COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
APPLICATION FOR PERMIT TO BUILD
FOR OFFICE USE ONLY PERMIT NUMBER:
FOOD H
___ ASSESSORS FORM
___ FIRE DEPARTMENT
___ ASSESSORS FLOOR PLAN
___
GREASE TRAP
___ SPECIAL INSPECTION FORM
___ PLANNING
___ CROSS CONNECTION
___ SANITATION APPROVAL
___ PUBLIC POOL
IT IS THE RESPONSIBILITY OF THE PERSON OBTAINING THE PERMIT TO DELIVER ALL
CLEARANCES AND APPROVALS TO THE BUILDING DEPARTMENT OFFICE.
VALUATION: $_______________ PERMIT FEE: $____________
PLAN REVIEW FEE: $_____________ ܆܆ PAID ܆܆ UNPAID
TO BE COMPLETED BY APPLICANT
UPPLY THE LICENSE IN
ALL TRADES LISTED BELOW PRIOR
SUB-CONTRACTOR INFORMATION
CONTRACTOR #:
: LOT: BLOCK:
:
OWNER
STATE CONTRACTOR #: ______________________ -OR-
CITY OF GJ LICENSE #: ______________________
ADDRESS:
#:
MESA COUNTY USE TAX
ARE BUILDING MATERIALS TO BE PURCHASED OUTSIDE MESA
COUNTY?
܆
YES
NO
GENERAL OR MAIN CONTRACTOR
IF YES, CONTACT MESA COUNTY TREASURER 970-244-1824
DESCRIPTION OF WORK PLANNED
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
APPLICATION AND THE ABOVE IS CORRECT AND I AGREE TO
COMPLY WITH ALL CITY/ COUNTY ORDINANCES AND STATE
LAWS REGULATING BUILDING CONSTRUCTION.
-- FOR OFFICE USE ONLY --
APPROVAL DATE: PLAN REVIEWER:
WILL ENGINEER DO CONCRETE
INSPECTIONS?
NOTICE TO ALL APPLICANTS WORKING WITHIN THE CITY
LIMITS OF GRAND JUNCTION: THAT ANY PERSON, FIRM
OR COMPANY WORKING WITHIN THE CITY LIMITS OF
GRAND JUNCTION AS A GENERAL CONTRACTOR OR
SUB
-
CONTRACTOR MUST OBTAIN AND MAINTAIN A CITY
CONTRACTOR’S LICENSE.
200 S. Spruce Street ● PO Box 20,000-5005 ● Grand Junction, Colorado ● 81502
Telephone: 970.244.1631
● Fax: 970.244.1769 ● www.mesacounty.us/building
Version 3/2020
