Building Permit Invoice by sdaferv


									                                                                  Building Permit
                                                                  IJD Inspections Ltd.
                                                        #E4, 5560-45 Street, Red Deer, Alberta T4N 1L1
                                                     Toll Free 1-877-617-8776 / Fax 1-866-801-7639

                                                                                                                      Permit #
EPS# (Office Use)                                                                       Development Permit #

Owners Name:                                                                            Address:
                                                                                        City:                            Prov:            P.C.:
                                                                                        Phone: (             )                     Fax: (         )

Architect and/or Engineer (if applicable):

Contractor:                                                                             Address:
                                                                                        City:                            Prov:            P.C.:
                                                                                        Phone: (             )                     Fax: (             )

Municipality:                                                                            Street Address:
Lot                   Block                 Plan                                        Subdivision Name:
Legal Subdivision: Part of:                     Sec:            Twp:              Rge:             W.of:                  Square Footage:
Project Information:
Type of Work:                       New Construction                        Addition                    Repair                   Alteration                   Other
Intended use or occupancy of the building
Building Area (ft ²):                  Number of Storys:                                           Expected Completion Date:
Description of Work

Value of Work (materials and labour): $

           Permit Applicant Name (print or type)                                                                   Permit Applicant Signature
 Permit Validation Section:
  Application Date:
 Special Conditions:
          See Plan Review Report                                                                  See Handout Included
Issuing SCO's Name                                                                   Issuing SCO's Signature

Issuing SCO's Designation #                                                                                      Date of Issue

Permit Fee        $                                    Method: Visa              M/C          Cash         Cheque           Debit Card          Other
                                          Purchase Order #:                                                                       THIS IS YOUR RECIEPT
*SCC Levy        $
                                          Cardholders Signature                                                          Expir. Date                  /
Total Fee         $
                                          Credit Card #:
The personal information on this form is protected by the Freedom of Information and Protection of Privacy Act
 *Safety Codes Council Levy is $4.00 or 3.5% of the permit fee, whichever is greater. Permits are GST exempt                                              Print Form

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