2. 
4. Miscellaneous Permit Application
6. Date*
   Date
7. Type of Permit*

   1. Electrical
   2. Mechanical
   3. Plumbing

   1. Mobile Home
   2. Other
8. If other, please describe
10. Applicant*
11. Phone:*
12. Email*
14. Address of Property*
15. Lot#
16. Subdivision
18. Owner
19. Phone
21. Email Address
23. Mobile Home Setter/Contractor
24. Phone
26. Electrical Contractor
27. Phone
29. Mechanical Contractor
30. Phone
32. Plumbing Contractor
33. Phone
35. Is Contractor Billable?

    1. Yes
    2. No
36. Fees:

    1. Mechanical - $25/each
    2. Electrical - $25/each
    3. Plumbing - $25/each
    4. Mobile Home - $15/each
37. If not billable, please PAY ONLINE here:
    Click to open GovPay.net
39. Intended Use:*

    1. One Family Dwelling
    2. Two Family Dwelling
    3. Multi-Family
    4. Commercial
40. If Multi-Family, how many units?
41. Upload any supporting documents
43. Describe Project*
45. For Remodel Only: Estimated Cost of Project*
47. eSignature*
    I understand and agree that by typing my name above I am providing a legal signature on this application for the building permit.
48. Relationship to Applicant*
    Describe your relationship to the applicant.
Leave This Blank:


50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit Submit and Print

* indicates a required field