I/we agree to perform the work described herein in accordance with the plans and/or
specifications submitted. All work done shall be in compliance with all applicable codes and
regulations of the City of Fort Lupton. I/we agree that no work should be initiated without this
ulations can cause
I/we agree to perform the work described herein in accordance with the plans and/or specifications
submitted. All work done shall be in compliance with all applicable codes and regulations of the City of
Fort Lupton. I/we agree that no work should be initiated without this application being approved. Any
violation of applicable codes and regulations can cause revocation of this permit.
Applicant Name:
Signature of Applicant: Date:
PRELIMINARY BUILDING INSPECTIONS
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Site Drainage Certificate
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Temporary Construction Meter
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Other(s) – listed in comments
FINAL INSPECTIONS
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□ Certificate of Occupancy
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Temporary Certificate of Occupancy
PUBLIC WORKS INSPECTIONS
□ Sewer & Water Tap □ Meter & Pit □ Curb & Sidewalk
COMMENTS
Building Official: Date: ______________
Public Works Director: Date: _____
Planning Director: ________ Date: _ ______________
NOTE:
To schedule an inspection, please visit the City of Fort Lupton website under Inspections or call 720-466-6110. Leave a message
with your name, phone number, address of job site and permit number. Inspections that are called in before 4 pm, Monday-Friday,
will be completed on the next business day. Inspections called in after 4 pm will be completed within 2 business days. Permits
expire 180 days from date of issue, unless work has commenced and inspections have been done. Building permit cards MUST be
posted on site where visible from the street. Any work performed prior to obtaining a building permit may be subject to
double permit fees.
The applicant, his or her agents and employees, shall comply with all of the rules, restrictions and requirements, of the City zoning
regulations and building codes governing location, construction and erection of the above proposed work for which the permit is
granted. The City, or its agents, are authorized to order immediate cessation of construction at any time a violation of the codes or
regulations appears to have occurred. Violation of any of the codes or regulations applicable may result in the revocation of this
permit. Buildings MUST conform to plans as submitted and approved by the City. Any changes of the plans or layout must be
approved prior to proceeding with construction. The applicant is required to call for inspections at various stages of the
construction, and in accordance with the aforesaid rule, the applicant shall give the Building Inspector not less than one day notice
to perform such activities. If the applicant fails to appear at the inspection, date and time specified, the applicant may be charged
for the Building Inspector’s time. In the event construction is not commenced within 180 days of the issuance of this permit, then
the permit is automatically void. Cessation of work for a period of 180 continuous days shall also cause this permit to be void.
Permits are not transferrable.
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