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2. RESIDENTIAL BUILDING PERMIT

   Please fill form out completely and submit. A permit tech will contact you once the application has been entered and is ready to be paid. Payments can be made over the phone with a credit card but a 2.55% (or minimum of $2) service fee will apply.

6. Property Information
8. Property Address:*
9. Parcel Number:
11. Subdivision
12. Lot #
13. Block:
15. Attach copy of address verification letter

    All new homes will be required to submit a copy of the address verification letter from Benton County 911 Addressing prior to issuance of permit. You can contact their office at 479-271-1085.

19. Building Information
21. Class of Work:*

    1. New Home
    2. Addition

    1. Remodel
    2. Detached Garage

    1. Accessory Structure
    2. Storm Shelter

    1. Fence
    2. Pool
23. Heated Sq/Ft:
24. Total Sq/Ft:
25. Number of Stories:
26. Valuation of Work:
28. Is this property on a Septic System?*

    1. Yes

    1. No
29. Attach copy of approved perc test from the county:
31. Does this property have a variance?*

    1. Yes

    1. No
32. Attach copy of approved variance from Community Development:
34. Do you want a Permit Card Holder ($7 charge)?*

    1. Yes

    1. No
36. Submit approved site plan*

    We will require the site plan and the approved site plan form from Community Development before you submit your permit. They can be reached by calling 479-621-1186. This will need to be attached as one PDF file. 

38. Submit set of plans*

    We will need a set of plans for new construction, additions, pools, and any accessory structures. On interior remodels we will need a before and after set of plans. These are required prior to submitting your permit and will need to be attached as one PDF file.

40. Description of Work:*
44. Owner Information
46. Name:*
47. Address:*
49. City:*
50. State:*
51. Zip:*
52. Phone Number:*
56. Contractor Information
58. Contractor:*
59. Contact Person:*
61. Address:*
62. City:*
63. State:*
65. Zip:*
66. Phone Number:*
67. Email Address:*
71. Separate permits are required for plumbing, electrical, and mechanical. This permit becomes null and void if work or construction authorized is not commenced with six months, or if construction of work is suspended or abandoned for a period of six months at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulation construction or the performance of construction.
73. Signature of Owner/Contractor*
    By typing in your name, you are acknowledging that you have the authority to apply for this permit. The name on permit assumes responsibility of the construction site.
74. Date:*
    Date:
Leave This Blank:


76. 1. Receive an email copy of this form.
77. Email address

    This field is not part of the form submission.

78. Submit Submit and Print

* indicates a required field