KENTUCKY BUILDING CODE PERMIT APPLICATION
PROJECT INFORMATION
Site Address __________________________________________________________________________________________
Business or Project Name
_________________________________________________________________________OWNER INFORMATION
Last or Corporate Name ____________________________________________________ First _______________________
Mailing Address ______________________________________________________________________________________
City ___________________ State _____ Zip ___________ Phone_______________ Cell_________________
DESIGN PROFESSIONAL INFORMATION
Architect (Name & Firm)________________________________________________________ Phone________________
Address__________________________________________ City_________________ State_____ Zip___________
Engineer (Name & Firm)________________________________________________________ Phone________________
Address__________________________________________ City__________________ State_____ Zip___________
CONTRACTOR INFORMATION
Project Contractor______________________________________________________________ Phone________________
Mailing Address________________________________________________________________ Cell_________________
BUILDING INFORMATION
Use of Building_______________________________________________________________________________________
New Freestanding___ Addition___ Renovation___ Tenant Space___ Change Of Use___ Foundation___ New Floor Area____________ Existing Floor Area___________ Basement (Y/N)______ No. Of Floor Levels_____
CONSTRUCTION COST
Building_____________ Mechanical_____________ Electrical_____________ Plumbing_____________
PLAN SUBMITTALS
Site Plan___ Soil Report___ Architectural ___ Structural___ Mechanical___ Electrical___
Sprinkler___ Alarm System___ Range Hood___ Swimming Pool___
CERTIFICATION
I hereby certify that I am the owner of record of the named property, or 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 I agree to conform to all applicable laws of this jurisdiction. In addition, if a permit for work described in this application is issued, I certify that the code official or the code official’s authorized representative shall have the authority to enter areas covered by such permit at any reasonable hour to enforce the provisions of the code(s) applicable to such permit. I further testify that the above information is true and accurate.
Signature __________________________________________________________ Date ________________
Departmental Approvals: Zoning_______________________________ Date________________