Fillable Buildingpermitapplicationv9.17 Building Permit Application

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Buildingpermitapplicationv9.17 Building Permit Application

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U.S.A. forms for Village of Inverness

BROWSE VILLAGE OF INVERNESS (IL) FORMS

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SHORT FORM PERMIT APPLICATION INSTRUCTIONS

1. This application is set up to type-in then print out. All blanks must be filled in. Use the

on-screen guides by hovering over the blanks to help direct your responses. Some

blanks require you to type-in the information, while others use drop-down menus for

selection. Be sure to complete the application only for the work being proposed.

Incomplete applications will not be accepted.

2. This application will print on most Laser & Ink jet printers trouble-free. Use only

quality white, 8-1/2” x 11” papers to print the application on. Set print quality to

“normal” for best results and print in black & white only. Improper paper sizes, poor

print quality, cutoffs and enlarged or reduced permit applications will not be

accepted.

3. Remember to sign the lower right-hand corner of the application. Only properly

endorsed applications will be accepted.

4. Please review and understand our Building Permit Requirements. Failure to do so

may delay the application process. The installation of Standby Generators, Decks

and Patio's have additional requirements not listed herein. These requirements are

available in the Resource Center of the Building Department web page.

5. There may be private covenants, conditions and restrictions running with the title to

the property which is the subject of this permit application which regulate, govern

and control and/or affect what type of improvements may be made on the subject

property. Please be advised that it is our recommendation to have the title insurance

reviewed by an attorney. A properly endorsed Acknowledgement of Covenants and

Restrictions shall be required with all permit applications.

6. Permit application & document submittal shall be made in person by a responsible

party. Submittals by any other means will not be accepted.

7. For further assistance regarding the short form permit application process, please

contact the Village of Inverness' Building Department Permit Coordinator at (847)

358-7960, Monday thru Friday, between the hours of 9:00 AM and 4:30 PM.

Rev. 8/17

BUILDING PERMIT REQUIREMENTS

1. Building Permit Application: Shall be typed-in and filled out completely only for the work being proposed.

2. Acknowledgement of Covenants and Restrictions: Property owner's signature required.

3. Plat of Survey: Two plats are required; one (1) original signed by an Illinois State Licensed Land Surveyor**

and one (1) copy shall be submitted. A current survey, drawn no smaller than 1"=30' scale, must show all

easements, property and building lines, setbacks and every existing building and improvement on the property.

Depiction of well and septic locations shall be drawn only on the copy of the survey*.

4. Septic Work: To include; Site Plan/Septic System Layout: three (3) plan sets, Percolation Test: two (2)

originals, Application for Sewage Disposal System: two (2) originals, all prepared, original signed and

sealed by an Illinois State Licensed Professional Engineer.**

5. Architectural Plans & Specifications: Original signed and sealed by an Illinois State Licensed Architect or

Illinois State Licensed Structural Engineer**. All architectural plans & specifications to be printed out in black

and white only.

- Two (2) plan sets for residential homes and all other construction, remodeling and repair permits.

- Four (4) plan sets for commercial construction, remodeling and repair permits.

6. Energy Efficiency Compliance: Illinois State Law requires all new buildings, additions, alterations or

renovations comply with the 2015 Illinois Energy Code. An applicable Energy Efficiency Compliance Report

(REScheck or COMcheck) shall be submitted with the permit application or the Architectural plans shall

contain a statement and show compliance with the Prescriptive Method.

7. RRP Rule: In a rule issued by the USEPA, aimed at preventing lead poisoning among children and adults

Contractors performing any renovation/repair projects that disturb lead-based paint in residences built prior to

1978 shall submit the necessary certifications when applying for a permit.

8. Tree Preservation Plan: A residential teardown or addition of 50% or more of existing dwelling footprint shall

require a tree plan be prepared by a Registered Landscape Architect or an I.S.A., A.H.S., A.S.C.A. Certified

Arborist based upon a plat of survey or the engineered site/septic plan for all new residential construction.

Three (3) certified sets of the tree preservation plan shall be submitted when applying for a permit of

this type.

9. Developer's Architectural Approval: Letter may be required depending on the subdivision.

10. Plumbing Contractor Letter of Intent: Work proposed requiring plumbing; Illinois State Law requires an

original signed and sealed or notarized Contractor's Letter of Intent and one (1) copy of the Plumbing

Contractor's valid (#055) License/Certificate shall be submitted with the permit application.

11. Permit Application/Document Submittal: All submissions shall be in person by a responsible party.

Submittals by any other means will not be accepted.

*If the work proposed is on the opposite side of the house from the septic system, the location of the septic system and

well may be drawn in on the survey. However, if the work proposed is on the same side of the house as the septic

system, an As-Built drawing of the septic system original signed and sealed by a Licensed Professional Engineer** or

Licensed Septic Installer shall be required.

**Illinois State Law requires the proper sealing and signing of all plans and specifications. An original signature shall be

a hand-written inked type. All certifications are subject to their respective Illinois Department of Professional Regulation

Act's for design professionals.

Rev. 8/17

The undersigned hereby applies to the Building Department of the Village of Inverness, IL, for a

permit to erect, alter, construct, or enlarge the structure or part thereof herein described, and if granted the permit applied for, I will

comply with all requirements of the Village ordinances relating thereto and pay the fees required by such ordinances.

The purpose of this building permit is to:

R.E.I. No. Lot Sub. Twp. Section

Property address Zip Code Constructed of

of story(s), feet wide, feet long and feet high.

Number of bedrooms: Below ground area:

Location on lot: ft. from front, ft. from left side, ft. from right side, ft. from back lot line.

Distance to improvement: ft. from well, ft. from septic tank, ft. from closest seepage line.

Construction Value Square Foot Area

This estimate is made by

Owner of Record

Roofer/IL Lic#

Brick Mason

AdrCement Mason

AdrPlumber/IL Lic#

Septic Inst/IL Lic#

Adr

Electrician

Architect of Record

1.) In consideration for the processing and review of this application, and for other good and sufficient and lawful consideration, the

undersigned further agree(s) to promptly pay to the Village any out-of-pocket expenses incurred by the Village resulting directly or

indirectly from or related to said application, and if the undersigned fail(s) to pay such expenses when due, the Village shall, without

any limitation on other remedies, have the right to bring an action at law to collect all amounts due and all costs of collection, including

attorneys' fees and court costs. 2.)The Village code requires that this permit be completed within the required time depending on the

size of the project calculated during the review. A new permit application and or additional fees will be required if the authorized work

has not been completed in compliance with applicable codes, including final inspections, by the expiration date indicated below. 3.)

The applicant having read this application and fully understanding the intent thereof declares that the statements made are true to the

best of my knowledge and belief. 4.) No error or omission in either the plans or application, whether said plans or application has been

approved by the building inspector or not shall permit or relieve the applicant from constructing the work in any other manner than that

provided for in the ordinances of this Village relating thereto.

Cell Number

OFFICIAL USE ONLY-THIS PERMIT EXPIRES:

Signature of Permit Applicant

Home Number

Work Number

FAX Number

Permit Applicant

Address

City

State Zip Code

General Contractor

Excavator

Carpenter

Adr

Phn

Rev. 8/17

ORIGINAL

_________________

APPLICATION FOR BUILDING PERMIT

BUILDING DEPARTMENT, VILLAGE OF INVERNESS, IL 60067

Permit Fee =

Refundable Bonds =

Total Amout Paid =

$_________________

PERMITTEE COUNTY / TOWNSHIP FILE

Adr

Phn

Insulation Contractor

Email:

Print Application

VILLAGE OF INVERNESS

BUILDING DEPARTMENT

1415 BALDWIN ROAD

INVERNESS, IL 60067

(847) 358-7960

Acknowledgement of possible Covenants, Conditions and Restrictions of Record:

The undersigned, having applied to the Village of Inverness for a building permit, acknowledges:

a) That there may be private covenants, conditions and restrictions running with the title to the property

which is the subject of their permit applications which regulate, govern, control and/or affect what type of

improvements may be made on the subject property;

b) That the Village, by issuance of a building permit has no power to and does not abrogate, vary,

terminate, waive or release any such covenants, conditions and restrictions of record which may be

applicable to the subject property;

c) That the undersigned remains obligated to comply with such covenants, conditions and restrictions of

record notwithstanding the facts that they have received a building permit from the Village of Inverness;

d) That the undersigned and their attorney should review a title insurance policy or title insurance

commitment for the subject property to determine what covenants, conditions and restrictions of record

are in fact applicable to the subject property; and

e) That, in consideration for the issuance of a building permit, the undersigned further agree to hold

harmless and indemnify the Village, its officers, employees and agents, from any cost, claim, expense or

liability to the Village, resulting directly or indirectly from or related to, any violation by the undersigned of

such covenants, conditions and restrictions of record as may be applicable to the subject property,

including reasonable attorney's fees and other costs of defense.

(Ordinance 92-433, 1-14-92)

______________________________________ ________________________________________

ACKNOWLEDGEMENT OF COVENANTS AND RESTRICTIONS

Owner of Record

(Signature)

Applicant

(Signature)

Address (Please Print) Address (Please Print)

Rev. 8/17

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