BUILDING PERMIT APPLICATION
Doniphan County, Kansas
(COMPLETE ALL ITEMS - MARK WHERE APPLICABLE)

 

     I.    ADDRESS OF BUILDING                

     II.    TYPE AND COST OF BUILDING  

       

 A. TYPE OF IMPROVEMENT:                  
            New Building
            Addition
            Repair/Replacement
            Moving (Relocation)
            Foundation Only

 

 

 

 

 

C. OWNERSHIP
     Private (individual, corporation, non-             profit, institution)

 

D. COST

Cost of Improvement
(To be installed, but not included in the above cost.)
       Electric                         
       Plumbing                       
       Heating/Air Conditioning
       Other (elevator, etc.)      

 

B. PROPOSED USE:  
     Residential
            One Family
            Two or More Family
                  Number of units
            Hotel/Motel/Dormitory
                  Number of units
            Garage
            Other (Specify)
               

 

 

 

Public (Federal, State, or  Local  government.)

 

 

Non-Residential - Describe the proposed use of buiding.

  




Non Residential
Amusement/Recreational
Church
Industrial
Service Station
Repair Garage
Hospital/Institutional
Office/Bank
Public Utility
School/Library
Stores/Mercantile
Tanks/Towers
Other (Specify)

 

 

III. CONTRACTOR

       Contractor                                                      Phone
       Mailing Address 

IV  OWNER

       Owner                                                             Phone
       Mailing Address 

V. SIGNATURE
       
    The Applicant of this building permit agrees to conform to all applicable laws of  Doniphan County, Kansas.

    ______________________________________________           ________________________________
    Signature                                                                                         Date

DO NOT WRITE IN THIS SPACE - FOR OFFICE USE

Approved By:

_________________________________________________           __________________________________
Name                                                                                                    Title

Date Permit Used ___________________________________           Permit Fee _______________

 

 

 

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