COALVILLE CITY BUILDING PERMIT APPLICATION

COALVILLE CITY BUILDING PERMIT APPLICATION Phone

435-336-5981

Fax 435-336-2062

Note: A minimum 24 hour notice is required on

all

inspection requests

This side of form for office use only! Permit Number

Phone:

Owner of Property:

Date Issued

Utah State Permit Number

Square feet of building:

Mailing Address:

Bldg. Address: Assessors Parcel No.

Proposed use of Structure:

Date of Application

Lot #

Suhd. Name:

Finished Bsmt

Valuation

Main Level

Building Fee

2nd Floor

Plan Review

3rd

Electrical

Garage

Plumbing

Deck

l-IVAC

Other

Permitted Use

Building Footprint

Acres in Parcel

of Dwellings now on site

# of Bldgs. now on site

It

Fees for Building Permit:

Water # of out Bldgs on site

Number of

Sewer

Dwellings:

Demolition

Occupancy:

Double ble Fee

Type of Improvement/ Construction

State 1%

Sign:

New Const:

Remodel:

Repair:

Move:

DI:

Addition:

Demo:

Number of Sub Total:

Stories: Type

Impact Fees:

Construction: Architect or Engineer:

Roof Snow

Area Code:

Load:

Phone:

Culinary Water Sewer

Other Requirements:

General Contractor:

Sub Total:

Address: Total: .: . LicNo

Approvals:

Area Code: ,

Phone: Zoning:

Electrician: Phone:

Area Code:

Zoning District:

Setbacks:

Front Yard:

.: . LicNo

Rear Yard:

Side Yards:

Plumber:

Left:



Right:

Phone:

Area Code: Lic. No.:

Community Development Director

I I VAC:

Date

Phone:

Area Code: Lie. No.:

Public Works:

'this permit becomes null and void if work or construction is not commenced within 180 days after permit has been issued, or if construction is suspended or abandoned for a period of 180 days at

Public Works Representative

Date

Building Representative

Date

any time after work has begun. I hereby certify that I have read and examined this application and know the same to be true and correct.

Signature of Contractor

Building:

Date Comments:

Signature nt Owner

{Make Checks Payable to Coalville City)

Date