HVAC PERMITTING Fax completed form(s) to the Building Activity

Growth and Resource Management
Building and Zoning
123 W. Indiana Ave., DeLand, FL. 32720
(386)822-5739 • Fax (386) 626-6588
Section 105.2.1 of the Florida Building Code allows equipment replacement and repairs to be performed when an
emergency condition exists as long as the permit application is submitted the next working business day. To document
the emergency and to remove confusion regarding un-permitted activity, this form needs to be completed and faxed to
the Chief Building Official’s office support prior to work commencing.
Emergency Equipment Replacement or Repair Understanding and Agreement
I attest that the HVAC work described below qualifies as an Emergency repair per section 105.2.1 of the current Florida
Building Code.
Description of Work:
I agree to indemnify and hold harmless, the County of Volusia, its officers, agents, or employees from and against
any and all claims, demands, loss or liability of every nature connected with performing work without first obtaining the
proper required permits.
I agree, as per 105.2.1 FBC-B, to apply for the permit on the next working business day providing all applicable
documents required by the Code for review and permit record (Including but not limited to: matched system
documentation (C101.4.7 and R101.4.7 FBC-EC), and wind resistance documentation for commercial projects
(301.15 FBC-M).
Company Name:
Contractor’s Name:
License #:
Contractor’s Signature:
Contact Phone Number:
Street Address of Project:
Apt. or Unit #:
Note: An agent may sign this form on the contractor’s behalf provided that an agent authorization form signed by the
contractor is faxed to this office in addition to this document.
The current Florida Building Codes can be viewed @ http://www2.iccsafe.org/states/florida_codes/
Fax completed form(s) to the Building Activity @ (386) 626-6588