CONSTRUCTION PERMIT APPLICATION Date Received__________
Permit # _________________
Building Department
1401 Draper Street Kingsburg, CA 93631
(559) 897-5328 Fax (559) 897-6558 Inspection (559)897-6526
Valuation (cost of project): $______________Lot #_______ APN# ____________ Tract # ________
Residential Commercial:
___ New structure ___ Addition ___ Remodel __ Tenant Imp __Signs ___Fire Damage ___Fire Alarms
___ Electrical ___ Mechanical ___ Plumbing ___ Patio Cover ___ Fence Other _________________
Project Description: _________________________________________________________________
_________________________________________________________________________________
New Residential or Commercial
Addition to Commercial or Industrial
Applicant Statement: I certify that I have read this application and state that the above information is correct to the best of
my knowledge. I agree to comply with all city and county ordinances and state laws relating to building construction, and
hereby authorize representatives of the City to enter upon the above-mentioned property for inspection purposes. I (We)
agree to save, indemnify and keep harmless the City of Kingsburg against liabilities, judgments, costs and expenses which
may accrue against said City on consequence of the granting of this permit.
Contractor Authorized Agent Owner
P
rinted Name _________________________________________
Signature _____________________________________________________ Date___________________________
State Law requires all cities to report the disposal and recycling of project waste. Please fill out the Construction and
Demolition Management Plan completely and turn in all weight tickets in order to qualify for a return on deposits and to
avoid additional penalties. The waste hauler you use must be registered with the City and have a Franchise Agreement
and Business License.
All residences must have working Smoke/Carbon Monoxide Detectors installed prior to final inspection.
Contractor License No______________________________
Contractor Name.: _________________________________
Mailing Address ___________________________________
City/State/Zip _____________________________________
Phone ___________________ E-mail__________________
Project Address: ________________________________
Owner Name: __________________________________
City/State/Zip __________________________________
Phone __________________ Cell __________________
E-mail _______________________
OWNER/PROJECT INFORMATION
Name: _______________________________________
Phone: __________________________
E-mail ________________________________________
Company Name: _______________________________
License No. ___________________________________
Mailing Address ________________________________
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