Fillable Building+ Permit+ Appl Fillable (City of Markesan (WI))

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Building+ Permit+ Appl Fillable (City of Markesan (WI))

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It is the Owner/Contractors Responsibility to Call in ALL INSPECTIONS to the Inspector.
FOR INSPECTIONS CALL:
GENERAL BUILDING PERMIT APPLICATION
PERMIT #
___________________
GENERAL ENGINEERING COMPANY
P.O. BOX 340 PORTAGE, WI 53901 OFFICE: (608) 745-4070
EXPIRATION DATE:
Parcel Number:
#
Municipality Number
____ ____ - ____ ____ ____
PROJECT DESCRIPTION (Submit Building Plans & Site Plan)
Does this project require any
additional approvals or permits? yes no
Building Address:
Responsible Party Email Address:
Finished Project Value
$
Zoning Permit No.:
Corner Lot
yes no
Bldg. Height
Ft.
Setbacks:
Front
Rear
Left
Right
Owner’s Name
Mailing Address
Telephone
Fax
Construction Contractor’s Name
WI Lic. No.
Mailing Address
Telephone
Fax
Dwelling Contractor Qualifier
WI Lic. No.
The Dwelling Contr. Qualifier shall be
an owner, CEO, COB or employee of
the Dwelling Contr.
Telephone
Fax
HVAC
WI Lic. No.
Mailing Address
Telephone
Fax
Electrical
WI Lic. No.
Mailing Address
Telephone
Fax
Plumbing
WI Lic. No.
Mailing Address
Telephone
Fax
RESIDENTIAL
Single Family/Duplex
Addition: Electrical Plumbing HVAC Construction sq. ft. Erosion Control
Detached Accessory Building: Electrical Plumbing HVAC Construction sq. ft
Remodel: Electrical Plumbing HVAC Construction sq. ft.
Other: Fence Electrical Plumbing HVAC Construction sq. ft. Erosion Control
Electrical Service Upgrade (Amp ) Removal of Structure (Raze)
COMMERCIAL
New Commercial Building: Electrical Plumbing HVAC Construction Erosion Control
Commercial Addition/Alteration: Electrical Plumbing HVAC Construction Erosion Control
Building Sq. Ft.
State of Wisconsin Plan Approval Needed: yes no (Approved plans must be submitted with permit application)
Zoning – When applicable, must obtain a copy of setback information regarding height, lot coverage, etc.
I agree to comply with all applicable codes, statutes and ordinances and with the conditions of this permit; understand that the issuance of the permit creates no legal liability, express or implied, on the state or municipality; and
certify that all the above information is accurate. If I am an owner applying for an erosion control or construction permit, I have read the cautionary statement regarding contractor financial responsibility on the reverse side of the last
ply of this application. I expressly grant the building inspector or the inspector’s authorized agent permission to enter the premises for which this permit is sought at all reasonable hours and for any proper purpose to inspect the work
which is being done. It is the Owner/Contractors Responsibility to Call in ALL INSPECTIONS to the Inspector.
APPLICANT’S SIGNATURE ______________________________________
DATE SIGNED ___________________
APPROVAL CONDITIONS This permit is issued pursuant to the following conditions. Failure to comply may result in suspension or revocation of this permit or
other penalty. See attached for conditions of approval.
FEES:
PERMIT(S) ISSUED
PERMIT ISSUED BY:
Construction
Plumbing
Electrical
HVAC
Zoning
Other ________
Administrative
Total Permit Fee
$ _______________
$ _______________
$ _______________
$ _______________
$ _______________
$ _______________
$_______________
$_______________
Construction
HVAC
Electrical
Plumbing
Erosion Control
Other____________ _________
Name ___________________________________________
Date ____________ Telephone __________________
Cert No. __________________________________
Fence Sign Removal of Structure (Raze)
GEC
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Building+ Permit+ Appl Fillable (City of Markesan (WI))

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Completed 13 July 2020

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