August 2019v.2
Page 1 of 2
Property Code:
Building Permit Application
Applicant Information [ ] Check here if primary contact
Name Street Address
Primary Phone Number City
Primary Email
State Zip Code
Owner Information (if different from applicant) [ ] Check here if primary contact
Name Street Address
Primary Phone Number City
Primary email State Zip Code
For Official Use Only
Application Received by:
Fee Paid $
Check#
Building Permit #
#
Site Plan Attached
Yes
No
n/a
Owner Signature
Yes
No
n/a
Project Narrative
Yes
No
n/a
Check all that apply:
* = state permits are required
Building Permits
[ ]
Demolition
[ ]
Exterior Renovations
[ ]
Interior Renovations
[ ]
New Construction*
[ ]
Repair/Replace
[ ]
Water & Wastewater
[ ]
Electrical*
[ ]
Plumbing*
[ ]
Roofing
Description of Work to be Completed
Include extra pages if necessary
Property Address
Description of Work
Estimated Cost of Work $__________________________________
August 2019v.2
Page 2 of 2
Property Code:
The area below can be used to draw simple site plans that show property boundaries, existing structures, proposed structures, or proposed
conditions. Include dimensional measurements for any features identified and setbacks from property boundaries. If the project area is larger or
more complex than what can be accommodated below, additional drawings prepared by a design professional should be provided.
Scale: 1 square = 1 foot
Applicant’s Signature
Property Owner's Signature
(If different from applicant)
Date
Date
click to sign
signature
click to edit
click to sign
signature
click to edit