PROJECT INFORMATION
Project address
Project description
$
Project square footage / dimensions Project cost
PROPERTY OWNER INFORMATION
Property owner name
Property owner mailing address
Property owner e-mail
Property owner telephone (primary) Telephone (secondary)
APPLICANT / AGENT INFORMATION (if different from property owner)
Applicant name
Applicant address
Applicant e-mail
Applicant phone (primary) Applicant Phone (secondary)
Fax or additional contact instructions
Applicant is:
CERTIFICATION
Applicant / agent signature Applicant / agent name, printed Date
BUILDING PERMIT APPLICATION
City of Park Ridge, Illinois
Department of Community Preservation and Development
505 Butler Place, Park Ridge, Illinois 60068
tel 847-318-5291 fax 847-318-6411 www.parkridge.us
I, the undersigned, certify that the above information is correct to the best of my knowledge and I agree, in consideration
of and upon issuance of a building permit, to do or allow to be done only such work as herewith applied for. I further
declare that I am the property owner or otherwise authorized by the property owner to apply for this permit. I agree to
conform to all applicable laws of this jurisdiction.
Property owner
Tenant
General contractor
Design professional
Other
102-01 Bldg Permit Application 15 May 2018
TYPE AND NAME OF CONTRACTOR ADDRESS AND PHONE CL INS OL
GENERAL
CARPENTRY
CONCRETE/PAVING
DRYWALL
ELECTRICAL
EXCAVATING
FENCE
FIRE ALARM
FIRE SPRINKLER
HVAC
IRRIGATION
LANDSCAPING
MASONRY
PLUMBING
ROOFING
SEWER SERVICE
WATER SERVICE
SIDING
SIGN
TREE SERVICE
WASTE HAULER
WRECKING
OTHER
OFFICIAL USE
102-01 Bldg Permit Application 15 May 2018