11 LAFAYETTE STREET ST. MARYS PENNSYLVANIA 15857
PHONE (814) 781-1718 www.stmaryspa.gov FAX (814) 834-1304
City of St. Marys Residential Building Perm it Application
Owner:____________________________________ Phone: (___)______________
Owner Address:______________________________________________________
Worksite Address:____________________________________________________
Contractor:_________________________________ Phone: (___)_____________
Contractor Address:___________________________________________________
TYPE OF WORK
( ) New Home ( ) Addition ( ) Garage ( ) Deck
( ) Alteration ( ) Pool ( ) Fence ( ) Demolition
( ) Other Description of Work:_______________________________________
Utility Company Work Order # (when applicable):
West Penn Power____________________ National Fuel____________________
NEW BUILDING CHARACTERISTICS
Number of Stories________ New Building Area All Floors__________sq.ft.
Height of Structure________ft. Total Estimated Cost of Project:$___________
As the owner/owner’s agent, I hereby certify that the proposed work will conform to the
Pennsylvania Uniform Construction Code and all applicable laws of this jurisdiction.
Signature:____________________________________ Date:__________________
Permit No: __________ Permit Fee:__________
Date Issued: __________ Approved: __________
Plan Review Date:__________ Approved w/changes:__________
Permit Paid Date:_________ Check No:_________ [ ] Cash Receipt No:_________
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