Building Permit Application

2. Hanover County Building Inspector's Office

   P.O. Box 470 (mail) <br> 7516 County Complex Road (parcel) <br> Hanover, VA 23069 <br> Phone: 804-365-6040

   P.O. Box 470 (mail)
   7516 County Complex Road (parcel)
   Hanover, VA 23069
   Phone: 804-365-6040

3. Building Permit Application

   Two sets of plans must be included with permit

   Two sets of plans must be included with permit

5. Permit #

7. Payment Type

9. Date Issued
   Date Issued

13. Owner Name

14. Email Address

16. Mailing Address

18. City

19. State

20. Zip Code

22. Phone Number

23. Fax Number

25. Contact Person

29. Contractor Name

30. Email Address

32. Address

34. City

35. State

36. Zip Code

38. Phone Number

39. Fax Number

41. Contact Person

45. GPIN Number

46. District

47. Acres

49. Subdivision

50. Address

52. Lot

53. Block

54. Section

55. SE/CUP Site Plan Number

59. Setbacks:

    1. Front
    2. Back

    1. Right
    2. Left

60. Health Permit Number

61. Floodplain

62. USBC

64. Water or Well

    1. Water
    2. Well

65. Septic or Sewer

    1. Septic
    2. Sewer

66. Construction Type

67. Use Group

71. Description of Work:

73. Building Height

74. Number of Stories

75. Number of Bedrooms

76. Number of Bathrooms

78. Total Rooms

79. Basement Square Footage

80. Basement

    1. Finished
    2. Unfinished

81. Garage Square Footage

83. Porch Square Footage

84. Deck Square Footage

85. 2nd Electrical Meter (Accessory Buildings)

    1. Yes
    2. No

87. #Masonry F/P

88. #PF Gas

89. #PF Wood

91. Total Square Footage Finished 1st Floor

92. Total Square Footage Finished 2nd Floor

94. Total Square Footage Unfinished Floor

95. Total Square Footage Finished

97. Miscellaneous

98. Total Square Footage

102. Mechanics Lien Agent:

104. Name

105. Phone Number

107. Address

109. City

110. State

111. Zip Code

115. Estimated Cost

116. Permit Fee

118. 2% State Surcharge

119. Plan Surcharge

121. Septic Fee

122. Site and Soil

124. E and S Fee

125. Total Fees

127. Issuance of a Building Permit shall not be held to permit or to be an approval of the violation of any provision of any county ordinances and codes or any state laws. I here by acknowledge that I have read this application and know the same to be true and agree to comply with all county ordinances and state laws regulating building construction and use.

     Notice: Applicants are notified that incomplete applications may cause delays. Please complete all information as requested.

     Notice: Applicants are notified that incomplete applications may cause delays. Please complete all information as requested.

129. Signature

130. Date
     Date

132. Contact Me Via

     1. Mail
     2. Call
     3. Email

133. When permit has been issued and is ready to be picked up

135. Address

136. Phone Number

137. Email

Leave This Blank:


138. Print Only

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