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Construction Permit Application
{[CNAME]}
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}
Specify the Work Site address
Project
Applicant
Technical Sections
Attachments
Certification
Residential
Commercial
Public
Septic Tank
Gas
Oil
Electricity
Coal
Other
Masonry
Wood Frame
Structural Steel
Reinforced Concrete
Other
Public
Well
Siding
Property Type
9) Total Land Area Disturbed (Sqft)
Project Information
13) Type of Frame
Blacktop
Cost of Construction
4) Area of New Building (Sqft)
Fencing
1) Number of Stories
8) Sewage Disposal
Describe the work to be done in this project
Plumbing
Select proposed work type(s)
6) # of Parking Spaces
Masonry
Remodeling
Roofing
Qual
12) Heating Fuel
Demolition
Work Site
If Other
New Building
Lot
If Other
2) Height of Structure (Ft)
Electrical
11) Width
Work Site Unit
Building/Site Characteristics
Block
3) Largest Floor Area (Sqft)
Addition/Alteration/Repair
10) Length
Utility/Sheds
Recreation/Pools
5) Volume of New Structure (Cuft)
7) Water Supply
Same as Agent/Contractor
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AR
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CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
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KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
- Territories -
AS
GU
MP
PR
UM
VI
- Armed Forces -
AA
AP
AE
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
- Territories -
AS
GU
MP
PR
UM
VI
- Armed Forces -
AA
AP
AE
Responsible Person Information
State Licence Number
City/State/ZIP
ZIP
Address
Architect/Engineer Information
Name
State
Address
Phone #
State
Name
City/State/ZIP
Phone #
City
Tenant Information
Phone #
ZIP
Provide information for a primary contact person for this application. e.g. the property owner, the agent/contractor, a project supervisor, foreman, etc.
Cell #
Name
Fax #
Phone #
Name
Address
Federal Employer ID Number (EIN)
Builder's Registration
City
License Expiration Date
Email
Address
Name
Agent/Contractor Information
Cell #
Property Owner is Agent/Contractor
Property Owner Information
Email
Cell #
Email
Email
Add Plumbing
Add Fire Protection
Add Mechanical
Add Building
Add Electrical
Add technical sections for all applicable subcodes
Attachments
Attach any plans or supporting documents that will allow the construction department to review this application more efficiently.
Submit
Type Full Name :
Sign With Hand
Clear
Done
Yes
Signature
Certification
I have read and understand all requirements for my submission
I HEREBY CERTIFY I AM THE ( AGENT OF) OWNER OF RECORD AND AM AUTHORIZED TO MAKE THIS APPLICATION
Subtotals
The costs of work below are summarized from the information provided in this application.
Permit Subtotal
Total Cost of Work
Certificate Fee
Admin Fee
Electrical
Building
Plumbing
Demolition
Alteration
Fire
Estimated Fees
Mechanical
Subcode
New Building
Cost of Work Summary
The fees below are estimated based on the information provided in this application and are subject to change upon review.
Total
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AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
- Territories -
AS
GU
MP
PR
UM
VI
- Armed Forces -
AA
AP
AE
A-1
A-2
A-3
A-4
A-5
B
E
F-1
F-2
H-1
H-2
H-3
H-4
I-1
I-2
I-3
I-4
M
R-1
R-2
R-3
R-4
R-5
S-1
S-2
U
Pylon
Ground/Wall
Above Ground
In-Ground
Roofing
License Expiration Date
Demolition
Fence
Retaining Wall
Subcode Fee
Type of Work
Siding
Addition
Rehabilitation
Provide information for whoever will be performing Building work.
Total Fee
New Volume (Cuft)
Estimated Fees
Asbestos Abatement
Area (sqft)
Email
Demolition
Lead Haz. Abatement
Rehabilitation
Address
Description of Work
Radon Remediation
Phone #
Pool
Federal Employer ID Number (EIN)
Building Subcode
State Licence Number
Admin Fee
Estimated Cost of Work
Other Items Fee
New Building
Name
Total
City
State
Sign
Area (sqft)
New Area (Sqft)
Area (sqft)
Cell #
Height (exceeds 6ft)
ZIP
New Building
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Same as Owner
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Same as Agent/Contractor
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
- Territories -
AS
GU
MP
PR
UM
VI
- Armed Forces -
AA
AP
AE
A-1
A-2
A-3
A-4
A-5
B
E
F-1
F-2
H-1
H-2
H-3
H-4
I-1
I-2
I-3
I-4
M
R-1
R-2
R-3
R-4
R-5
S-1
S-2
U
Provide information for whoever will be performing Electrical work.
Description of Work
Alarm Devices/F.A.C Panel
Subcode Fee
Motors - Fract. HP
Cell #
License Expiration Date
Total
Utility Company
Lighting Fixture
TOTAL NUMBERS
Estimated Fees
Admin Fee
Emergency & Exit Lights
Specify
State Licence Number
New Building
Switches
Other Items Fee
Total Fee
Phone #
Detectors
Temporary
City
Light Poles
Pole/Pad #
Storable Pool/Spa/Hot Tub
Pole/Pad
Demolition
Items
Electrical Subcode
Pool Permit/with UW Lights
To enter AMP/KW/HP items click "Add Electrical Item" below
State
Rehabilitation
Communications Points
Address
Email
Federal Employer ID Number (EIN)
Quantity
Name
Estimated Cost of Work
Electrical Characteristics
Receptacles
Building Occupied As
Other
ZIP
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Same as Owner
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Add Fire Protection Item
Same as Agent/Contractor
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
- Territories -
AS
GU
MP
PR
UM
VI
- Armed Forces -
AA
AP
AE
A-1
A-2
A-3
A-4
A-5
B
E
F-1
F-2
H-1
H-2
H-3
H-4
I-1
I-2
I-3
I-4
M
R-1
R-2
R-3
R-4
R-5
S-1
S-2
U
New
Modification to Existing
Conversion
Replacement
Flammable
Combustible
New
Existing
New
Existing
System
Gas
State
Phone #
Pre-engineered Systems
State Licence Number
Fire Protection Characteristics
Smoke Control System
Cell #
Location of Panel
Location of Main Control Valve
Address
Dry Chemical
Oil
Provide information for whoever will be performing Fire Protection work.
Estimated Fees
Total
Alarm Valves
Fuel Storage Tank
License Expiration Date
Foam Suppression
Method of Alarm/Suppression System Supervision
Water Supply Source
Fireplace Venting/Metal Chimney
Fuel-Fired Appliances
Kitchen Hood Exhaust System
Other Systems
Pre-action Valves
TOTAL
Total Fee
Wet Chemical
Supervisory Devices (i.e., tampers, low/high air)
Federal Employer ID Number (EIN)
Description of Work
Fire Pump/GPM Type
Subcode Fee
Other Items Fee
Heating System
Standpipes
Number
110v Interconnected
Electric
Fire Protection Subcode
City
Fuel Type
Admin Fee
CO2 Suppression
Alarm System
CO Detectors/110v
New Building
Fire Alarm System
ZIP
Number
Flammable/Combustible Tanks
Signaling Devices (i.e., horn strobes, bells)
Solar
Number
Rehabilitation
Estimated Cost of Work
Capacity
Oil
Fire Suppression/Standpipe System
Gas
Item
Alarm Devices (i.e., smoke, heat, pulls, water/flow)
Number
Email
Sprinkler Heads (Dry and Wet)
Location
Demolition
FM200 Suppression
Other
Dry Pipe
Name
Suppression Systems
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Reset
Same as Owner
Same as Agent/Contractor
Add Plumbing Item
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
- Territories -
AS
GU
MP
PR
UM
VI
- Armed Forces -
AA
AP
AE
A-1
A-2
A-3
A-4
A-5
B
E
F-1
F-2
H-1
H-2
H-3
H-4
I-1
I-2
I-3
I-4
M
R-1
R-2
R-3
R-4
R-5
S-1
S-2
U
Public Sewer
Private Septic
Public Water
Private Well
Provide information for whoever will be performing Plumbing work.
Estimated Cost of Work
State Licence Number
City
Sink
Quantity
Hose Bibb
Drinking Fountain
Public Sewer/Private Septic
Gas Piping
Other Items Fee
Bath Tub
Stacks
Steam Boiler
Water Closet
Sewer Connection
Washing Machine
Cell #
Shower
Plumbing Subcode
Water Service Connection
Public Water/Private Well
Admin Fee
Federal Employer ID Number (EIN)
Plumbing Characteristics
Dishwasher
State
Name
Water Heater
Hot Water Boiler
Greasetrap
Total
Total Fee
Subcode Fee
Floor Drain
ZIP
Water Service Size
Lavatory
Rehabilitation
Backflow Preventer
Address
Urinal/Bidet
Fuel Oil Piping
Building Sewer Size
Demolition
Description of Work
Estimated Fees
Items
Email
License Expiration Date
Phone #
Interceptor/Separator
New Building
LPGas Tank
Sewer Pump
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Add Mechanical Item
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Same as Agent/Contractor
Same as Owner
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
- Territories -
AS
GU
MP
PR
UM
VI
- Armed Forces -
AA
AP
AE
A-1
A-2
A-3
A-4
A-5
B
E
F-1
F-2
H-1
H-2
H-3
H-4
I-1
I-2
I-3
I-4
M
R-1
R-2
R-3
R-4
R-5
S-1
S-2
U
New
Modification to Existing
Conversion
Replacement
Provide information for whoever will be performing Mechanical work.
Items
Address
Fuel Type
Estimated Cost of Work
Total
Hydronic
Fireplace
Mechanical Characteristics
Heating System Work
Mechanical Subcode
Hot Air Furnace
License Expiration Date
Gas Piping Connections
Hot Air
Admin Fee
Steam Boiler
Demolition
Water Heater
City
Rehabilitation
Oil Tank
Fuel Oil Piping Connections
Description of Work
Other Items Fee
Total Fee
Generator
State
Electric
Estimated Fees
Email
Oil
LPG Tank
New Building
Quantity
Other
Hot Water Boiler
Subcode Fee
Cell #
State Licence Number
Name
Federal Employer ID Number (EIN)
Gas
ZIP
Solar
Type
Phone #
Save
Cancel
Building
Electrical
Fire
Mechanical
Plumbing
A-1
A-2
A-3
A-4
A-5
B
E
F-1
F-2
H-1
H-2
H-3
H-4
I-1
I-2
I-3
I-4
M
R-1
R-2
R-3
R-4
R-5
S-1
S-2
U
Use Group
Construction Item
Fee
Search Item by Name
Subcode
Size
(Electrical Only)
Item
Quantity
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