Miscellaneous Improvement & Accessory Structures Permit Application Package (Revised July 2015) Page 1 of 2
PRIMARY CONTACT: Owner Contractor
PROPERTY OWNER INFORMATION
Name:
Property Address: Parcel:
Lot: Block: Subdivision
Mailing Address: City: State: Zip:
Phone: Phone: Email:
Authorization of Representation:
I, the undersigned, do hereby authorize the below contractor to represent me with respect to any issues or proceedings
associated with the foregoing permit application that are filed with the City of Bella Vista.
____________________________________________ ____________________________________________
Property Owner Date
CONTRACTOR INFORMATION
Contractor/Company Name: State Contractor’s License #:
Primary Contact Name: License Expires:
Mailing Address: City: State: Zip:
Primary Phone: Phone: Email:
PERMIT TYPE
Type of Work:
Residential (under 4 living units) Commercial (over 4 living units)
New Addition Remodel Repair
Fence Permit Material:__________________ Height:_______ $25.00
Right of Way Use Driveway (Not permitted under a permit.) $10.00/$25.00
Storm Shelter Circle Type: Basement, In-ground/Garage, Yard (Residential Only) $25.00
Pool/Spa Circle Type: Above ground, In-ground (Includes required barrier. Excludes permit for
deck.)
$25.00
Demolition Permit for over 120 sq. ft. $50.00
Retaining walls 30 & Above (Over 4’ requires an Engineer.) $50.00
Sea Wall $50.00
Moving / Relocation Permit $100.00
Accessory Improvements.
The City of Bella Vista determines the valuation of construction using the International Code Council’s
Building Valuation Data Table. The valuation method of calculating permit fees includes, but is not
necessarily limited to, both new residential and commercial construction, additions, as well as
accessory structures including workshops, storage buildings, decks, ramps, stairs, roof over decks
or porches, screened decks converted to sunrooms, carports, pergolas, gazebos, conversion of
carports to garages, covered and open docks, boathouses or enclosure thereof. Please ask Staff to
determine if your project will be calculated using the valuation method.
The valuation table is published every six months to provide an up-to-date average construction cost
per square foot based on Occupancy and Construction Type. A copy of the table is available from
the Building Division office or at the ICC’s website at www.iccsafe.org. After valuation is
determined, see the permit fee schedule to calculate permit fees.
Description of Work:______________________________________________________________________
Fee is based
on ICC
Valuation
FOR OFFICE / REVIEW USE ONLY
Application Date: File #
Total Fees:
Reviewer: # Inspections Required: Date Paid:
Approval Date: Act 474 Surcharge: Paid By: Cash Check Credit
Permit # Permit Fees: Check #:
Zoning: Floodplain: Y / N Receipt #
MISCELLANEOUS/ACCESSORY
IMPROVEMENTS PERMIT APPLICATION
Miscellaneous Improvement & Accessory Structures Permit Application Package (Revised July 2015) Page 2 of 2
PLAN SUBMITTAL REQUIREMENTS
Fences
Plot plan with location, drawn to scale, including dimensions.
Right of Way Use /
Driveway
Plot plan with location, drawn to scale, including dimensions.
Size of proposed culvert.
Cross-section of culvert construction.
Additional improvements.
Driveway surface material.
Storm Shelter
Plot plan with location, drawn to scale, including dimensions.
Elevation drawings detailing the installation, dimensions and materials.
Evidence the shelter meets the requirements for FEMA-360 and ICC-500 and has been Missile
Impact tested.
Pools/Spa
Plot plan with location, drawn to scale, including dimensions.
Elevation drawings of construction detailing the materials and their location with dimensions.
A barrier is required. Indicate, in detail, the type, materials and dimensions to be used as a barrier.
Demolition
Plot plan indicating the extent of demolition, showing what items are to be demolished or retained.
Retaining walls
Plot plan with location of the wall, drawn to scale, including dimensions.
Cross section drawing including footing design, dimensions, height, materials, and elevations above
and below the wall.
Sea Wall
Plot plan with location of the wall, drawn to scale, including dimensions.
Cross section drawing including footing design, dimensions, height, materials, and elevations above
and below the wall.
Moving / Relocation
Plot plan showing the new location for the structure, drawn to scale.
Schedule of moving (time, date, and route to be followed) submitted to Police and Fire
Departments.
If routing includes state/federal highways, provide AHID permit prior to permit issuance.
Advance notice to utility providers.
Accessory Structures
Plot plan with location, drawn to scale, including dimensions.
Elevation drawings of structure detailing the materials and their location with dimensions.
Drawings need to include a footing/foundation plan.
Drawings need to be labeled to include any utilities that may be added or moved.
APPLICATION CHECKLIST
1. Application form and fee.
2. Additional documents as required under plan submittal requirements.
3. Contractor must provide a copy of current license as required from the State of Arkansas.
4. Subcontractors must provide copies of current licensing, as required, and have system permits authorized.
ACKNOWLEDGEMENTS
1. A permit becomes null and void if work or construction authorized is not commenced within 6 months, or if construction or
work is suspended or abandoned for a period of 6 months at any time after work is started. Exterior improvements must be
completed within 6 months.
2. Inspection of permitted work may reveal code violations not discovered during plan review.
3. A clean set of construction plans, bearing the City’s approval, must be kept at the job site at all times.
4. Any alterations or deviations from approved plans must undergo further review by the Building Official.
5. In the event that construction or work has commenced prior to obtaining the proper permit(s), the Building Official will issue
a stop work order until such time that proper permit(s) have been obtained.
6. The City of Bella Vista shall not be responsible for the workmanship, safety, quality, or conformity to contractual
specifications of any permitted construction. This is a matter between the owner and general contractor.
I, the undersigned, do hereby certify that I have read and examined this document and know the same to be true and correct. I
certify that the above, together with the attached sites plans and building drawings, constitutes a true description of the proposed
building and accessory construction and the location on the site of all items of construction will be in accordance with these
documents. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or
not. I understand inspections by City Inspectors will be made only to determine compliance with construction codes and not to
assist the owner or contractor in properly locating the structure. I acknowledge my responsibility to insure, by boundary line
survey if necessary, that the location of the structure will conform to setback requirements of the Bella Vista Zoning or Subdivision
Ordinances. I understand that granting of a permit does not presume to give authority to violate or cancel the provisions of any
state or local law regulating construction or the performance of construction.
General Contractor / Owner Signature: Date: