Building Permit Application

City of Combine

Permit Application
Project Address*
Valuation/Cost of Project*
Project Description*

New HomeRemodel/AdditionPlumbing Permit (Not part of a new build)Mechanical Permit (Not part of a new build)Electrical Permit (Not part of a new build)Accessory BuildingMH (Mobile Home)Swimming Pool
Description of Work*
Area Square Feet:
Living
Garage
Porch
Total
Number of stories
Owner Name*
Address*
Owner Email
example@example.com
Phone Number*
Fax Number
Contractor/Contact Email
example@example.com
General Contractor Name/Company
Contact Person
Phone Number
Contractor License Number
Mechanical Contractor Company
Contact Person
Phone Number
Contractor LIcense Number
Electrical Contractor Company
Contact Person
Phone Number
Contractor License Number
Plumber/Irrigator Company
Contact Person
Phone Number
Contractor LIcense Number
TPO Energy Provider
Contact Person
Phone Number
Contractor LIcense Number
A permit becomes null and void if work or authorized construction has not commenced within 180 days, or if construction or work is suspended or abandoned for a period of 180 days at any time after work has commenced. All construction must be completed within six (6) months from issuance of permit. If construction is not completed within six (6) months you may request a six (6) month extension at no cost. If construction or work is not completed within twelve (12) months, you will have to apply for a new permit at the current cost. All permits require final inspection.

A final inspection must be passed before any building is occupied.

I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction.
Signature of Applicant*

Clear
Date*

MonthDayYear
Upload Site Plan, Energy Code Compliance Report & Construction Plans

Cancelof
Should be Empty:

City of Combine

Area Square Feet: