DEMOLITION PERMIT APPLICATION by HC120808022137

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									                                                                                       Permit # _____________

             DEMOLITION PERMIT APPLICATION
Demolition Location: __________________________________________________
Owner: ____________________________________________________________
Address: ___________________________________________________________

Contractor: _________________________________________________________
Address: ___________________________________________________________
Contractor’s Proof of Insurance (Certificate No.):________________________________
No. of Stories: _______ Building Use: ______________________________________

No. of Dwelling Units: _________

Building Size:        ______ft. wide                 by ______ft. long                             by ______ ft. high

Application Date: ____________

Work Start Date: _____________

Work Completion Date: ___________

Total Contract Price: $___________________________

Please describe how the demolition will be carried out, be specific: _________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

Demolition. The fee for a demolition permit shall be based on the estimated cost of demolition per building /
structure including work on filling, grading, cleaning or safeguarding of the site. A permit shall be issued only after
clearance from all utility companies having services that will be or could be affected has been obtained. The fee
scales of subsection 9-1-3B4 of the City Code shall apply for each building/structure to be demolished.

Permit Fee: $ ________________

Remarks: ___________________________________________________________
__________________________________________________________________
__________________________________________________________________

I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the
owner to make this application as his authorized agent and we agree to conform to all applicable laws of this
jurisdiction.

Signature of applicant___________________________________________________

Inspector___________________________________________________________
                        F:\word\Building & Zoning\CCO\Permits and Applications\Permits on Website\DEMOLITION PERMIT APPLICATION.doc

								
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