City of Piedmont
Permit Application
All Building Permits require staff review therefore we are unable to issue building permits on an immediate basis. Building permits require
extensive review and will be completed in a timely basis. Residential: One set of plans (paper and electronic) with plot plans are to accompany
the completed building permit for review. Non-Residential: Two paper sets and one electronic copy of dimensioned plans are to accompany
the completed building permit for review. Staff will contact you when your building permit has been issued and is ready for pick up.
PLEASE NOTE: ALL FEES ARE TO BE PAID BEFORE A PERMIT CAN BE ISSUED. THE CITY OF PIEDMONT’S FEE SCHEDULE CAN BE FOUND ON THE CITY
WEBSITE. FEES ARE SUBJECT TO CHANGE. NO CONSTRUCTION IS TO BEGIN WITHOUT AN AUTHORIZED BUILDING PERMIT.
☐ Residential or ☐ Non-Residential?
Building Type (One per application):
Type of Permit (One per application):
# of Units: __________
☐ Above Ground
☐ In Ground
Establishment (See Back)
Other: _______________
_________________________________________________________
Project Owner’s Name
_________________________________________________________
Project Address
_________________________________________________________
Legal Description of Property (Ex. NW/4, Sec. 32, T14N,
R5W)
_________________________________________________________
Project Mailing Address (If Different)
_____________________________ $_____________________________
Phone Number Estimated Value
__________________________________________________________
Project Housing Addition (If Applicable)
__________________________________________________________
Building Contractor’s Name
__________________________________________________________
Address
__________________________________________________________
City, State, Zip Code
__________________________________________________________
Mailing Address (If Different)
__________________________________________________________
Phone Number
__________________________________________________________
E-Mail Address for Permit and Inspection Results
_____________________________________________________________________
Intended Use (Required for all Residential and Non-Residential Permits
1
st
Floor: ________
3
rd
Floor: ________
Covered
Porch/Patio: ________
Size of Lot: ___________ Acres
*Note: Cross connections between public and private water supplies are illegal. Public water and sewer connections ARE ILLEGAL without the City of Piedmont’s permission.
Will the construction alter or change the flow of water drainage on the property? ☐ Yes ☐ No
ALL CONTRACTORS MUST BE LICENSED THROUGH THE CITY OF PIEDMONT
____________________________________________________________________________
Plumbing Contractor and Phone Number
____________________________________________________________________________
Mechanical Contractor and Phone Number
____________________________________________________________________________
Electrical Contractor and Phone Number
____________________________________________________________________________
Fence Contractor and Phone Number
____________________________________________________________________________
Sprinkler Contractor and Phone Number
____________________________________________________________________________
Other Contractor and Phone Number