Planning & Development Department
Building Permit Application
04/01/2019
501 North 44th St, Suite 200 - Phoenix, AZ 85008 - (602) 506-3301 - (602) 506-3282 fax
www.maricopa.gov/planning
Page 1 of 2
STORIES HEIGHT
N/A
ADDRESS
CITY STATE ZIP CITY
STATE ZIP
CONTACT NAME PHONE CONTACT NAME PHONE
EMAIL EMAIL
N/A
SINGLE FAMILY RESIDENTIAL
PROPERTY INFORMATION
PROJECT INFORMATION
PARCEL NUMBER
NEAREST CROSS STREETS
PERMIT TYPE
CUSTOM HOME CUSTOM HOME W/ BASEMENT
PROJECT ADDRESS
DETAILED WORK DESCRIPTION
__________________________________
__________________________________
CITY
, AZ
OWNER NAME
PRODUCTION HOME
#SP:______________________
WASTE WATER: SEWER SEPTIC ELECTRIC: APS SRP
$
UTILITIES TO PROPERTY (CHECK ONE AND FILL IN BLANK IF APPLICABLE)
GAS:
PROPANE
NATURAL GAS CO:__________________
CMU/BLOCK: ______LF ______HT
CHAINLINK: ______LF ______HT
CHECK "NO" OR "YES". PROVIDE THE RELATED INFORMATION IF APPLICABLE.
WATER: WELL HAULED COMPANY:_______________________
FENCE PERMIT TYPE
SQ FT
NO YES Building permit #:
B______________________
OTHER:________ _____LF ______HT
OTHER:_________ ______LF ______HT
ADDITIONAL PERMIT TYPE
1. Are there any code violations on this property?
IRON: ______LF ______HT
RETAINING: ______LF ______HT
NO YES Violation case #:
V______________________
PIPE: ______LF ______HT WOOD: ______LF ______HT
2. Is there any other construction occurring on this property right now?
NO YES Street name:
_________________________
APPLICANT INFORMATION
CONTRACTOR INFORMATION
3. Will there be a new septic tank or changes to existing septic?
#SP:______________________
NO YES Septic receipt #:
OW_____________________
PROPANE TANK: ________ GAL WATER TANK: ________ GAL
4. Does the driveway tie into a Maricopa County right-of-way?
ACCESSORY POOL / SPA
COMPANY NAME (IF APPLICABLE)
COMPANY NAME
ADDRESS
CHECK ONE
TRUST ACCOUNT NUMBER
AGENT ARCHITECT/ENGINEER OWNER SAME AS CONTRACTOR
ALL
Site Plan or Grading & Drainage Plan
7
Custom Home
Building Plan and Structural Calculations (if applicable)
3
SUBMITTAL DOCUMENTS REQUIRED FOR FIRST REVIEW
APPLICANT
SCOPE OF WORK
REQUIRED DOCUMENT
COPIES
ALL
Complete Permit Application Form and Proof of Ownership (copy)
1
Accessory Structure
Building Plan, Details and/or Structural Calculations
3
Firepit / Fireplace / BBQ / Propane
Details or Manufacturers' Specifications
3
Production Pool & Spa (Standard Plan)
Approval Letter from Pool Engineer
3
Above-Ground or Custom Pool & Spa
Building Plan and Calculations or Manufacturers' Specifications
3
Other:______________________________
_____________________________________________
______
FOR OFFICE USE ONLY
TRACKING NUMBER:
GOTO(S):
Fence or Pool Barrier ≤6' / Retaining Walls ≤4'
Fence Details
4
Fence or Pool Barrier >6' / Retaining Walls >4'
Engineered Fence Details and Structural Calculations
4
# BED
# BATH
YES NO
AREA OF LOT
SQ FT
Planning & Development Department
Building Permit Application
04/01/2019
501 North 44th St, Suite 200 - Phoenix, AZ 85008 - (602) 506-3301 - (602) 506-3282 fax
www.maricopa.gov/planning
Page 2 of 2
INITIALS:
PERSONAL GUARANTEE OF FINANCIAL RESPONSIBILITY
INITIALS:
DEVELOPMENT DISCLAIMER NOTICE
INITIALS:
PERSONAL ASSURANCE OF SUBMITTAL ACCURACY
INITIALS:
ACKNOWLEDGEMENT & AGREEMENT
SINGLE FAMILY RESIDENTIAL
I also certify, to the best of my knowledge, that each of the buildings, structures, and conditions reflected on the
FEE INFORMATION
I am aware and understand the fee information below:
I hereby absolutely, unconditionally and irrevocably guarantee to Maricopa County the prompt payment of any and all fees and charges in connection
with this application, without the necessity of Maricopa County first seeking payment from the named applicant.
This includes that if at any time, a written cancellation is submitted for this project application, I personally guarantee
prompt payment of the balance of any and all fees and charges incurred.
By initialing / signing this application and disclaimer, I state that I am either the owner of record of the parcel and/or authorized by the owner(s) to represent
them regarding the subject parcel. I understand that the issuance of a Building Permit for this property (APN _________________________________) by
Maricopa County DOES NOT GUARANTEE THE AVAILABILITY OF POTABLE WATER AT THIS SITE.
I also am aware and understand that issuance of the Building Permit does not obligate Maricopa County to issue a permit for
electrical service for a shared well to serve this site, should this site be included within a private shared well agreement.
I hereby unconditionally and without reservation guarantee and warranty to Maricopa County that the documents submitted to Maricopa County Planning
and Development, including but not limited to the application materials and/or any and all site plan(s) and building plans, provide a true and accurate
depiction of the requested construction and accurately reflect the existing conditions of the subject parcel.
I am aware that Maricopa County Planning and Development will rely upon the accuracy of the materials provided to perform a Zoning Clearance review,
as required in the Maricopa County Zoning Ordinance, Section 1504.5. I have also seen and verified that the submitted site plan materials include and
accurately provide all listed items on the Department’s Site Plan Checklist.
I am aware and understand that the issuance of a Building Permit does not represent that Maricopa County has verified or authenticated the veracity of
any materials submitted in support of the application for permit. I understand that Maricopa County will issue a Building Permit based upon the subject
materials and that any falsification of documentation submitted as part of this permit application may void the Building Permit upon which it is based.
In addition, issuance of a Zoning Clearance in conjunction with this application by the Department does not approve or imply the approval of other
structures, permitted or unpermitted, which may be on the same property, but which are not the subject of this permit request.
submitted plan is in compliance with the Maricopa County Zoning Ordinance, which may be found at:
www.maricopa.gov/DocumentCenter/View/272/Maricopa-County-Zoning-Ordinance-PDF
I acknowledge that I am the property owner or I have the authority to represent the property owner on this application as an authorized agent for the
property. Further, I guarantee access to Maricopa County personnel for the purpose of building inspections, zoning enforcement and the provision of
emergency services. I agree to abide by all of the development laws of Maricopa County. The information and plans provided are correct to the best of my
knowledge including recorded lot dimensions and structure locations. I understand filing of an application containing false or incorrect information, with the
intent to avoid the licensing requirement of ARS Title 32, is falsification pursuant ARS section 13-2701 and is a class 2 misdemeanor.
Owner / Builder will do the work themselves, with their own employees, for owner’s use and not for sale or rental within one year
of completion.
YES NO
Owner / Applicant is claiming another exemption under ARS, Section 32-1121.A. A signed statement from the Registrar of
Contractors verifying exemption must be attached.
YES NO
PRINT NAME:
(CHECK ONE):
AGENT CONTRACTOR OWNER
SIGNATURE:
DATE:
FOR OFFICE USE ONLY
TRACKING NUMBER:
GOTO(S):
For residential projects, there is an online fee estimator to assist with planning / preparing for your project:
www.maricopa.gov/391/Fee-Schedule-and-Estimators
An upfront fee will be required upon acceptance - $510 for a New Single Family Residence or Production Home.
If the application / permit submittal is not approved on the initial review, full permit fees will be required at the time the
revised submittal is accepted.
Any remaining fee balance must be paid prior to permit issuance.
If a permit application is denied, any unearned fees will be refunded.