main point of contact and receive emails and notifications from the
city.
o Affiliation – Applicant
o Email Address
o Name, Company or Business
o Mailing Address
o Suite, Floor, Unit, Apt., etc
o Attention
o City and State
o Zip Code
o Telephone Number
o Fax Number
Owner Information – To receive a permit you must have a signed/notarized Owner’s Affidavit. To begin the
permitting process, you must know the owner’s contact information. The city requires an applicant and an owner.
The owner can serve as both.
o Affiliation – Owner Owner is Applicant
o Email Address
o Name, Company or Business
o Mailing Address
o Suite, Floor, Unit, Apt., etc
o Attention
o City and State
o Zip Code
o Telephone Number
o Fax Number
Contractor/Architect/Engineer of Record Information – To receive a permit, you must have a licensed
contractor associated with the project. If the owner also serves as the contractor of architect/engineer, they must
enter themselves as such in addition to that of owner.
o Affiliation – Owner is Contractor Contractor Architect Engineer
o License Number
o Email Address
o Name, Company or Business
o Mailing Address
o Suite, Floor, Unit, Apt., etc
o Attention
o City and State
o Zip Code
o Telephone Number
o Fax Number
STEP 3 – PROJECT DESCRIPTION
Project Details – Applicant will need to know the following information to begin the permitting process.
o Is this permit to be Expedited – Yes or No
o Improvement Type – New/Addition/Renovation
o Building Classification – Please Circle 1 Classification
Triplex
Quadruplex Multi-Family
Hotel/Motel Dormitory
Warehouse Non-Building Structure
Subdivision Business
Amusement/Recreation Church/Other Religious
Industrial Parking Garage
Service Station/Repair Hospital/Institutional
Office Building Public Building/Utility
Educational/School Stores/Mercantile
Daycare Multi Use
Accessory Structure Restaurant
Cellular Tower
o Square Footage of New or Addition
o Total Cost of Improvement (do not use $ , or . )
o Cost of Alteration Improvement only
o Brief Scope of Work
o Trades involved with this project – HVAC Electric Plumbing Gas Fire
o Change of Use – Yes or No
o Existing or Previous Use
o Proposed Use
o Shell Permit – Yes or No
o Occupied by State of Florida – Yes or No
o Is this Structure on the Historical Preservation Registry – Yes or No
o Hazardous Material Being Removed – Yes or No
• Water & Sewer Account Information – For new construction, you will need to enter the utility information. For a renovation project, you can leave it blank.
o Utility Account – Use Master Utility Account or Create a New Utility Account
o When to Ship Work Orders – Ship order @ Permit Issuance or Delay & Ship work order until...
o Delay Until Date
o Utility Account Number
o Utility Account Holder's Name
o Utility Account Holder's Telephone Number
FORMS,
CHECKLISTS &
HELPFUL INFORMATION
Growth Management Department | Building Inspection Division | Phone: (850)891-7001 | Fax: (850)891-0948
Location: 435 N. Macomb Street, Tallahassee, FL 32301 | Mailing: 300 S. Adams Street B-28, Tallahassee, FL 32301
BI FORM CL-COM_BDLG_ONLINE, 4/04/2014 PREVIOUS EDITIONS ARE OBSOLETE 1
COMMERCIAL BUILDING PERMIT ONLINE APPLICATION CHECKLIST
1) Land Use Approval TCC # ______________if required per LUES Division requirements.
2) Site Plan Approval TSP # _______________if required per LUES Division requirements.
3) Environmental Permit TEM # ___________if required per LUES Division requirements or, Simultaneous Review Form
4) Concurrency Certificate TCM #_________ if required per Concurrency Division requirements.
5) Owner’s Affidavit, signed by owner of property & digitally notarized. A Florida Licensed Contractor must be listed as the Owner’s Agent.
6) Florida Lien Law Acknowledgement Form if owner is acting as contractor under FS 489.103 . 7) Disclosure Statement, signed by property owner & digitally notarized if owner is acting as contractor under Florida
Statute 489.103. 8) Utility Approvals (includes all new or upgraded electrical services, generators, and connections to City water and or
sewer system) - To streamline your utility reviews and approval, the following information must be uploaded with your electronic submission of plans:
a) Site plan with proposed utilities and building footprint b) An electrical riser diagram indicating the following
1) Requested service voltage, nominal service size, conduit and conductor sizes 2) Preference for overhead (OH) or underground (UG) service 3) All components including: meter socket, disconnects, etc., 4) The distribution panel schedule with connected and calculated loads 5) Generator agreement (if generator is proposed)
c) Indicate the physical locations of the meter socket, current transformer (C/T) and potential transformer (P/T) can, and the main service disconnect
d) Proposed water lines, plumbing riser diagram and backflow assemblies
9) Digitally signed (3rd party verified) plans including architectural, mechanical, electrical & plumbing sheets as applicable to the project.
10) Florida Building Code, Energy Conservation Form 502 or 506 including Input Data Report, digitally signed and sealed
with original signatures as required on the “Certifications” . 11) HVAC load sizing calculations are required for new buildings, all new/replaced HVAC equipment, any project adding
additional conditioned area to an existing building, and any change of use of a space (i.e. office to restaurant).
12) Digitally signed and sealed Soils Report if new buildings and any other building or addition > 400 sq. ft.
13) Digitally sealed project specifications if applicable.
Growth Management Department | Administration Division | Phone: (850)891-7001 | Fax: (850)891-0948
Location: 435 N. Macomb Street, Tallahassee, FL 32301 | Mailing: 300 S. Adams Street B-28, Tallahassee, FL 32301
ADMIN FORM FM-CP_DIGITAL_SIGNATURE_DOC_LIST, 5/27/2014 PREVIOUS EDITIONS ARE OBSOLETE 1
CITY PROJECTS LIST OF REQUIRED DIGITALLY SIGNED & SEALED OR NOTARIZED DOCUMENTS
COMMERCIAL BUILDING PERMIT APPLICATION
• Plans on projects valued at $25,000 and greater must be digitally signed and sealed by an architect or engineer. • Specification Manual must be digitally signed and sealed by an architect or engineer. • Soils Report must be digitally signed and sealed by an engineer. • Energy Calculation must be digitally signed by the preparer, and digitally signed and sealed by the design professionals as listed on the
certification page. • Summary Sheet from Pre-Engineered Building must be digitally signed and sealed by engineer. • Specialty Engineering and Shop Drawing must be digitally signed and sealed by an engineer. • Mechanical, Electrical and Plumbing Plans designed by a contractor as authorized in Chapter 471, of the Florida Statutes, must be
digitally signed. • Mechanical, Electrical and Plumbing Plans designed by an engineer as required in Chapter 471, of the Florida Statutes, must be digitally
signed and sealed. • Ownership Affidavit must be digitally notarized by a notary. • Owner Builder Disclosure Affidavit must be digitally notarized by a notary. • Notice of Commencement must be digitally notarized by a notary. • Tower Permit Lessee Authorization Form must be digitally notarized by a notary. • Simultaneous Review Form must be digitally signed notarized by a notary.
TYPE A SITE PLAN REVIEW • Boundary Survey must be digitally signed and sealed by surveyor/engineer. • Owner’s Affidavit must be digitally notarized by notary.
TYPE B SITE PLAN REVIEW
• Boundary Survey must be digitally signed and sealed by surveyor/engineer. • Owner’s Affidavit must be digitally notarized by notary. • Sign Posting Affidavit must be digitally notarized by a notary.
LIMITED PARTITION REVIEW • Recording Affidavit must be digitally notarized by a notary. • Boundary Survey must be digitally signed and sealed by surveyor/engineer. • Sign Posting Affidavit must be digitally notarized by a notary. • Owner’s Affidavit must be digitally notarized by notary.
PRELIMINARY PLAT REVIEW • Boundary Survey must be digitally signed and sealed by surveyor/engineer. • Sign Posting Affidavit must be digitally notarized by a notary. • Owner’s Affidavit must be digitally notarized by notary.
MAJOR & MINOR MODIFICATIONS • Boundary Survey must be digitally signed and sealed by surveyor/engineer. • Owner’s Affidavit must be digitally notarized by notary.
City of Tallahassee Growth Management Department reserves the right to request additional unlisted documentation be submitted digitally signed, sealed or e-notarized. For more information on digital signatures, seals and e-notary please visit: http://www.talgov.com/growth/growth-certauthorities.aspx
Growth Management Department | Building Inspection Division | Phone: (850)891-7001 | Fax: (850)891-0948
Location: 435 N. Macomb Street, Tallahassee, FL 32301 | Mailing: 300 S. Adams Street B-28, Tallahassee, FL 32301
BI FORM FM-BP_NAMING_CONVENTION, 5/29/2014 PREVIOUS EDITIONS ARE OBSOLETE 1
ONLINE BUILDING PERMIT NAMING CONVENTION OF DOCUMENTS
Naming Convention of Documents
Please Read: All documents and plans are to be rotated properly. Documents are to be submitted as a single document package. Plans are to be submitted as individual sheets. When resubmitting documents or plans the resubmittal must be named as it was when it was originally uploaded. Documents and plans that are uploaded incorrectly will be denied and returned to the applicant for proper submittal.
Document / Form / Affidavit Naming Convention Link to / Example Folder
Owners Affidavit OwnersAff.pdf
http://www.talgov.com/Uploads/Public/Documents/growth/pdf/owners-affidavit.pdf
Affidavits and General Information
Tower Lessee Permit Authorization TowerLesAuth.pdf
http://www.talgov.com/Uploads/Public/Documents/growth/pdf/forms/tower_permit_lessee_authorization.pdf
Affidavits and General Information
Lien Law Acknowledgement LienLaw.pdf
http://www.talgov.com/Uploads/Public/Documents/growth/pdf/construction_lien_law_summary_acknowedgement.pdf
Affidavits and General Information
Contractor of Record Acknowledgement ContrRecAck.pdf
http://www.talgov.com/Uploads/Public/Documents/growth/pdf/forms/fm_contractor_record.pdf
Affidavits and General Information
Owner Builder Disclosure OBDiscl.pdf
http://www.talgov.com/Uploads/Public/Documents/growth/pdf/forms/ownr-bldr-dsclsr-affdvt.pdf
Affidavits and General Information
Notice of Commencement NOC.pdf
http://www.clerk.leon.fl.us/sections/clerk_services/online_forms/official_records/notice_of_commencement.pdf
Affidavits and General Information
Multiple Building Permit Online Application MultiBldg(bldg #).pdf
http://www.talgov.com/Uploads/Public/Documents/growth/pdf/forms/multi-bldg-permit-app.pdf
Affidavits and General Information
Agent Authorization letter (Site Specific) AgentAuth.pdf
Affidavits and General Information
Simultaneous Review Form SimtRevw.pdf
http://www.talgov.com/Uploads/Public/Documents/growth/pdf/forms/simultaneous_review.pdf
Affidavits and General Information
Signed and Sealed Soils Report SoilRept.pdf
Soils Report
Energy Form Project Summary ProjSum.pdf
Energy Form(s) and Calculations
Energy Form InPut Summary InputSum.pdf
Energy Form(s) and Calculations
HVAC Load Calculations LoadCalc.pdf
Energy Form(s) and Calculations
Growth Management Department | Building Inspection Division | Phone: (850)891-7001 | Fax: (850)891-0948
Location: 435 N. Macomb Street, Tallahassee, FL 32301 | Mailing: 300 S. Adams Street B-28, Tallahassee, FL 32301
BI FORM FM-BP_NAMING_CONVENTION, 5/29/2014 PREVIOUS EDITIONS ARE OBSOLETE 2
Fresh Air Calculations FreshAirCalc.pdf
Energy Form(s) and Calculations
Architectural Plans ArchPlans(page #).pdf
Example: ArchPlans01.pdf, ArchPlans02.pdf NOTE: When resubmitting plan sheets, if you need to insert a page between two other pages please use an underscore (_) and a number after the page number as depicted in the following example: ArchPlans01_1.pdf When uploaded to the project, this example would fall after the ArchPlans01.pdf sheet. Architectural Plans
Structural Plans StrucPlans(page#).pdf
Example: StrucPlans01.pdf, StrucPlans02.pdf NOTE: When resubmitting plan sheets, if you need to insert a page between two other pages please use an underscore (_) and a number after the page number as depicted in the following example: StrucPlans01_1.pdf When uploaded to the project, this example would fall after the StrucPlans01.pdf sheet. Structural Plans
Electrical Plans ElecPlans(page #).pdf
Example: ElecPlans01.pdf, ElecPlans02.pdf NOTE: When resubmitting plan sheets, if you need to insert a page between two other pages please use an underscore (_) and a number after the page number as depicted in the following example: ElecPlans01_1.pdf When uploaded to the project, this example would fall after the ElecPlans01.pdf sheet. Electrical Plans
Growth Management Department | Building Inspection Division | Phone: (850)891-7001 | Fax: (850)891-0948
Location: 435 N. Macomb Street, Tallahassee, FL 32301 | Mailing: 300 S. Adams Street B-28, Tallahassee, FL 32301
BI FORM FM-BP_NAMING_CONVENTION, 5/29/2014 PREVIOUS EDITIONS ARE OBSOLETE 3
ONLINE BUILDING PERMIT NAMING CONVENTION OF DOCUMENTS
Plumbing Plans PlumPlans(page #).pdf
Example: PlumPlans01.pdf, PlumPlans02.pdf NOTE: When resubmitting plan sheets, if you need to insert a page between two other pages please use an underscore (_) and a number after the page number as depicted in the following example: PlumPlans01_1.pdf When uploaded to the project, this example would fall after the PlumPlans01.pdf sheet. Plumbing Plans
Mechanical Plans MechPlans(page #).pdf
Example: MechPlans01.pdf, MechPlans02.pdf NOTE: When resubmitting plan sheets, if you need to insert a page between two other pages please use an underscore (_) and a number after the page number as depicted in the following example: MechPlans01_1.pdf When uploaded to the project, this example would fall after the MechPlans01.pdf sheet. Mechanical Plans
Gas Plans GasPlans(page #).pdf
Example: GasPlans01.pdf, GasPlans02.pdf NOTE: When resubmitting plan sheets, if you need to insert a page between two other pages please use an underscore (_) and a number after the page number as depicted in the following example: GasPlans01_1.pdf When uploaded to the project, this example would fall after the GasPlans01.pdf sheet. Gas Plans
Growth Management Department | Building Inspection Division | Phone: (850)891-7001 | Fax: (850)891-0948
Location: 435 N. Macomb Street, Tallahassee, FL 32301 | Mailing: 300 S. Adams Street B-28, Tallahassee, FL 32301
BI FORM FM-BP_NAMING_CONVENTION, 5/29/2014 PREVIOUS EDITIONS ARE OBSOLETE 4
Supporting Documents for Land Use and Environmental Services Example.pdf
Land Use and Environmental Services
Utility Plans UtilityPlans(page #).pdf
Example: UtilityPlans01.pdf, UtilityPlans02.pdf NOTE: When resubmitting plan sheets, if you need to insert a page between two other pages please use an underscore (_) and a number after the page number as depicted in the following example: UtilityPlans01_1.pdf When uploaded to the project, this example would fall after the UtilityPlans01.pdf sheet. Utility Plans
Specifications Manual SpecManual.pdf
Specifications Manual
Wind Load Analysis Wind.pdf
Special Engineering Engineered Shop Drawings ShopDraw.pdf
Special Engineering
PreEngineered Metal Buildings PreEngBldg.pdf
Special Engineering
Hotel and Restaurant Approval HotelRest.pdf
Other Agencies
Other Agencies Supporting Documentation Example.pdf
Other Agencies
Threshold Inspection Plans ThresInsp.pdf
Miscellaneous
Owners Designation of Threshold Inspector OwnerLetter.pdf
Miscellaneous
Shoring and Re-Shoring Plans ShoringPlan.pdf
Miscellaneous
Private Provider Documentation PrivProv.pdf
Miscellaneous
Other Supporting Documentation Example.pdf
Miscellaneous
Growth Management Department | E-Government Services | Phone: (850) 891-7078 | [email protected]
Location: 435 N. Macomb Street, Tallahassee, FL 32301 | Mailing: 300 S. Adams Street, Box B 28, Tallahassee, FL 32301
ADMIN FORM FM-ORIGINAL_DOC_AFF, 10/18/2012 PREVIOUS EDITIONS ARE OBSOLETE 1
ORIGINAL DOCUMENT NOTARY PUBLIC AFFIDAVIT
The intended use of this document is to allow for a Notary Public to attest that the photocopy of a document being transmitted electronically is a true and correct copy of the original document. The digitally signed Notary Public Affidavit can be used for any instance where a photocopy is being made of a signed and sealed document for the purposes of submitting for a City Projects review. One digitally signed Notary Public Affidavit must be submitted for each occurrence of a copy of an original document made for the purpose of submitting to City Projects. When using this Notary Public Affidavit, please follow these steps when creating your document for submittal to City Projects:
1) Scan the original signed and sealed document. 2) Create a PDF where this Notary Public Affidavit is the first page, followed by
the scanned copy of the original document. 3) Be sure that all of the pages of the scanned copy are in the same order as the
original document and rotated correctly. 4) Name the document according to the document’s specific naming convention
as outlined at: http://www.talgov.com/Uploads/Public/Documents/growth/pdf/std_naming_conventions.pdf
5) Complete the Notary Public Affidavit and digitally sign the PDF.
Project #: __________________________________ Project Name: __________________________________
Address: __________________________________ Parcel #: __________________________________ STATE OF FLORIDA COUNTY OF __________ On this _____ day of __________, ____ , I attest that the preceding or attached document is a true, exact, complete, and unaltered photocopy made by me of ____________________________________________ presented to me by the document's custodian, ____________________, and, to the best of my knowledge, that the photocopied document is neither a vital record nor a public record, certified copies of which are available from an official source other than a notary public. ________________________________________ (Notary Public digital signature and seal)
Growth Management Department | Location: 435 N. Macomb Street | Mailing: 300 S. Adams Street Box B 28, Tallahassee, FL 32301
Land Use & Environmental Services Division | Phone: (850) 891-7100 | Fax: (850) 891-7184 Building Inspection Division | Phone: (850) 891-7125 | Fax: (850) 891-0948
ADMIN FORM AF-OWNERS, 10/18/2012 PREVIOUS EDITIONS ARE OBSOLETE 1
OWNERSHIP AFFIDAVIT &
DESIGNATION OF AGENT
I. Ownership.
I, , hereby attest to ownership of the property described below: Parcel I.D. Number(s) Location address: for which this Application is submitted. The ownership, as recorded on the deed, is in the name of: Please complete the appropriate section below: NOTE: The person signing under section IV Acknowledgement, must
be listed below as an officer or partner. • Individual • Corporation/Limited Liability
Company (LLC)
• Partnership
Provide Names of Officers/Members: Provide Names of General Partners: • Government Entity ________________________________ _______________________________ ________________________________ _______________________________ ________________________________ _______________________________ ________________________________ _______________________________ Dept. of State Registration No.: ________________________________ Name/Address of Registered Agent: ________________________________ ________________________________ ________________________________ II. Designation of Owner's Agent. (Leave blank if not applicable) As the owner of the above designated property and the applicant for which this affidavit is submitted, I wish to designate the below named party as my agent in all matters pertaining to the location address. In authorizing the agent named below to represent me, or my company, I attest that the application is made in good faith and that any information contained in the application is accurate and complete to the best of my knowledge and belief. (Note: Prior to the issuance of a building permit,
the owner’s agent must be the contractor listed on the permit application.) Owner’s Agent: Address: Contact Person: Telephone No.: III. Notice to Owner. A. All changes in Ownership & Applicant's Agent prior to issuance shall require new affidavit. If ownership changes the
new owner assumes the obligations and the original applicant is released from responsibility for actions taken by others after the change in ownership.
B. If the Owner intends the Designation of Applicant's Agent to be limited in any manner, please indicate the limitation
below. (i.e., Limited to obtaining a certificate of concurrency for the parcel; limited to obtaining a land use compliance certificate; etc.)
Growth Management Department | Location: 435 N. Macomb Street | Mailing: 300 S. Adams Street Box B 28, Tallahassee, FL 32301
Land Use & Environmental Services Division | Phone: (850) 891-7100 | Fax: (850) 891-7184 Building Inspection Division | Phone: (850) 891-7125 | Fax: (850) 891-0948
ADMIN FORM AF-OWNERS, 10/18/2012 PREVIOUS EDITIONS ARE OBSOLETE 2
IV. Acknowledgement. • Individual • Corporation/LLC • Partnership
_______________________________ ________________________________ ________________________________
Signature Print Corporation/LLC Name Print Partnership Name Print Name:______________________ By:_____________________________ By:_____________________________ Address:________________________ Signature Signature
_______________________________ Print Name:______________________ Print Name:______________________ Phone #:________________________ Its:_____________________________ Its:_____________________________ Address:_________________________ Address:_________________________ • Government Entity ________________________________ ________________________________ Phone #:_________________________ Phone #:_________________________ _______________________________ Print Government Name By:____________________________
Signature Print Name:_____________________ Title:___________________________ Department:_____________________
NOTARY INFORMATION (Please use appropriate block.)
STATE OF
COUNTY OF
• Individual • Corporation/LLC • Partnership
Before me, this ________ day of _________________, 20___, personally appeared _________________________ who executed the foregoing instrument, and acknowledged before me that same was executed for the purposes therein expressed. _________________________________________
• Government Entity
Before me, this ________ day of ______________, 20___, personally appeared ___________________ ______________ as _________________________ and on behalf of ___________________________, who executed the foregoing instrument, and acknowledged before me that same was executed for the purposes therein expressed.
Before me, this ________day of ____________________, 20___, personally appeared _________________________ of ___________________________, a ________________corporation/ (State)
LLC, on behalf of the corporation/ LLC, who executed the foregoing instrument and acknowledged before me that same was executed for the purposes therein expressed.
Before me, this ________ day of__________________, 20___, personally appeared ____ ___________________________, partner/agent on behalf of ___________________________, a partnership, who executed the foregoing instrument and acknowledged before me that same was executed for the purposes therein expressed.
________________________________ Signature of Notary
________________________________ Print Notary Name
NOTARY STAMP:
My commission expires:__________________ Identification Method: _____ Personally known. _____ Produced I.D. – Type:_____________________
Growth Management Department | Building Inspection Division | Phone: (850)891-7001 | Fax: (850)891-0948
Location: 435 N. Macomb Street, Tallahassee, FL 32301 | Mailing: 300 S. Adams Street B-28, Tallahassee, FL 32301
BI FORM FM-CONTRACTOR_RECORD, 5/29/2014 PREVIOUS EDITIONS ARE OBSOLETE 1
CONTRACTOR OF RECORD ACKNOWLEDGEMENT
I, _______________________________________________, the qualifier or authorized agent for Qualifier or Authorized Agent _________________________________________________, acknowledge that we will be the contractor of Business Name record for ____________________________________________. Project Address
___________________________________________________ _________________________ Signature of Qualifier or Authorized Agent Date Please Note: The qualifier or authorized agent of the qualifier must complete and sign the document above. The completed and signed document must be scanned and uploaded to the project.
Growth Management Department | Building Inspection Division | Phone: (850)891-7125 | Fax: (850)891-0948
Location: 435 N. Macomb Street, Tallahassee, FL 32301 | Mailing: 300 S. Adams Street B-28, Tallahassee, FL 32301
BI FORM FM-CONTRACTOR_AUTH, 01/24/2012 PREVIOUS EDITIONS ARE OBSOLETE 1
CONTRACTOR AUTHORIZATION FORM
NOTICE: This form must be turned in or mailed to our office. Emailed or faxed documents will not be accepted.
Name of Firm Licensed: Qualifier: Title: Qualifier’s License Number:
AGENT(S) NAME
(please print or type)
1. 6.
2. 7.
3. 8.
4. 9.
5. 10.
The above named individuals are authorized to sign for permits and transact business for the company identified above. I understand that it is my sole responsibility as the qualifying contractor to keep this information current and resubmit a new accurate authorization form each time a change needs to be made to the above list of individuals.
SIGNATURE OF QUALIFIER DATE STATE OF, COUNTY OF: The foregoing instrument was acknowledged before me by
who is personally known to me or who has produced
as identification and who did not take an oath.
WITNESS my hand and official seal this _____day of ________________A.D., 20_____. _______________________________ _______________________________ Notary Public State of Florida at Large Notary Public Seal
CUSTOM DIGITAL SEAL ORDER FORM Complete this form to order your custom digital seal. Step 1 – Seal Information Name:
State:
License Number: License Type:
Step 2 – Billing Information Firm Name:
Contact:
Address:
City: State: Zip Code:
Phone Number: Email Address:
If you or your firm DOES NOT has an account, you can order your seal by: • Completing the Credit Application, http://www.semblueinc.com/tax-forms-certificates.html, and sending it back
with this form to open an account • Emailing your credit card information to [email protected] • Entering your credit card information below:
o Name on Card:
o Credit Card Number:
o Expiration Date: CCVS Number:
o Billing Address Number and Zip Code:
Step 3 – Proof We will email a proof to the address indicated in Step 2 to confirm all information. All information will need to be checked for accuracy before we email you the final seal. Any changes made after that will be considered as a new order. Step 4 – Electronic Seal We will email a Pdf, Tiff and Gif to the address indicated in Step 2. PRICING Individual Seal $50 Multiple Seals for a Single Firm $35 for each seal