THIS APPLICATION DOES NOT CONSTITUTE PERMISSION TO BEGIN WORK. IF WORK
IS BEGUN PRIOR TO THE ISSUANCE OF A PERMIT, AN INVESTIGATION FEE IN
ADDITION TO THE PERMIT FEE SHALL BE ASSESSED. THE INVESTIGATION FEE
SHALL BE EQUAL TO THE PERMIT FEE.

LOCATION OF PROPERTY

An application is hereby made for a permit to cover the following work:
New Structure______Residential______ Commercial Remodel______Addition________
No. Rooms_____ No. Baths_____ No. Stories____Oil_____ Nat. Gas_____ LPG__________
Electric_____Wall Furnace_____Condensing Unit_____Cooling Coil_____
No. of Duct Outlets_____Roof Top Units____Fire Dampers____Wall Mounted Units_______
Walk in Cooler____Reach in Cooler____Exhaust Fan______ Range Hood_______

Explain the current and/or future use of building or space______________________________________
________________________________________________________________________________
________________________________________________________________________________
Describe other work to be performed____________________________________________________
________________________________________________________________________________
________________________________________________________________________________

OWNER_____________________________ADDRESS____________________________________
CONTRACTOR________________________ADDRESS___________________________________
State Lic.______________________________ No. Bond No.________________________________

*All mechanical work must comply with the latest edition of the Uniform Mechanical Code as published by the International Council of Building Officials (ICBO).

THE APPLICANT SHALL BE RESPONSIBLE FOR INFORMING ALL PARTIES INVOLVED,
INCLUDING THE DESIGN PROFESSIONAL, OF ANY CODE NON-COMPLIANCE AS NOTED
ON PLANS, INSPECTION REPORTS OR ANY OTHER DOCUMENTS ISSUED BY THE
BUILDING OFFICIAL/INSPECTOR.

I hereby acknowledge that I have read this application and state that above is correct and I agree to comply
with all City of Kirby ordinances, State Laws and the Uniform Codes as published by ICBO regulating
building construction.

AUTHORI ZED SIGNATURE _______________________(PRINT)____________________________
COMPANY______________________ ADDRESS___________________________PHONE_______
DATE OF APPLICATION___________________ DATE PERMIT ISSUED_____________________
Approved to issue permit____________________________________Building Official/Inspector

TOTAL PERMIT FEE $_____________________________________