Office Use Only: Office Use Only:
Reviewed by:
Initials Date
CDS 012 - Updated 6/8/18
Please fill out this form completely, supplying all necessary information and documentation to support your request;
including but not limited to a copy of contract, site plan and construction plans. Your application will not be
accepted until the application is completed and required information provided.
Contractor: Property Owner:
Company: Name:
Contact: Phone:
Phone: Mobile:
Mobile: E-Mail:
E-Mail: *If homeowner completing project personally-see Homeowner Statement
Homeowner Statement: By initialing below, I certify that I reside at the above address and am completing this project
personally without the assistance of any contractor. I further certify that this project is to be done in accordance to the
City of Cibolo Codes and Ordinances and is to be inspected by a City Inspector. This is not my place of business or rental
property, but my homestead where I reside. initial (please provide copy of Driver's License)
Commercial Residential
Project Address: Valuation:
MISCELLANEOUS PERMIT TYPE:
1) *Concrete Work: Sq Ft: Impervious Coverage:
Notes:
Load Bearing:
By initialing here, I verify that I have received the Concrete Requirement Handout:
2) *Demolition:
Commerical Residential
Notes:
Notes:
An Asbestos survey is required on Commercial projects in accordance with the Texas State Health Services Department
requirements and Texas Asbestos Health Protection Rules. Attach copy of Asbestos Survey.
See Utilities Department for dumpster requirements
3) * Fence: Is this:
Linear Ft: Type:
Height: Ft:
4) * Foundation Repair
* A copy of the final Engineer Report is required.
By initialing here, I verfiy that I have received the Tunneling Requirement Handout:
Continued on back
CITY OF CIBOLO
MISCELLANEOUS
PERMIT APPLICATION
Phone: (210) 658 - 4175
Fax: (210) 658 - 8065
Description of Work:
Proposed Date work to begin:
Type:
Type:
Square Footage:
Office Use Only: Office Use Only:
Reviewed by:
Initials Date
CDS 012 - Updated 6/8/18
Please fill out this form completely, supplying all necessary information and documentation to support your request;
including but not limited to a copy of contract, site plan and construction plans. Your application will not be
accepted until the application is completed and required information provided.
Contractor: Property Owner:
Company: Name:
Contact: Phone:
Phone: Mobile:
Mobile: E-Mail:
E-Mail:
*If homeowner completing project personally-see Homeowner Statement
Homeowner Statement: By initialing below, I certify that I reside at the above address and am completing this project
personally without the assistance of any contractor. I further certify that this project is to be done in accordance to the
City of Cibolo Codes and Ordinances and is to be inspected by a City Inspector. This is not my place of business or rental
property, but my homestead where I reside. initial (please provide copy of Driver's License)
ResidentialCommercial
Project Address: Valuation:
MISCELLANEOUS PERMIT TYPE:
1) *Concrete Work: Sq Ft: Impervious Coverage:
Notes:
Load Bearing:
By initialing here, I verify that I have received the Concrete Requirement Handout:
2) *Demolition:
Commerical Residential
Notes:
Notes:
An Asbestos survey is required on Commercial projects in accordance with the Texas State Health Services Department
requirements and Texas Asbestos Health Protection Rules. Attach copy of Asbestos Survey.
See Utilities Department for dumpster requirements
3) * Fence: Is this:
Linear Ft: Type:
Height: Ft:
4) * Foundation Repair
* A copy of the final Engineer Report is required.
By initialing here, I verfiy that I have received the Tunneling Requirement Handout:
Continued on back
CITY OF CIBOLO
MISCELLANEOUS
PERMIT APPLICATION
Phone: (210) 658 - 4175
Fax: (210) 658 - 8065
Description of Work:
Proposed Date work to begin:
Type:
Type:
Square Footage:
Office Use Only: Office Use Only:
Reviewed by:
Initials Date
CDS 012 - Updated 6/8/18
Please fill out this form completely, supplying all necessary information and documentation to support your request;
including but not limited to a copy of contract, site plan and construction plans. Your application will not be
accepted until the application is completed and required information provided.
Contractor: Property Owner:
Company: Name:
Contact: Phone:
Phone: Mobile:
Mobile: E-Mail:
E-Mail:
*If homeowner completing project personally-see Homeowner Statement
Homeowner Statement: By initialing below, I certify that I reside at the above address and am completing this project
personally without the assistance of any contractor. I further certify that this project is to be done in accordance to the
City of Cibolo Codes and Ordinances and is to be inspected by a City Inspector. This is not my place of business or rental
property, but my homestead where I reside. initial (please provide copy of Driver's License)
ResidentialCommercial
Project Address: Valuation:
MISCELLANEOUS PERMIT TYPE:
1) *Concrete Work: Sq Ft: Impervious Coverage:
Notes:
Load Bearing:
By initialing here, I verify that I have received the Concrete Requirement Handout:
2) *Demolition:
Commerical Residential
Notes:
Notes:
An Asbestos survey is required on Commercial projects in accordance with the Texas State Health Services Department
requirements and Texas Asbestos Health Protection Rules. Attach copy of Asbestos Survey.
See Utilities Department for dumpster requirements
3) * Fence: Is this:
Linear Ft: Type:
Height: Ft:
4) * Foundation Repair
* A copy of the final Engineer Report is required.
By initialing here, I verfiy that I have received the Tunneling Requirement Handout:
Continued on back
CITY OF CIBOLO
MISCELLANEOUS
PERMIT APPLICATION
Phone: (210) 658 - 4175
Fax: (210) 658 - 8065
Description of Work:
Proposed Date work to begin:
Type:
Type:
Square Footage:
Office Use Only: Office Use Only:
Reviewed by:
Initials Date
CDS 012 - Updated 6/8/18
Please fill out this form completely, supplying all necessary information and documentation to support your request;
including but not limited to a copy of contract, site plan and construction plans. Your application will not be
accepted until the application is completed and required information provided.
Contractor: Property Owner:
Company: Name:
Contact: Phone:
Phone: Mobile:
Mobile: E-Mail:
E-Mail:
*If homeowner completing project personally-see Homeowner Statement
Homeowner Statement: By initialing below, I certify that I reside at the above address and am completing this project
personally without the assistance of any contractor. I further certify that this project is to be done in accordance to the
City of Cibolo Codes and Ordinances and is to be inspected by a City Inspector. This is not my place of business or rental
property, but my homestead where I reside. initial (please provide copy of Driver's License)
ResidentialCommercial
Project Address: Valuation:
MISCELLANEOUS PERMIT TYPE:
1) *Concrete Work: Sq Ft: Impervious Coverage:
Notes:
Load Bearing:
By initialing here, I verify that I have received the Concrete Requirement Handout:
2) *Demolition:
Commerical Residential
Notes:
Notes:
An Asbestos survey is required on Commercial projects in accordance with the Texas State Health Services Department
requirements and Texas Asbestos Health Protection Rules. Attach copy of Asbestos Survey.
See Utilities Department for dumpster requirements
3) * Fence: Is this:
Linear Ft: Type:
Height: Ft:
4) * Foundation Repair
* A copy of the final Engineer Report is required.
By initialing here, I verfiy that I have received the Tunneling Requirement Handout:
Continued on back
CITY OF CIBOLO
MISCELLANEOUS
PERMIT APPLICATION
Phone: (210) 658 - 4175
Fax: (210) 658 - 8065
Description of Work:
Proposed Date work to begin:
Type:
Type:
Square Footage:
Office Use Only: Office Use Only:
Reviewed by:
Initials Date
CDS 012 - Updated 6/8/18
Please fill out this form completely, supplying all necessary information and documentation to support your request;
including but not limited to a copy of contract, site plan and construction plans. Your application will not be
accepted until the application is completed and required information provided.
Contractor: Property Owner:
Company: Name:
Contact: Phone:
Phone: Mobile:
Mobile: E-Mail:
E-Mail:
*If homeowner completing project personally-see Homeowner Statement
Homeowner Statement: By initialing below, I certify that I reside at the above address and am completing this project
personally without the assistance of any contractor. I further certify that this project is to be done in accordance to the
City of Cibolo Codes and Ordinances and is to be inspected by a City Inspector. This is not my place of business or rental
property, but my homestead where I reside. initial (please provide copy of Driver's License)
ResidentialCommercial
Project Address: Valuation:
MISCELLANEOUS PERMIT TYPE:
1) *Concrete Work: Sq Ft: Impervious Coverage:
Notes:
Load Bearing:
By initialing here, I verify that I have received the Concrete Requirement Handout:
2) *Demolition:
Commerical Residential
Notes:
Notes:
An Asbestos survey is required on Commercial projects in accordance with the Texas State Health Services Department
requirements and Texas Asbestos Health Protection Rules. Attach copy of Asbestos Survey.
See Utilities Department for dumpster requirements
3) * Fence: Is this:
Linear Ft: Type:
Height: Ft:
4) * Foundation Repair
* A copy of the final Engineer Report is required.
By initialing here, I verfiy that I have received the Tunneling Requirement Handout:
Continued on back
CITY OF CIBOLO
MISCELLANEOUS
PERMIT APPLICATION
Phone: (210) 658 - 4175
Fax: (210) 658 - 8065
Description of Work:
Proposed Date work to begin:
Type:
Type:
Square Footage:
Office Use Only: Office Use Only:
Reviewed by:
Initials Date
CDS 012 - Updated 6/8/18
Please fill out this form completely, supplying all necessary information and documentation to support your request;
including but not limited to a copy of contract, site plan and construction plans. Your application will not be
accepted until the application is completed and required information provided.
Contractor: Property Owner:
Company: Name:
Contact: Phone:
Phone: Mobile:
Mobile: E-Mail:
E-Mail:
*If homeowner completing project personally-see Homeowner Statement
Homeowner Statement: By initialing below, I certify that I reside at the above address and am completing this project
personally without the assistance of any contractor. I further certify that this project is to be done in accordance to the
City of Cibolo Codes and Ordinances and is to be inspected by a City Inspector. This is not my place of business or rental
property, but my homestead where I reside. initial (please provide copy of Driver's License)
ResidentialCommercial
Project Address: Valuation:
MISCELLANEOUS PERMIT TYPE:
1) *Concrete Work: Sq Ft: Impervious Coverage:
Notes:
Load Bearing:
By initialing here, I verify that I have received the Concrete Requirement Handout:
2) *Demolition:
Commerical Residential
Notes:
Notes:
An Asbestos survey is required on Commercial projects in accordance with the Texas State Health Services Department
requirements and Texas Asbestos Health Protection Rules. Attach copy of Asbestos Survey.
See Utilities Department for dumpster requirements
3) * Fence: Is this:
Linear Ft: Type:
Height: Ft:
4) * Foundation Repair
* A copy of the final Engineer Report is required.
By initialing here, I verfiy that I have received the Tunneling Requirement Handout:
Continued on back
CITY OF CIBOLO
MISCELLANEOUS
PERMIT APPLICATION
Phone: (210) 658 - 4175
Fax: (210) 658 - 8065
Description of Work:
Proposed Date work to begin:
Type:
Type:
Square Footage:
Office Use Only: Office Use Only:
Reviewed by:
Initials Date
CDS 012 - Updated 6/8/18
Please fill out this form completely, supplying all necessary information and documentation to support your request;
including but not limited to a copy of contract, site plan and construction plans. Your application will not be
accepted until the application is completed and required information provided.
Contractor: Property Owner:
Company: Name:
Contact: Phone:
Phone: Mobile:
Mobile: E-Mail:
E-Mail:
*If homeowner completing project personally-see Homeowner Statement
Homeowner Statement: By initialing below, I certify that I reside at the above address and am completing this project
personally without the assistance of any contractor. I further certify that this project is to be done in accordance to the
City of Cibolo Codes and Ordinances and is to be inspected by a City Inspector. This is not my place of business or rental
property, but my homestead where I reside. initial (please provide copy of Driver's License)
ResidentialCommercial
Project Address: Valuation:
MISCELLANEOUS PERMIT TYPE:
1) *Concrete Work: Sq Ft: Impervious Coverage:
Notes:
Load Bearing:
By initialing here, I verify that I have received the Concrete Requirement Handout:
2) *Demolition:
Commerical Residential
Notes:
Notes:
An Asbestos survey is required on Commercial projects in accordance with the Texas State Health Services Department
requirements and Texas Asbestos Health Protection Rules. Attach copy of Asbestos Survey.
See Utilities Department for dumpster requirements
3) * Fence: Is this:
Linear Ft: Type:
Height: Ft:
4) * Foundation Repair
* A copy of the final Engineer Report is required.
By initialing here, I verfiy that I have received the Tunneling Requirement Handout:
Continued on back
CITY OF CIBOLO
MISCELLANEOUS
PERMIT APPLICATION
Phone: (210) 658 - 4175
Fax: (210) 658 - 8065
Description of Work:
Proposed Date work to begin:
Type:
Type:
Square Footage:
5) *Flammable / Combustible Tanks, Related Equipment & Piping
Type of Liquid:
Notes:
** 3 (three) sets of plans are required (can be part of building plan submittal)
6) *Outdoor Structures:
Dimensions: x Sq Ft: Notes:
By initialing here, I verify that I have received the Deck Handouts:
7) *Placement: (Manufactured Home, Mobile Home, Construction Trailer etc.)
(Note: Additional permits for utility hook ups is required.)
Is this:
Dimensions: x Sq Ft: Impervious Coverage:
Age of structure (to be moved onto property:
8) *Portable Storage Units:
Number of days to be on-site:
Note: Storage units used for moving and kept on site for no more than 14 days shall not require a permit.
9) Public Utilities: (attach map)
Contractor:
Location:
Notes:
10) *Storage Sheds: Dimensions: x Sq Ft:
Type: Impervious Coverage:
** Sheds may not be placed in an easement.**
11) * Swimming Pool / Spa: (electrical permit may be required)
x Sq Ft:
Type:
By initialing here, I verify that I have received the Pool/Spa requirement handout:
LIST OF SUB-CONTRACTORS: (if applicable) (NAME AND PHONE NUMBER)
Electrician: Phone:
Plumber: Phone:
Mechanical: Phone:
Other: Phone:
A permit becomes null and void if work or construction authorized is not commenced with 6 months or if construction or work is
suspended , or abandoned for a period of 6 months at any time after work is started.
As Contractor, I authorize the property owner to pick up this permit on my behalf. I understand that work may not begin until the
permit is posted on the job site. I assume all responsibility for any penalty that may be assessed if work is performed without the
permit being posted.
Initial, if homeowner authorized to pick up permit on your behalf
I hereby certify that I have read and examined this document 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 herein or not. I understand granting of a permit
does not presume to give authority to violate or cancel the provisions of any city guidelines, ordinances, codes, state or local
laws regulating construction or the performance of construction.
(SIGNATURE OF OWNER, CONTRACTOR OR AUTHORIZED AGENT) DATE
**Note: Inspection of permitted work may reveal code violations not discovered during plan review.
Floodplain:
Dimensions:
Number of Tanks:
Contracted By:
MISCELLANEOUS PERMIT APPLICATION CONTINUED
Impervious Coverage:
click to sign
signature
click to edit
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