Fillable General Permit Application (City of Gulfport Mississippi)

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General Permit Application (City of Gulfport Mississippi)

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The General Permit Application (City of Gulfport Mississippi) form is 1 page long and contains:

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Country of origin: US
File type: PDF

U.S.A. forms for City of Gulfport Mississippi

BROWSE CITY OF GULFPORT MISSISSIPPI (MS) FORMS

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PROPERTY INFORMATION
JOB ADDRESS:_____________________________________________________
___________________________________________________________________
TAX PARCEL NUMBER: ___________________________________________
IF METES AND BOUNDS, ATTACH A PHOTOCOPY (REQUIRED FOR ISSUANCE)
OR DEED OR SURVEY WITH LEGAL DESCRIPTION.
PROPERTY OWNER
NAME:_____________________________________________________________
Last First
PHONE:(______)__________________ FAX:(______)___________________
MAILING
ADDRESS:_________________________________________________________
STREET
___________________________________________________________________
CITY STATE ZIP
WORK CLASS
STRUCTURE TYPE
____WOOD FRAME (V-B)
____ BRICK VENEER/WOOD FRAME (V-B)
____ WOOD FRAME – 1 PROTECTED (V-A)
____NON-COMBUSTIBLE-EXTERIOR /
COMBUSTIBLE-INTERIOR (3-B)
____NON-COMBUSTIBLE-EXT. (2 HR)
COMBUSTIBLE- INT. (1 HR) (3-A)
____NON-COMBUSTIBLE EXT. /INT. (2-B)
____ NON-COMBUSTIBLE-EXT. (1 HR)
INTERIOR (1 HR) (2-A)
____ NON-COMBUSTIBLE-EXTERIOR (2
HR) INTERIOR (2HR) (1-B)
____ NON-COMBUSTIBLE-EXT. (3HR)
INT.(3HR) (1-A)
____ HEAVY TIMBER (4)
OCCUPANCY TYPE
_____SINGLE-FAMILY(R-3)____MIXED____
_____ DUPLEX (R-3)
_____ MULTIPLE DWELLING (R-2)
_____ HOTEL/MOTEL (R-1)
_____ ASSISTED LIVING FACILITY (R-4)
_____ BUSINESS (B)
_____ MERCANTILE (M)
_____ ASSEMBLY (A)
_____ EDUCATION (E)
_____ FACTORY-INDUSTRIAL (F)
_____ HIGH HAZARD (H)
_____ INSTITUTIONAL (I)
_____ STORAGE (S)
_____ UTILITY & MISC (U)
FOUNDATION TYPE
_____ MONOLITHIC SLAB
_____ CHAINWALL SLAB
_____ PIERS
_____ OTHER_____________
EXT. FINISH &
MATERIAL
________________________
________________________
WORK DESCRIPTION
_____________________________
_____________________________
______________
CITY OF GULFPORT
GENERAL PERMIT APPLICATION VER. 2016A
PLEASE PRINT LEGIBLY
PERMIT #___________________ DATE:_________________
1410 24
th
Avenue, Gulfport, Mississippi 39501 (228) 868-5715
Please read and fill in ALL information that is requested. Failure to complete this
application may result in a delay in issuing the desired permit.
***CALL BEFORE YOU DIG 1-800-227-6477***
N CONTRACTOR INFORMATION
GULFPORT LICENSE #______________________________________________
COMPANY NAME:_________________________________________________
__________________________________________________________________
PHONE:(______)_________________ FAX:(______)_____________________
EMAIL:___________________________________________________________
CONTRACTOR NAME:_____________________________________________________________________________________
Last First
ADDRESS:________________________________________________________________________________________________
Street City State Zip
EL. CONT:____________________________ PLG CONT:_____________________ HVAC CONT:________________________
OFFICE USE ONLY
ZONING DISTRICT:______________ AEAZD:___________ WARD:________ SPECIAL FLOOD HAZARD AREA:________________ FIRE DISTRICT (Y/N)_______________________
PROPOSED USE:__________________________________________ REPORT CODE:_____________________________________
APPROVAL DATE:________________________________________ APPROVED BY PLANNING:_____________________________________________________________________
APPROVAL DATE:________________________________________ APPROVED BY BUILDING:_____________________________________________________________________
APPROVAL DATE:________________________________________ APPROVED BY CODE ENFORCEMENT:__________________________________________________________
***STAFF APPROVAL OF THIS APPLICATION EXPIRES AFTER 180 DAYS IF A PERMIT IS NOT ISSUED***
1
2
3
1._____NEW CONSTRUCTION
2._____ADDITION (ATTACHED)
3._____ADDITION (DETACHED)
4._____ALTERATIONS
5._____REPAIRS
6._____FENCE
7._____DEMOLITION
8._____MOVING BUILDING
9._____OTHER ____________
4
5
8
ENGINEER: _______________________________DESIGNER:___________________________________ARCHITECT:________________________________
NAME: ____________________________________________________ADDRESS: ______________________________________________________________
PHONE:(______) __________________ STATE OF MS REG #_____________________________________________________________________________________
I HEREBY CERTIFY THAT I HAVE READ THIS APPLICATION AND THAT ALL INFORMATION CONTAINED HEREIN IS TRUE AND CORRECT,
THAT I AGREE TO COMPLY WITH ALL APPLICABLE CODES, ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION,
THAT I AM THE OWNER OR AUTHORIZED INDIVIDUAL TO ACT AS THE OWNER AGENT FOR THE HEREIN DESCRIBED WORK, AND THAT THE
TOTAL CONTRACT OR VALUATION IS:
$ _____________________________________ DATE _____________________ SIGNATURE ____________________________________________
10
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BUILDING DIMENSIONS
PROPERTY DIMENSIONS
SQUARE
FOOTAGE:
LENGTH:
WIDTH:
HEIGHT:
STORIES:
FINISHED FLOOR
ELEVATION:
LENGTH:
WIDTH:
6
7
Staff Use Only
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General Permit Application (City of Gulfport Mississippi)

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Completed 15 July 2020

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