COMMUNITY AND DEVELOPMENT SERVICES APPLICATION FOR RESIDENTIAL BUILDING PERMIT HOPKINSVILLE KY Application Date:* Zoning:*OWNER INFORMATIONLast Name:*First Name:*Phone*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code BUILDING DETAILChoose Building Type*New ResidentialResidential AdditionAccessory StructureAccessory Pools and DecksAccessory Structures: Detached Garage Storage Building Detached Carport Accessory Pool or Deck Type: Above Ground Swimming Pool In Ground Swimming Pool Deck Construction Plan Designated*Size of Structure*Building Area (Sq. Ft.)*Stories*Height of Structure*Total Building Cost: Material & Labor*ELECTRICAL DETAILAny extensions or modifications to wiring system?*YesNo(Any extensions or modifications require an electric permit and inspection by a State Electrical Inspector)Service*NewChangeExtensionSize AmpPROPERTY INFORMATIONAddress* Street Address ZIP Code Subdivision*Lot #*Parcel #*Is any part of the property located in the Flood Plain?*YesNoIf yes, what zone?Will the structure obstruct natural drainage?*YesNoAre there sinkholes or other obstructions on site?*YesNoHave all utility and drainage easements onsite been designated on the Site Plan?*YesNoHas a proper sized entrance tile (minimum 15") been installed at the entrances to the property or is curb and gutter being used?*TileCurb & GutterLOT DETAILInterior Lot*Corner Lot*Front Yard Setback off Property Line*Feet (Consider Right of Way)Rear Yard Setback off Property Line*FeetLeft Yard Setback off Property Line*FeetRight Yard Setback off Property Line*FeetLot Width at Publicly Maintained Street*FeetLot Width at Building Setback*FeetExisting structures on property?*YesNoTypeSize of StructureSq. Ft.EASEMENT WIDTHUtility:Front Yard*Ft.Right Side Yard*Ft.Left Side Yard*Ft.Rear Yard*Ft.Drainage:Front Yard*Ft.Right Side Yard*Ft.Left Side Yard*Ft.Rear Yard*Ft.Sketch project showing streets, property lines and lot dimensions, existing and proposed structures, setback distances and all utility and drainage easements.Or upload your sketchAccepted file types: pdf, jpg, gif, png. The above information is true and correct to my best knowledge and belief.Signature*Date* SUBCONTRACTORS TO BE EMPLOYED ON THIS PROJECTGeneral Contractor Name or FirmGeneral Contractor Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code General Contractor PhoneGeneral Contractor License #Electrical Contractor Name or FirmElectrical Contractor Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Electrical Contractor PhoneElectrical Contractor License #Plumbing Contractor Name or FirmPlumbing Contractor Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Plumbing Contractor PhonePlumbing Contractor License #Heating/Cooling Contractor Name or FirmHeating/Cooling Contractor Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Heating/Cooling Contractor PhoneHeating/Cooling Contractor License #Framing Contractor Name or FirmFraming Contractor Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Framing Contractor PhoneFraming Contractor License #Masonry Contractor Name or FirmMasonry Contractor Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Masonry Contractor PhoneMasonry Contractor License #Siding Contractor Name or FirmSiding Contractor Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Siding Contractor PhoneSiding Contractor License #Finish & Trim Contractor Name or FirmFinish & Trim Contractor Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Finish & Trim Contractor PhoneFinish & Trim Contractor License #Roofing Contractor Name or FirmRoofing Contractor Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Roofing Contractor PhoneRoofing Contractor License #Drywall Contractor Name or FirmDrywall Contractor Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Drywall Contractor PhoneDrywall Contractor License #Painting Contractor Name or FirmPainting Contractor Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Painting Contractor PhonePainting Contractor License #Excavation Contractor Name or FirmExcavation Contractor Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Excavation Contractor PhoneExcavation Contractor License #Other Contractor Name or FirmOther Contractor Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Other Contractor PhoneOther Contractor License # I hereby certify that I understand that all contractors and subcontractors to be employed on this project must have a current business license issued by the City of Hopkinsville and are in compliance with Kentucky Law regarding to Workers Compensation and Unemployment Insurance.Applicant’s SignatureDate I hereby certify that all work on this project will be performed by the homeowner and no additional workers will be employed.Applicant’s SignatureDate CERTIFICATION In consideration of the issuance of the requested permit, I hereby agree and covenant, with the City of Hopkinsville, the Hopkinsville-Christian County Planning Commission, that I will observe and conform with all applicable codes, zoning ordinances, and all other applicable codes, laws, restrictions and ordinances, and I hereby assume all risk incidental to any error or any violations or interpretations thereof. The Property Owner and Contractor hereby release the City of Hopkinsville, the Hopkinsville-Christian County Planning Commission and their employees from all liability of every kind and nature for damages which may occur from defective wiring or construction of or on said premises and hereby agrees to hold harmless the City of Hopkinsville, the Hopkinsville-Christian County Planning Commission and their employees from any kind and all such liabilities. I hereby certify that I understand the contents of the above paragraphs and that information used to complete this application is true and correct to my best knowledge and belief. 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 said owner to make this application as his authorized agent.Applicant’s Signature*Date* Permit Fee* Price: $0.00 Permit Fee* Price: $0.00 Permit Fee* Price: $0.00 Permit Fee* Price: $0.00 Permit Fee* Price: $25.00 Total $0.00 CommentsThis field is for validation purposes and should be left unchanged.
