Fillable GENERAL PERMIT APPLICATION (Fort Lupton)

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GENERAL PERMIT APPLICATION (Fort Lupton)

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Permit Number: BLD - - / CO-20 -
Planning & Building
130 S. McKinley Avenue Phone: 303.857.6694
Fort Lupton, CO 80621 Fax: 303.857.0351
EMAIL: BuildingDept@fortluptonco.gov
www.fortluptonco.gov
GENERAL PERMIT APPLICATION
(Please type or print legibly)
(Incomplete Applications will not be accepted)
* Required
Please choose one property type:
Residential ∆ Commercial
(May require approval from the Fort Lupton Fire District)
Applicant Name:
Phone #:
Email Address:
Address of Job Site (If no address, provide legal description and parcel #):
Legal Description:
Parcel #:
Property Owner (Check if applicant is the property owner
∆
):
Property Owner Phone #:
Property Owner Mailing Address:
Property Owner Email:
Description of Work
If applicable: Is your site plan attached? ∆ Yes ∆ No ∆ N/A
Contractor Information
Check if property owner will be completing the work
General Contractor:
Phone Number:
Email:
License #:
Building Contractor:
Phone Number:
Email:
License #:
Electrical Contractor:
Phone Number:
Email:
License #:
Plumbing Contractor:
Phone Number:
Email:
License #:
Mechanical Contractor:
Phone Number:
Email:
License #:
Construction Valuation
Any work performed prior to obtaining a building permit may be subject to double fees.
Materials: $_______________________ + Labor: $_____________________________ = Total Value: $_____________________________
For Office Use Only
Permit Fee (201): $ + Use Tax (218): $ = Total Fees: $
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
PRELIMINARY BUILDING INSPECTIONS
o
Air Conditioning
o
Blocking & Tie Downs
o
Caissons
o
Concrete Slab
o
Copy of Open Hole Letter
o
Damp Proofing
o
Electrical Rough
o
Electrical Underground
o
Exterior Sheathing
o
Floor Framing
o
Footing
o
Foundation Rebar
o
Framing Rough
o
Gas Piping
o
Insulation Certificate
o
Ledger Attachment
o
Mechanical Rough
o
Perimeter Drain
o
Permanent Meter Release
o
Plumbing Rough
o
Plumbing Underground
o
Setback
o
Skirting
o
Site Drainage Certificate
o
Steps & Landing
o
Temporary Construction Meter
o
Water Piping
o
Other(s) – listed in comments
O Final Building
O Final Electrical
FINAL INSPECTIONS
O Final Grade & Debris o Final Mechanical
O Final Plumbing
O Certificate of Occupancy
o Temporary Certificate of Occupancy
O Sewer & Water Tap
PUBLIC WORKS INSPECTIONS
O
Meter & Pit
O
Curb & Sidewalk
COMMENTS
City Official: ________________________________________________________________
Building Official
: ___________________________________________________________
Public Works Director
: ___________________________________________________
Planning Director: ________________________________________________________
Date: ________________
Date
: _
_______________
Date
: ________________
Date: ________________
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:
NOTE:
To schedule an inspection, please visit the City of Fort Lupton website under Inspections or call 970-305-3161 and choose
ext. 1. 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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GENERAL PERMIT APPLICATION (Fort Lupton)

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Completed 31 January 2021

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