Revised May 14, 2020 Page 2 of 2
Building site address Date
MD Homebuilder Registration
(New residential dwellings only)
Lot size Building size (sq. ft.) Building height # of stories
Proposed work area (sq. ft.) Basement area only (sq. ft.)
Total floor area (sq. ft. including basement) Is it a corner lot? Yes No
Proposed setbacks from property line (ft) Front Left Rear Right
If a water or sewer connection is required, I prefer:
City installation To seek approval of the Public Works Department to have it installed by a licensed
contractor (which may require a Street/Sidewalk Opening Permit and/or a bond)
Are trees being removed? Yes No If yes, complete a Tree Permit application.
Are there trees within 15’ of the limit of disturbance? Yes No If yes, show trees on a submitted site
plan and identify those to be removed.
e permit is required for new tenants, change of occupancy or owner, or expansion of a commercial use. (A Use
Permit Application must accompany the Building Permit Application.)
A certificate of occupancy may be required as determined by the Code Official.
gnature of owner or authorized agent
The applicant certifies and agrees as follows: (1) that they are authorized to make this application; (2) that the information
is correct; (3) that they will comply with all regulations of the City of Annapolis which are applicable hereto; (4) that they
will only perform work on the above property specifically described in this application; (5) that they grant City officials the
right to enter onto the property for the purpose of inspecting the work permitted and posting notices; (6) if you choose to
appeal the issuance, decision, determination or order of this permit, the petition for appeal shall be in writing stating the
grounds for appeal and shall be filed with the Building Board of Appeals within 15 calendar days of issuance, decision,
determination or order. Any right to appeal shall be waived if not timely filed.
Owner or Authorized Agent (print)
FOR CITY USE ONLY
PZ final approval Date
App fee paid Permit fee Fee due