Enterprise Zone Program
Application for Building Permit Fee Waiver
Business Information
(Please Type or Print)
(Tax Map Designation and Road or Street, or E-911 Structure Address if Known)
Estimated Cost of Project:
Jobs Retained:
Filer's Statement - I hereby declare that, to the best of my knowledge and belief, the information contained in
this form is true and accurate and that I am authorized to act on behalf of the business.
Date Submitted: ____________________ Authorized Signature: _____________________________________
Building Inspection Department Information
(For Office Use Only:)
Property Located in Enterprise Zone
Yes
No
Construction by or for a qualified industry Yes No
Type of Improvements: New Construction Alteration Addition Improvements
Estimated Costs
Type of Permit: of Construction Fee Waived State Tax
Land Disturbing __________________ ____________ _____________
New Construction __________________ ____________ _____________
Alterations/Renovations __________________ ____________ _____________
Electrical Work __________________ ____________ _____________
Mechanical Work __________________ ____________ _____________
Plumbing __________________ ____________ _____________
Chimneys __________________ ____________ _____________
Signs __________________ ____________ _____________
Moving Building __________________ ____________ _____________
Demolition __________________ ____________ _____________
TOTALS $_________________ $___________ $____________
Date: __________________________ Building Official: ________________________________________
Please print name:____________________________________
