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Demolition Permit (interior only) 11/29/2011 DEMOLITION PERMIT APPLICATION Interior only Address: ____________________________________________________________ Z oning : ________ S ubdivision : ___________________________________________ F lood P lain : YES / NO T ype o f w ork : _______________________________________________________________________ E stimated V alue : $ ______________________ OWNER/CONTRACTOR OWNER : _______________________________ CONTRACTOR : __________________________ Street: __________________________________ Street: __________________________________ City, State, Zip: __________________________ City, State, Zip: _________________________ Phone: (____) _____________________________ Phone: (____) _____________________________ Fax: (____) ________________________________ Fax: (____) ________________________________ E-mail: ____________________________________ E-mail : ___________________________________ I hereby declare that the above and attached inform ation is correct and agree, in consideration of and upon issuance of a Building & Use Permit, to do or allow to be done only such work he rewith applied for, and that such premises and its existing and proposed buildings or structures shall be used or allowed to be used for only such purposes as are set forth above or other uses permitted in the district. _______________________________________ ________________________________________ (Owner’s Signature) Date (Contractor’s Signature) Date I ssued By: ____________________________________ Date: _________________________________ (Building Official) (Buildin g Official) In Illinois it is the law to call: JULIE, INC. @ 1-800-892-0123 or 811 – Two (2) worki ng days prior to digging to locate utilities. 14400 S. Coil Plus Drive, Plainfield, IL 60544 Phone (815) 439-2937 Fax (815) 609-6114 Web www.plainfield-il.org