Fillable Form 5.: CITY OF TOMBALL CONSTRUCTION PERMIT APPLICATION (City of Tomball)

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Form 5.: CITY OF TOMBALL CONSTRUCTION PERMIT APPLICATION (City of Tomball)

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The Form 5.: CITY OF TOMBALL CONSTRUCTION PERMIT APPLICATION (City of Tomball) form is 3 pages long and contains:

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  • 25 check-boxes
  • 202 other fields

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BROWSE CITY OF TOMBALL (TX) FORMS

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CITY OF TOMBALL
Revised 01/20/2020
PERMIT NO.
CONSTRUCTION PERMIT APPLICATION
Note: If a Structure is proposed, a Building Permit is required
SELECT PERMIT TYPE Site Work Public Utilities
Public ROW
SECTION 1: General Provisions (APPLICANT to read and sign)
1.
No work of any kind may start until a permit is issued.
2.
The permit may be revoked if any false statements are made herein.
3.
If revoked, all work must cease until permit is re-issued.
4.
Development shall not be used or occupied until a Certificate of Compliance and/or Occupancy is issued.
5.
The permit will expire if no work or construction is commenced within six (6) months of issuance, or if construction or work
is abandoned for a period of six (6) months at any time after work is commenced.
6.
Applicant is hereby informed that other permits may be required to fulfill local, state, and federal regulatory requirements.
Separate permits are required for building, electrical, plumbing, heating, ventilation or air conditioning.
7.
All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not.
8.
The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law
relating to construction, nor does it give authorization or approval to encroach on any easement or property or violate any
deed restrictions.
9.
The City of Tomball shall never be liable for any damage or loss by reason of the issuance hereof.
10.
Each holder and other persons acting under authority of this permit are personally responsible for compliance with all the
above provisions and assume the entire risks incidental to the work being permitted.
11.
Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable inspections required
to verify compliance.
12.
THE APPLICANT HEREBY CERTIFIES THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO THIS
APPLICATION ARE, TO THE BEST OF MY KNOWLEDGE, TRUE AND ACCURATE.
13.
TAP AND IMPACT FEES – Upon installation, the listed applicant will be held financially responsible for at least the
minimum utility charge for all taps listed below.
APPLICANT’S SIGNATURE DATE
SECTION 2: Proposed Development (To be completed by APPLICANT)
OWNER INFORMATION:
STREET ADDRESS:
CITY
STATE: ZIP:
PHONE NUMBER: EMAIL:
ENGINEER INFORMATION:
STREET ADDRESS:
CITY
STATE: ZIP:
PHONE NUMBER: EMAIL:
ARCHITECT INFORMATION:
STREET ADDRESS:
CITY
STATE: ZIP:
PHONE NUMBER: EMAIL:
CONTRACTOR INFORMATION:
STREET ADDRESS:
CITY
STATE: ZIP:
PHONE NUMBER: EMAIL:
PROJECT LOCATION:
To avoid delay in processing the application, please provide enough information to easily identify the project location. Include an area
map with the project location identified.
Project Title:
Project Address:
Subdivision (If applicable): Legal Description:
Lot No.: Block: Tract:
Page 1 of 3
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signature
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PERMIT NO.
DESCRIPTION OF WORK (Check all applicable boxes):
A.
STRUCTURE TYPE
ACTIVITY
STRUCTURE TYPE
New Structure
Residential (Single Family)
Addition
Residential (Duplex)
Alteration
Residential (Multi-Family)
Relocation
Non-Residential
Replacement
Floodproofing
Demolition
Combined Use (Residential & Commercial)
Manufactured Home (Single Lot)
Manufactured Home (Manufactured Home Par
ESTIMATED COST OF PROJECT $
B. OTHER DEVELOPMENT ACTIVITIES
Clearing Filling Mining Drilling Grading
Excavation (Except for Structural Development Checked Above)
Watercourse Alteration (Including Dredging and Channel Modifications)
Drainage Improvements (Including Culvert Work)
Road, Street, or Bridge Construction
Subdivision (New or Expansion)
Utility Extensions (Water, Sanitary, and Gas)
Individual Water or Sewer System (If allowed by Ordinance)
Other (Please Specify)
C. OTHER PERMIT REQUIRED (Submit Copy of Permits)
TxDOT HCFCD Harris County
DESCRIPTION:
OFFICIAL USE ONLY
LIVING UNIT EQUIVALENCY (LUEs):
DRAINAGE BASIN: TOTAL ACREAGE OF SITE: acres
PROJECT ACREAGE (Area of Site being developed for Impact Fees): acres
TAP SIZE TAP FEE IMPACT FEE TOTAL
WATER
SANITARY
GAS
$ $
$
$ $
$
$
$
DRAINAGE
$
$
CITY ENGINEER
CITY COMMENTS:
Page 2 of 3
PLAN CHECK FEE
CONSTRUCTION FEE
SIDEWALK FEE
$
$
$
TOTAL AMOUNT DUE
$
SIGNATURE:
DATE:
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signature
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PERMIT NO.
TYPE OF WORK (To be Completed by APPLICANT)
Describe the type of construction you are applying for in the space below, if there is not enough space attach extra page.
Include public water mains, public sanitary sewer mains, public storm sewer mains, public gas mains, public streets,
erosion controls and drainage facilities (i.e., detention ponds)
PRIVATE /
PUBLIC
TYPE OF
CONSTRUCTION
DESCRIPTION OF
PROPERTY LOCATION
LENGTH
SIZE
COST
CONTRIBUTOR *
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
TOTAL COST
$
2% OF TOTAL COST
$
Names of all persons contributing to any part of the cost of the construction , whether new or for improvements must be listed with the amount
paid by each for the property listed.
Construction plans with the Engineer's seal must be submitted in duplicate for review for all utility construction permits issued by the
City of Tomball. These plans must reflect all materials to be used and the exact dimensions of the project. All applications and
plans for public utility / ROW construction work are to be submitted to the City Engineer where they will be filed and become public
record.
Construction for will begin on or after the
day of
, 20 .
The map or plat of the subdivision named above is recorded in HCFC or Volume , Page , of
the
Records of Harris County, Texas.
FOR PUBLIC UTILTY WORK AND PUBLIC ROW WORK ONLY
By signing this section I agree to follow the Code of Ordinances for the City of Tomball and any associated laws applicable in
the City of Tomball, Harris County, the State of Texas and the United States. Therefore I am bound to defend at my own cost
and expense any suit(s), action(s), claim(s) or damage(s) sustained against the City of Tomball for any loss, cost, expense or damage
charged or imposed upon the City for granting this permit. Furthermore, I agree to keep in good repair the refilling and surfacing
necessitated by the excavation covered by this application for a period of one year. I also understand and agree that this permit shall
be granted giving the City of Tomball, or any other person entitled, the lawful right to use said street, alley or other public place. I
understand and agree that should this permit be granted for the purpose of locating or placing any pipe, conduit, duct, tunnel or other
structure there is no fixed or vested right in said location and the City of Tomball, or any other person entitled, has the lawful right to
lay or place its pipes, conduits or other structures in, under, over or across such pipes, conduits or other structures laid without cost or
charge by the prior location for such use. I also understand and agree that these improvements, when constructed, will be public
improvements, the property of the City of Tomball, and without right of reimbursement by the City for any of the costs, except as
stipulated in the CITY OF TOMBALL CODE OF ORDINANCES.
APPLICANT’S SIGNATURE DATE
APPLICANT’S NAME (In Print)
Page 3 of 3
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Form 5.: CITY OF TOMBALL CONSTRUCTION PERMIT APPLICATION (City of Tomball)

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Completed 5 August 2020

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