BUILDING PERMIT APPLICATION

BUILDING PERMIT APPLICATION 240 E GAMMON RD (801) 226-1929 [email protected] Effective July 1, 2016

SUBMITTAL DATE: SITE ADDRESS:

PARCEL #:

SUBDIVISION:

PHASE:

LOT:

PROJECT DESCRIPTION: VALUATION:  RESIDENTIAL  NEW CONSTRUCTION  REMODEL  SOLAR  OTHER

 ADDITION  BASEMENT FINISH  REPAIR

 COMMERCIAL  NEW CONSTRUCTION  TENANT FINISH  SOLAR  OTHER

APPLICANT NAME:

PHONE:

PRIMARTY CONTACT:

EMAIL:

OWNER:

PHONE: MAILING ADDRESS

CITY

 ADDITION  SIGN  REPAIR

ST

ZIP CODE

DESIGNER: EMAIL:

PHONE:

ENGINEER: EMAIL:

PHONE:

GENERAL CONTRACTOR:

LICENSE:

EMAIL:

PHONE:

ELECTRICAL CONTRACTOR:

LICENSE:

EMAIL:

PHONE:

MECHANICAL CONTRACTOR:

LICENSE:

EMAIL:

PHONE:

PLUMBING CONTRACTOR:

LICENSE:

EMAIL:

PHONE:

I ACKNOWLEDGE THAT ALL OF THE INFORMATION PROVIDED ON THE APPLICATION IS TRUE AND ACCURATE AND THAT SUBMITTAL OF AN APPLICATION DOES NOT CONSITUTE THE ISSUANCE OF A BUILDING PERMIT OR THE APPROVAL FOR CONSTRUCTION.

APPLICANT SIGNATURE

DATE