Building Permit

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APPLICATION FOR BUILDING PERMIT

I. Location of Building
Location Zoning:
Between (street) and (street)
Subdivision Lot Block Lot Size ' x '

II. Identification

Owner(s) or Leasee(s)	Address	City	St.	ZIP	Phone


Contractor(s)	Address	City	St.	ZIP	Phone


Architect or Engineer	Address	City	St.	ZIP	Phone

III. Type and Cost of Building - All applicants complete Parts A - E
A. Type of Improvement
1. New building       2. Addition (enter new residential units in Part E, #21)
3. Alteration (see 2 above)    4. Repair, replacement
5. Wrecking (enter multifamily residential units in Part E, #21)    6. Moving (relocation)    7. Foundation only
B. Ownership
8. Private 9. Public
C. Principal Type of Frame
10. Masonry    11. Wood frame
12. Structural Steel 13. Reinforced concrete
14. Other
D. Principal Type of Heating Fuel
15. Gas     16. Oil     17. Electric     18. Coal
19. Other
E. Proposed Use (for wrecking most recent use)
Residential
20. One family     21. Two or more family (# of units )
22. Transient hotel, motel or dormitory (# of units )     23. Garage
24. Carport     25. Other
Non-Residential
26. Amusement/Recreational          27. Church/Religious
28. Industrial                                29. Parking garage
30. Service station/Garage           31. Hospital/Institution
32. Office/Bank/Professional           33. Public utility
34. School/Library/Educational         35. Stores
36. Tanks/Towers                        37. Other
F. Type of Sewage Disposal
38. Public     39. Private
G. Cost
40. Cost of Improvement $
To be installed but not included in above cost
a. chimney     b. plumbing     c. HVAC     d. Other
41. Total Cost of Improvement $
H. Dimensions
42. Number of stories
43. Total sq. ft. floor area, based on exterior dimensions
44. Total land area (sq. ft.)
I. Number of Off-Street Parking Spaces
45. Enclosed       46. Outdoors
J. Residential Buildings Only
47. # of bedrooms       48. # of bathrooms: full partial

IV. Specification
Footings: width ', thickness ', depth ', reinforcing ', below grade '
Foundation: width ', above grade ', reinforcing , masonry

	Size	Spacing	Span	Site or Plot Plan - for Applicant use
Girders	'	'	'
Joist 1st fl.	'	'	'
Joist 2nd fl.	'	'	'
Joist ceiling	'	'	'
Ext. studs	'	'	'
Int. studs	'	'	'
Roof rafters	'	'	'
Covering
Exterior walls
Interior walls
Roof sheathing
Roofing

The approval of this application and the issuance of a permit does not legalize or authorize any work that is not in compliance with the Code of the City of West Plains or the State of Missouri regulating same.

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.

Name: Signature: ___________________________________ Date: / /20

Do not write below this line

V. Validation
Building permit #:                            Building permit issued:        /        /
Building permit fee: $                      Certificate of occupancy: $
Drain tile: $                                     Plan review fee: $
Use group:                  Fire grading:                     Live loading:                  Occupancy load:
Approved by:                                                      Title:

VI. Zoning Plan Examiners Notes
District __________________________________________________________________________________________
Use ____________________________________________________________________________________________
Front Yard _______________________________________________________________________________________
Side Yard ________________________________________________________________________________________
Rear Yard ________________________________________________________________________________________
Notes

Return to:
West Plains City Hall
1910 Holiday Lane
P. O. Box 710
West Plains, Missouri 65775