Residential Building Permit Application
Date
*
-
Month
-
Day
Year
Date
A: Location of Project
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Project Name/ Subdivsion
Lot or Bldg#
B- Identifaction
Owner or Lessee
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Contractor
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Permit Applicant
Name
*
First Name
Last Name
C- Type of Improvement and Use
Check Applicable
New
Addition
Alteration
Demoliion
Relocation / moving
Foundation only
Basement only
Accssry. Bldg
Single Family
Duplex/ Two Family (1-hr seperation)
Townhouse (2-hr seperation)
Carport (detached)
Deck (detached)
Fence
Garage (detached)
Manufactored Home
Patio
Pool
Pole Barn
Other
Accssry. Bldg SqFt =
Manuf Home SqFt =
Pole Barn SqFf
Pool
Inground
Above Ground
No. of Stories w/o Basement
SqFt of Finished Basement
SqFt of Unfinished Basement
Total SqFt All Floors Under Roof
Total Land Area (acres or SqFt)
Number of Bedrooms
Number of Bathrooms
Construction Cost
Electrical Cost
Plumbing Cost
HVAC Cost
Total Cost
round up to the nearest dollar
D. Building Characteristics
Principal Type Of Frame
Masonry
Wood Frame
Structural Steel
Reinforced Concrete
Other
Electric Provider
EPB
WRECC
Principal Type of Heating Fuel
Coal
Gas
Electricity
Oil
Other
Type of Sewage Disposal
Private (septic tank)
Public
Type of Water Supply
Private (well, cistern)
Public-City
Public County
Central air conditioning
Yes
No
Heat Only
Yes
No
E
I hereby certify that I am the owner of record or have been authorized to make this application for a construction permit
"Note: The information provided on this form is subject to the open records act and may be viewed by others upon request."
Name of Applicant
*
First Name
Last Name
Address
*
Date
*
-
Month
-
Day
Year
Date
Signature
*
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