10/28/15
CITY OF HUDSON
505 3
RD
STREET
HUDSON WI 54016-1694
FAX (715)386-3385
www.ci.hudson.wi.us
COMMERCIAL
BUILDING PERMIT
APPLICATION
DAVID GRAY
BUILDING INSPECTOR
(715)386-4775, ext. 132
dgray@ci.hudson.wi.us
SCOTT ST. MARTIN
FIRE CHIEF
(715)377-3152
sstmartin@ci.hudson.wi.us
The city has a combination permit system. A permit will include the building permit, electrical, plumbing, and/or HVAC. Therefore, information
for all contractors associated with the project must be completed in the contractor section below.
Building/Site Address
Owner's Name
Telephone (Daytime)
Email or Fax
Mailing Address
Applicant's Name (if different than owner)
Telephone (Daytime)
Email or Fax
Mailing Address
Project Description
Anticipated Start Date Application will not be
accepted without the
following:
Contractor(s) Company Name, Address, & Telephone Number WI Credential Number(s)
General Contractor
Electrical Contractor
Master Electrician
Heating/Venting/Air Conditioning (HVAC)
Plumbing
I understand that I am subject to all applicable codes, laws, statutes, and ordinances, including those described on the reverse side of this form;
am subject to any conditions of this permit; understand that the issuance of this permit creates no legal liability, express or implied, on the state
or municipality; and certify that all the above information is accurate. I expressly grant the building inspector, or the inspector’s authorized
agent, permission to enter the premises for which the permit is sought at all reasonable hours and for any proper purpose to inspect the work
which is being done.
SIGNATURE OF APPLICANT_________________________________________ DATE___________________
Fire Sprinkler*
Fire Alarm*
*If fire sprinkler or fire alarm only, the following fees apply: $125.00
Sprinkler/Alarm System - Plan Review & Inspection over $1,500.00
Sprinkler/Alarm System - Plan Review & Inspection under $1,500.00
$ 65.00
NOT REQUIRED
NOT REQUIRED
CLEAR
PRINT
click to sign
signature
click to edit
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