Planning and Zoning

I have completed the checklist for the my Building Permit Application prior to submitting my application.

Building Permit Application
New Single Family Dwelling, Addition, Renovation/Rehab, Accessory Structure
Applicant/Owner Information
Applicant:

Date:

Phone:

Email:

Street Address:

City:

ZIP Code:

Project:



Property Owner:

Telephone:

Address:

City:

State:

ZIP Code:

Project Information
New Single Family DwellingAddition to Existing SF DwellingRenovation/Rehab to Existing SF DwellingAccessory Structure (Post Building/Detached Garage/In-Ground Pool)
Scope of Work:

Is this property in a floodplain?:
SelectYesNo
Utility Providers (electric, water, etc.):

Contractor Information
General Contractor:

Address:

City/State/Zip:

Phone:

Email:

Plumbing:

Phone:

Email:

License #:

Energy Rating Company:

Phone:

Electrical:

Phone:

Email:

What Electrical Provisions Are Being Used?
Select2020 Indiana Residential Code2009 Indiana Electrical Code

Mechanical/HVAC:

Phone:

Email:

Square Footage of Project
Basement (if applicable):

1st Floor (excluding garages and covered porches/patios):

2nd Floor (excluding covered porches and/or patios):

Garage:

Total SQFT of any covered porches, covered patios, and/or ANY deck 30” or more above adjacent grade:

Total SQFT:

No. of Bedrooms:

No. Full Bath:

No. Half Bath:

Total No. Bathrooms:

Est. Cost of Project:

**PLEASE READ BEFORE PROCEEDING**
Please ensure all required documents are submitted to prevent any delay in the issuance of the requested Building Permit.

Complete Copy of the BUILDING PERMIT Application:

DIMENSIONAL DRAWING of the Proposed Floor Plan:

**IF APPLICABLE** Copy of the Proposed Properties WATER/SEWAGE PERMIT

Disclaimer and Signature:
The plans furnished to the Perry County Planning Department are a basis which Perry County is entitled to act in issuing or revoking any permit or certificate of compliance. The plan(s) are incorporated, by reference, into this application. If there is any misrepresentation in this application or any associated documents, Perry County may revoke any permit or Certificate of Occupancy issued in reliance upon such representation. I agree to comply with all Perry County Ordinances, permit conditions, and State statues which regulate the building and construction, use, occupancy, and site development, and grant Perry County Officials the right to enter onto the property for the purpose of inspecting work related to this permit and/or posting any notices deemed necessary. I understand that, should I fail to have work ready for inspection and a re-inspection is deemed necessary, a re-inspection fee of $50 may be assessed. Furthermore, I understand that the 2005 Indiana Residential Code, as it pertains to energy efficiency (675 IAC 14-4.3 139.1), mandates a permanent certificate to be posted on or in the electrical distribution panel, and my failure to ensure that this posting is in place at time of final inspection of a new dwelling will result in an automatic failure of inspection and $50 re-inspection fee. Spec sheets for all engineered materials are required to be on site during times of construction for inspector reference. Failure to do so may result in a delay in your inspection process.

As the applicant for a building permit, I understand that I am required to request all inspections before a building can be occupied. Under Perry County Zoning Ordinances, it is unlawful to occupy a building until a Certificate of Occupancy has been issued by the Perry County Planning Department There are no exceptions to this rule. Under the terms of the Ordinance, I have an obligation to obtain a Certificate of Occupancy. I further acknowledge that I may be fined in accordance with Perry County Zoning Ordinances, in the event that I fail to comply with this requirement. I acknowledge that it is my obligation to inform the occupant of the structure if a Certification of Occupancy has not been issued, or if any outstanding code violations exist. I acknowledge my obligation to obtain a Certificate of Occupancy under Perry County Zoning
Ordinance, and understand that I have an obligation to advise any potential occupant of my failure to have final inspection completed and/or have a Certificate of Occupancy issued.

I certify that my answers are true and complete to the best of my knowledge.

Signature:

Date: