Building & Electrical Permit Application Step 1 of 2 50% Page 1 ofBuilding PermitElectrical PermitMunicipalityCountyTax ParcelConstruction Site LocationDate ReceivedMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920OwnerTenantOwner Address Street Address City State / Province / Region ZIP / Postal Code Tenant Address Street Address City State / Province / Region ZIP / Postal Code Owner phoneTenant PhoneFront Yard in FeetFront of building to property lineRear Yard in FeetRear of building to property lineSide Yard in FeetSide Yard in FeetDescribe proposed work in detailState Classification New Commercial Other Commercial New Residential Other Residential Building PermitContractorif owner, put same name aboveAddress Street Address City State / Province / Region ZIP / Postal Code PhoneCellFed Employee No.Certificate of Insurance for Workers Compensation needed or signed exemption formEstimate of total costs for all workTotal square ftUse GroupType ConstructionNo. of StoriesHeight of StructureDescription of WorkType of WorkAlterations/Additions of:Square FtType of work Roofing Fencing Sign Pool Deck Demolition Accessibility Roofing - Total square feetFencing, supply height if it exceeds 6 footSign - Total Square feetPool - Total Square feetDecks - Total Square FeetDemolition - Total Square feetAccessibility DescriptionOtherUpload Drawings, Plans, and Other Required Documents Drop files here or Select files Accepted file types: jpg, jpeg, png, pdf, doc, docx, xlsx, Max. file size: 50 MB, Max. files: 5. I hereby acknowledge that I have read this application and state the above is correct to comply with all Municipal ordinances and state laws regarding construction.Signature Building Signature Owner Contractor Owner Representative Electrical PermitContractorif owner, put same name aboveAddress Street Address City State / Province / Region ZIP / Postal Code PhoneCellFed Employee NoCertificate of Insurance for Workers Compensation needed or signed exemption formEstimate of total costs for all workTechnical SiteLight Fixtures Data No.Receptacles Data No.Switches Data No.Detectors Data No.Motor-Fractional Data No.HPCommunication Devices Data No.Alarm Devices/Systems Data No.Emergency & Exit Lights Data No.Pool Bonding Data No.Service Data No.Service SizeSub-Panel Data No.Sub-Panels SizeFeeders Data No.Feeders SizeBaseboard Heater Data No.Dryer Receptacle Data No.Range Data No.Dishwasher Data No.Garbage Disposal Data No.Heater Data No.Central A/C Units Data No.Signs Data No.Upload Drawings, Plans, and Other Required Documents Drop files here or Select files Accepted file types: jpg, jpeg, png, pdf, doc, docx, xlsx, Max. file size: 256 MB. Survey FeeOthersSignatureElectrical Signature Owner Contractor Owner Representative
