2. TWO SETS OF BLUEPRINTS AND A CERTIFIED LOT SURVEY MAY BE REQUIRED
4. SITE ADDRESS
5. Property Type

   1. Residential

   1. Commercial
7. PARCEL ID
8. APPLICANT IS A:

   1. CONTRACTOR
   2. OWNER
9. PROJECT VALUATION: LABOR & MATERIALS
13. CONTRACTOR NAME
14. CONTACT PERSON
16. CONTRACTOR LICENSE NUMBER
17. CONTRACTOR ADDRESS
19. City
20. State
21. Zip
23. CONTRACTOR PHONE
24. CONTRACTOR EMAIL
28. HOMEOWNER NAME
29. HOMEOWNER PHONE
31. HOMEOWNER ADDRESS (IF DIFFERENT FROM SITE ADDRESS)
33. City
34. State
35. Zip
39. TYPE OF WORK

    1. NEW CONSTRUCTION
    2. ACCESSORY BUILDING
    3. BASEMENT FINISH
    4. PLUMBING

    1. ADDITION
    2. RE-ROOF
    3. DECK
    4. DEMOLITION

    1. REMODEL
    2. RE-SIDE
    3. PORCH
    4. EXCAVATION/FILL

    1. GARAGE
    2. WINDOWS/DOOR
    3. HVAC
    4. OTHER
41. If re-roof, is the roof:

    1. Over 20 squares
    2. Less than 20 squares
42. Windows/Doors

    1. 1-3
    2. 4-8
    3. 9+
43. Standard Residential Rates and Fees

    Re-roof over 20 squares: $76.00

    Re-roof under 20 squares: $51.00

    Re-side: $51.00

    Windows/Doors 1-3: $51.00  4-8: $81.00  9+: $111.00

    All other project fees are calculated based on valuation of labor/materials.

47. PLEASE PROVIDE A BRIEF DESCRIPTION OF THE WORK BEING PERFORMED
51. TYPE OF STRUCTURE

    1. SINGLE FAMILY

    1. MULTI FAMILY

    1. TOWN HOME
55. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
57. Electronic Signature
59. APPLICANT EMAIL
61. Online Payment Link:
    AllPaid
Leave This Blank:


63. 1. Receive an email copy of this form.
64. Email address

    This field is not part of the form submission.

65. Submit

* indicates a required field