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    Annual Program Decal Online - 2024 Registration Application

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    pom12seed

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    © All Rights Reserved
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    Annual Program Decal Online - 2024 Registration Application

    Uploaded by

    pom12seed
    2 views2 pages

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    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
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    Download as pdf or txt
    2 views2 pages

    Annual Program Decal Online - 2024 Registration Application

    Uploaded by

    pom12seed

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    PALM BEACH COUNTY BUILDING DIVISION

    DECAL ONLINE PERMIT REGISTRATION APPLICATION


    FOR REPLACEMENT OF
    MECHANICAL UNITS AND WATER HEATERS

    Building Division Use Only

    D.R #__________________________ Submittal Date _______________________

    _______________________________________________________________________________
    CONTRACTOR INFORMATION
    TYPE OF WORK ALLOWED

    Company Name:___________________________ (Please Check Work for Which Application is


    Being Made)
    Address:____________________ _____________
    _____ MECHANICAL
    Apt/Bay/Suite #____________________________ 1 & 2 Family Dwelling Air Conditioning Change
    Outs
    City: ________________State: _____Zip:_______
    _____ PLUMBING
    Contact Name: ____________________________ 1 & 2 Family Dwelling water heater (WH)
    replacement within or serving individual dwelling
    Phone: ________________________ _______ unit.

    Email: ___________________________________ _____ ELECTRIC


    Equipment must be installed at or above the finish floor
    Minor electric disconnect for water heater and
    elevation of the habitable area of the dwelling unit.
    Contractor License No. ______________________ mechanical systems authorized under a decal
    For those installations chosen for random inspections,
    Qualifier: _________________________________ the contractor is responsible for moving appliance or
    (PRINT)
    other obstacles and providing necessary access to allow
    thorough inspection.
    Qualifier Signature: _________________________

    STATE OF FLORIDA
    COUNTY OF PALM BEACH
    Sworn to or affirmed before me by means of □ physical presence or □ online notarization

    this ______ day of ____________, ______


    (month) (year)
    by____________________________________________________, who is
    (Name of Person Acknowledging)

    personally known to me or has produced __________________ as Identification.

    OFFICE USE ONLY:


    Number of Inactive permits (past 2010):
    ________________________________ Notary State of Florida
    (Signature of Notary Public) ______ Primary _______ Sub

    ________________________________ Name of Notary (typed, printed or stamped) ______ Number of Complete permits
    DECAL PERMIT PROGRAM APPLICATION INSTRUCTIONS

    1.) Contractor/Qualifier completes The “Contractor Information” portion of form.

    2.) Contractor applies online – REQUEST TO REGISTER IN DECAL PROGRAM

    3.) The Chief Inspector may require a meeting with Contractor prior to action.

    4.) Contractors who submit a non-qualifying application will be notified by email. The review fee (50%
    annual fee) for the application is non-refundable.

    5.) If approved, the program acceptance letter will be emailed to contractor along with an invoice for the
    balance due (50% annual fee).

    6.) Permit program acceptance is administered through the Decal Manager. Cost of Annual Permit
    program participation is $250.00.

    NOTE: State Law requires a certified copy of a recorded Notice of Commencement (NOC) to be filed with the
    Building Division if work exceeds $5000, or is equal to or greater than $15000 for Air Conditioning change outs.
    For work exceeding these thresholds, contractors are to attach a certified copy of the recorded NOC to the
    Owner Waiver before sending to the Decal Office. FORMS ARE AVAILABLE IN THE PERMIT CENTER OR VIA
    WEBSITE: www.pbcgov.com/pzb/building .

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