TOWN OF WAYNESVILLE

BUILDING INSPECTION PERMIT APPLICATION

Permit Date:  ___________________

Owner:  __________________________________________________________________
Address: __________________________________________________________________
Directions: _________________________________________________________________
Telephone: _________________________________________________________________

Type of Improvement 

New Building _____   Manufactured Home _____  Service Change _____   Additions _____ Mechanical _____ Electrical _____  Alteration _____   Plumbing _____Other _____

Proposed Use: _______________________________________________________________(Garage, Single Family Dwelling, Two Family Dwelling, Mercantile, Business, Assembly, Storage or Industrial)

Dimensions                                                                Set Backs

Basement _________________ Sq. Ft.                    Front _______
First Floor ________________  Sq. Ft.                    Side  _______
Second Floor ______________ Sq. Ft.                    Rear  _______
Third Floor    ______________  Sq. Ft.
Other       _________________ Sq. Ft.                    Flood Area Data
                _________________ Sq. Ft.                    Floodway            _______
                _________________ Sq. Ft.                    Floodplain           _______
Total        _________________  Sq. Ft.                   Lowest Floor El.  _______
                                                                                 Zone                    _______
Total Project Cost ________________                     F.I.R.M. Panel # _______

Electrical Contractor __________________________________  License # _______________
Plumbing Contractor __________________________________  License # _______________
Mechanical Contractor ________________________________  License #  _______________
Building Contractor ___________________________________  License # _______________

Signature of Applicant __________________________________________________________

___________________________________________________________________________

Official Use Only                                                                                           Cost of Permit
Plan Apprlval _______________                                                             Electrical   _________________
Issued by          _______________                                                             Plumbing    _________________
Permit #           _______________                                                             Mechanical _________________
Date Issued     _______________                                                              Insulation   _________________
Final Date      _______________                                                               Building     _________________
                                                                                                                            Other          _________________
                                                                                                                            Total           _________________