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EXPRESS BUILDING PERMIT APPLICATION
FEE IS $50 PER CATEGORY
Date: _________________________ Estimated Cost of the Project: $_________________________
Job Location: _______________________________________________________________________________
Are you located in the Old Kings Highway Historic District (OKHHD)? Yes No
(Applies to Windows, Doors, Roofing, Siding, Deck Resurface) If YES, have you applied to OKHHD for approval? Yes No
Owner/Agent Name & Address: _______________________________________________________________________________________________
(I Authorize the Contractor Listed Above to Act on My Behalf and Perform Work Described)
_______________________________________________ ___________________ _________________________________
(Owner’s Signature to Authorize Work) (Date) (Email Address)
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Contractor (Name & Name of Business if Applicable): ________________________________________________________________________
CSL Number: _____________________________________________ CSL Expiration Date: ____________________________________________
HIC Registration Number: ________________________________ HIC Registration Expiration Date: ______________________________
Copies of Current CSL & HIC Cards Attached Worker’s Compensation Insurance Affidavit Attached
________________________________________________________________ _________________________________________________________
Applicant’s Signature Applicant’s Email Address
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Work to be Performed (Please Check All Categories That Apply):
Windows Same Size Replacement: Number of Units: _______________ U-Value: ______________________
(PLEASE NOTE THAT SOME LOCATIONS MAY REQUIRE SAFETY GLAZING PER CURRENT CODE)
Doors Same Size Replacement: Number of Units: _______________ U-Value: ______________________
Siding: Stripping Old Siding Layering Over
Number of Squares: _______________ Existing Material: ___________________________ Proposed Material: ___________________________
Re-Roofing: Stripping Old Shingles Layering Over
Number of Squares: _______________ Existing Material: ______________________ Proposed Material: ________________________________
Insulation/Weatherization: Square Footage: _______________ R-Value: ________________________
Deck Resurfacing (NO FRAMING/RAILS) Square Footage: _______________ Decking Material Being Used: ______________________________
________________________________________________________________ _____________________________________________
Building Officials Signature Date
BBD Express Permit Application 1/25/2022
PERMIT NUMBER:
________________________
MAP: ________ LOT: ______
FEE: $_______
CHECK #: ________________