11-8-19
Building Safety
125 W. Mountain St.
Fayetteville, AR 72701
479.575.8238
permit@fayetteville-ar.gov
Project Site Address ______________________________________________________________________________
Property Owner __________________________________________________________________________________
Phone # ________________________________ Email __________________________________________________
Contractor ______________________________________________________________________________________
Phone # ________________________________ Email __________________________________________________
Review Contact ___________________________________________________________________________________
Phone # ________________________________ Email __________________________________________________
Project Type: Residential/Single-Family Commercial/Community
Description of Work _________________________________________________________________________________
Project Valuation $_______________________
Pool Specifications: Length __________________ Width __________________ Total Area __________________
Retaining Wall >4ft? Y N
If yes, a Grading Permit is required – Contact Engineering at 479-575-8206.
In the Floodplain? Y N If yes, a Floodplain Development Permit is required – Contact the Floodplain Engineer at 479-575-8208.
Streamside Protection Zones (SPZ) on lot? Y N If yes, SPZ must be labeled on site plan.
Submittal Requirements
• Site Plan
• Electric Permit Application
• Commercial/Community Pools
o Complete and detailed construction documents (packet submitted to the State will be accepted)
o State Health Department Approval Letter
• Additional Trade Permits – separate permits are required for mechanical and/or gas work
This permit becomes null and void if work or construction authorized is not commenced within 6 months,
or if construction is suspended or abandoned for a period of 6 months at any time after work is commenced.
Signature ______________________________________________________________________________________
Owner/Contractor/Authorized Agent
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signature
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