Fillable Miscellaneous-permit-application-2019 CITY OF LITTLE ROCK

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Miscellaneous-permit-application-2019 CITY OF LITTLE ROCK

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CITY OF LITTLE ROCK
DEPARTMENT
OF PLANNING & DEVELOPMENT
BUILDING
CODES DIVISION APPLICATION FOR:
723
WEST MARKHAM, 2ND FL MISCELLANEOUS PERMIT
LITTLE
ROCK, AR 72201
PHONE (501) 371-4832 OR (501) 371-4805
FAX: (501) 371-4546 EMAIL: permits@littlerock.gov
OFFICIAL USE ONLY
PERMIT NO. 2019
DATE ISSUED
ISSUED BY
**SUBDIVISION COVENANTS AND RESTRICTIONS NOTICE**
The City gives permission for this project in accordance with local
ordinances. However, there may be subdivision covenants and
restrictions that apply, and this permit does not void or override those
covenants and restrictions.
PROJEC
T ADDRESS:
OWNER/TENANT: TELEPHONE:
ADDRESS
:
CONTRA
CTOR: LICENSE NO.:
ADDRESS:
TELEPHONE/FAX:
OCCUPAN
CY:
VALUATI
ON OF WORK: (LABOR AND MATERIAL)
PERMIT
TYPE: FENCE & WALL ROOFING SIDING
NOTICE
: SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, GAS, PLUMBING AND MECHANICAL WORK.
I hereby certify that the data submitted on or with this application is true and correct. Also, I have read and understand the
Subdivision Covenants and Restrictions Notice, as stated above. Any deviation from information contained herein unless
Approved by the Building Official will render this permit null and void.
SIGNATURE OF CONTRACTOR, OWNER OR AGENT DATE
REV 1/19
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Miscellaneous-permit-application-2019 CITY OF LITTLE ROCK

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Completed 1 November 2019

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