Emergency Work Notification

Emergency Work Notification
Florida Building Code Sec. 105.2.1 – Emergency Repairs
Where equipment replacements and repairs must be performed in an emergency, the permit application shall be submitted within the next working business day to the Building Official.

This form is required for notification of emergency work performed prior to permit issuance. A permit application must be submitted by the next working business day.
Date*

MonthDayYear
Date
License Number*
Company Name*
I (qualifier name) First Name Last Name certify that the work described above is necessary to address an emergency condition as permitted under FBC 105.2.1 and that a complete permit application will be submitted to the City of Coral Springs Building Department no later than the next working business day.
Contact E-mail Address*
Contact Number
Add the best number to contact you.
Job Site Address*

Street Address

Street Address Line 2

CityState

Zip Code
Emergency Work Description*
Please explain why the work is categorized as an emergency.
By typing my name in the below space, I am electronically signing this form. By signing this electronic signature certifies the information to be true, accurate, and complete.*

First NameLast Name
Should be Empty: