App: _______________
Recv’d: ______________
Page 1 of 2
BUILDING PERMIT APPLICATION
HOMEOWNER PERFORMING THE WORK
City of Sierra Vista Information: (520) 417-4413
1011 N. Coronado Drive Inspections only: (520) 452-7019
Sierra Vista, Arizona 85635
Fax No: (520) 452-7023
In accordance with the building, plumbing, electrical, mechanical codes and other ordinances of the City of Sierra Vista, the proposed work is to be executed in
conformity with said laws. This permit grants no conditions in excess of what the ordinances permit. NOTE: Permit shall expire and become null and void if
work is not commenced within 180 days from the date of approval of this permit, or if such work when commenced is suspended or abandoned for a
period of 180 days. 20% of the permit fee will be charged if the permit is cancelled or if initial inspection is not completed within 180 days of permit
approval date. A refund of 80% of the paid permit fee may be requested by the permit applicant within the 180 days.
Please be advised that there may be deed restrictions limiting the use of your property. The Department of Community Development does not investigate or enforce any such deed
restrictions. Deed restrictions are generally enforced by local property-owner or homeowners’ association. You may wish to further investigate any such deed restrictions before
proceeding with this application. Further there may be permits required by state and federal agencies, and you may wish to further investigate these. The Department of Community
Development does not assume any responsibility to ensure that the proper permits have been obtained.
Date: _____________________________
Project Address: ____________________________________________________ Telephone No: ________________________________
Property Owner Name: _______________________________________________ Is This a Rental Property? Yes No
Address: __________________________________________________________ City/State/Zip: _________________________________
If different than above
Email Address: ____________________________________________________________________________________
Project Activity: NEW SFR PLUMBING HVAC WALL/FENCE REROOF SHED SOLAR POOL/SPA
PATIO/CARPORT SERVICE PANEL ELECTRICAL SEWER WATER HEATER OTHER
Material Cost: $ _______________________
Description of Work:
Description of Work and Cost of Project must be completed for approval of application. Two copies of a sketch or plot plan must be included showing
dimensions and distances to lot lines and existing structures. ONCE APPROVED THE PLANS AND PERMIT MUST BE ON SITE AT ALL TIMES!!
PURSUANT TO OUR LOCAL CODE AMENDMENTS: SECTION 109.2, INSERT SUBSECTION 109.2.3 – 80% OF THE PLAN REVIEW FEE AS DETERMINED IN SUBSECTION
109.2.1 SHALL BE PAID AT TIME OF SUBMITTAL AND BEFORE ANY REVIEW OF SUCH DOCUMENTS COMMENCES. APPROVED PLANS AND PERMIT MUST BE PAID
FOR IN FULL AND PICKED UP NO LATER THAN 30 CALENDAR DAYS UPON NOTIFICATION OF APPROVAL. PLANS PICKED UP AFTER THE 30 DAY PERIOD MAY BE
SUBJECT TO A DAILY STORAGE FEE OR SUCH DOCUMENTS MAY BE DISCARDED AT THE DISCRETION OF THE BUILDING OFFICIAL. STORAGE FEES MAY BE
ASSESSED AND DETERMINED BY THE BUILDING OFFICIAL BUT SHALL NOT BE LESS THAN $10.00 PER DAY.
I agree that the information provided above is correct and true, and that I will be performing all work under this permit myself as permitted by ARS 32-1121A.
City inspections are provided to help the owner avoid code violations, but final responsibility for code compliance rests with the permit holder
.
Signature: __________________________________________________________________ Date: _____________________
Signature by owner of real property of record of the described property that is the subject of this application
DO NOT WRITE BELOW THIS LINE
Plan Review Fee: $_________________ Building Permit Fee: $_________________ Park Development Fee: $_________________
Collected at time of submittal if applicable
Fire Development Fee: $________________ Library Development Fee: $_________________ Police Development Fee: $___________
Sewer Connect Fee: $_________________ Transportation Dev. Fees: $_________________ Wall/Fence Fee: $_________________
TOTAL PROJECT FEES: $ ______________________
Comments:
Application Approved: Date:
Application Disapproved: Date:
Please complete back side
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signature
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