Fillable PERMIT APPLICATION Community Development Department 1000 Civic Center (Niles)

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PERMIT APPLICATION Community Development Department 1000 Civic Center (Niles)

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

PERMIT APPLICATION

Community Development Department

1000 Civic Center Dr. Niles, IL 60714

847-588-8040 WWW.VNILES.COM

PLEASE SELECT ALL OF THE TYPES OF PERMITS THAT APPLY FROM BELOW:

Please select:  RESIDENTIAL  COMMERCIAL  SITE WORK

Permit #(office use)

_________________________

 Deck

 Shed

 Pool / Spa

 Roof

 Demolition

 Engineering

 Elevator

 Generator

 Sign

 Fence

 Water Meter

 Grading

 Backflow

 Plumbing

 Electrical

 Mechanical/HVAC

 Addition

 Interior Remodel

 Window / Door

 New

 Parking lot

 Concrete/Flat Work

 Fire Alarm

 Patio

 Foundation Repair

 Lawn Irrigation

 Fire Sprinkler

 Hood / Duct

 Detached Garage

 Cell Tower

 Flood Control

 Water Heater

 Drain Tile

 Hood Suppression

 Stairs / Stoops

 Porch

 Exterior Remodel

 Driveway

 Other__________________

Job Address:

____________________________

Cost of Work

: _______________

Type of Work:

_______________

____________________________

PROPERTY OWNER

Name: _____________________________________________ Address: _______________________________________________

Phone: ______________________ Cell: _________________________ E-mail: _______________________________________

APPLICANT INFORMATION

Check One:  Property Owner (same as above)  Contractor  Tenant  Other

_________________________

Contact Person: ________________________________________ Address: ___________________________________________

Phone: _______________________ Cell: ________________________ E-mail: ________________________________________

Contractor Business Name (if applicable): _____________________________________________________________________

I hereby certify that I have read and examined this application and that all statements and information provided is correct; and

further certify that I am the owner of the property, and agree that all work will be performed in compliance with the terms of this

permit, approved construction documents, and all applicable Village of Niles code requirements.

As owner, I authorize (print name of authorized agent) _____________________________________________________________________

to submit this application and to act on my behalf in regard to this application and any permit issued pursuant to this application.

As authorized by the owner of the property, for which this permit is being requested, I hereby accept the responsibilities of the

owner as set forth above.

___________________________________________________________________________________________________________

Owners Signature Date Authorized Agent Signature Date



Updated12/5/19

Villageapproval:_________________________





ContractorsBusiness

name

Address,city,state,zip Phone# Email

GeneralCon‐

tractor

   

Carpenter

   

Electrician

LicenseRequired LicenseRequired LicenseRequired LicenseRequired

Plumber

LicenseRequired LicenseRequired LicenseRequired LicenseRequired

Mechanical

   

Steel

   

Brick

   

Excavator

   

Concrete

   

FireProtecon

LicenseRequired LicenseRequired LicenseRequired LicenseRequired

Water

LicenseRequired LicenseRequired LicenseRequired LicenseRequired

Sewer

   

Roof

   

Elevator

   

Data/Comm.

   

Alarm

LicenseRequired LicenseRequired LicenseRequired LicenseRequired

Other

   

ALL JOB SITE DUMPSTERS MUST BE OBTAINED FROM GROOT

1-800-244-1977

Failure to obtain Groot dumpsters will result in a stop work order and / or possible fine.

PLEASEVIEWCORRESPONDINGPERMITCONDITIONSHEETASADDITIONALINFORMATIONMAYBE

REQUIREDATTHETIMEOFSUBMITAL

BONDANDINSURANCEARENOLONGERREQUIRED

Providedetaileddescriponofwork:



Lighng

Voltage

277V

2

wire

3

wire

4

wire

15ampCircuits  

20ampCircuits  

30ampCircuits  

50ampCircuits  

Outletsonexisngcircuits

PlumbingFix‐

ture



FloorDrains 

WaterMeter

Size



TapSize 

Underground

sewer()



GasFixtures

RoofTopUnits

KitchenHoods

ExhaustFans



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PERMIT APPLICATION Community Development Department 1000 Civic Center (Niles)

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Completed 4 August 2020

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