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2. BUILDING PERMIT APPLICATION
3. Permit No.______________
5. Permit Applicant*

   1. Owner/Occupant

   1. Contractor

   1. Third Party
9. Customer Data
11. Name of Owner or Tenant*
13. Address*
15. City*
16. State*
17. Zip Code*
19. Phone Number*
20. Email Address*
24. Contractor Data
26. Company Name
28. Address
30. City
31. State
32. Zip Code
34. Phone Number
35. Email Address
39. Third Party Applicant
41. Name
43. Address
45. City
46. State
47. Zip Code
49. Phone Number
50. Email Address
54. Proposed Project Data
56. Construction Value*
    (Materials and Labor/Install Costs)
58. Description of Work*
    -- Select One --AdditionDeckDrivewayElectricalFenceFire AlarmFire SprinklerFire Suppression Wet ChemicalLand Development / Site ImprovementMechanicalNew BuildingOtherPatio / Stoop / SidewalkPlumbingRemodelRoofSewerShedSign - PermanentSign - TemporarySolarSwimming PoolTemporary TentWater HeaterWindows/Doors
60. Driveway Type
    -- Select One --AsphaltConcretePavers
61. Select Work Type(s)

    1. Patio
    2. Stoop
    3. Public Sidewalk
    4. Private Service Walk
62. Material Type
    -- Select One --ConcreteLandscape Pavers/Blocks
64. Fence Type
    -- Select One --Chain LinkMetalVinylWood
65. Fence Height
    -- Select One --3 Feet4 Feet5 Feet6 Feet
67. Description of Work
69. Mechanical Type
    -- Select One --Air Conditioner OnlyAir Conditioner and FurnaceFurnace OnlyKitchen HoodRoof Top Unit
71. New Building Type
    -- Select One --New Commercial BuildingNew Residential BuildingNew Accessory Structure
73. Description of Building
75. Shed Foundation
    -- Select One --Concrete SlabFramed Platform on Gravel/GroundShed Directly on Gravel/Ground
77. Sign Type
    -- Select One --MonumentWall Mounted
78. Sign Details
    -- Select One --IlluminatedNon-Illuminated
79. Sign Square Footage
80. UL Number
82. Swimming Pool Type
    -- Select One --Above GroundIn Ground
84. Start and End Dates
    Start and End Dates Start Date

    —

    Start and End Dates End Date
86. Plat of Survey
    Upload plat of survey indicating proposed work
88. Contract / Scope of Work/ List of Materials*
    Upload contract or written scope of work
90. Plans
    Upload scaled drawings/blueprints of proposed work
92. Cut Sheets
    Upload equipment cut sheets and specifications
94. Engineer's Estimated Cost of Construction

    Upload Engineer's itemized estimated cost of construction

96. Location of Sewer Work*
    -- Select One --Within 5 feet of the buildingMore than 5 feet from the building
97. Sanitary Check Valve Program?*
    -- Select One --NoYes
99. Description of Work*
103. Informational Handouts
     Guides & Publications

     Please review the informational handouts related to your project as a general guide for code compliance.
105. Please note that additional information may be requested to complete your submittal. Incomplete submittals will not be reviewed until complete.
Leave This Blank:


107. 1. Receive an email copy of this form.
108. Email address

     This field is not part of the form submission.

109. Submit Submit and Print

* indicates a required field