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Building Permit Application 1290 S Public Road, Lafayette Colorado 80026 [EMAIL REDACTED] [PHONE REDACTED] Project Address Application Date Lot Number Block Subdivision or Tract Name Property Owner Email Phone Business Name (if applicable for property above) Mailing Address (if different from above) Applicant Name Email Phone General Contractor Email Phone Electrical Contractor Email Phone Plumbing Contractor Email Phone Mechanical Contractor Email Phone Fire Alarm Contractor Email Phone Fire Sprinkler Contractor Email Phone Architect (if applicable) Email Phone Soils Engineer (if applicable) Email Phone Project Description (Construction dumpsters on the street require ROW Permit, please contact - [EMAIL REDACTED]) Electrical Valuation $ Total Project Valuation $ New Structure Square Feet Structure Fee Type Amount Basement Unfinished Existing sq ft New sq ft Building Fee’s Basement Finished Zoning AHDF 1st Floor Building Height Building Permit Fee 2nd Floor # Bedrooms City Use Tax Other # Bathrooms Boulder County Use Tax Garage Construction Type Electrical Inspection Decks Occupancy Group Plan Check Fee Covered Porch Occupancy Load Total Fee’s Patio Sprinklers ☐ Yes ☐No Other Fee’s Date Received GM Class ☐Exempt ☐Non-Exempt Year Built Staff Approval Initial Date ☐Building ☐Planning ☐Public Works ☐Fire Department ☐Lura Drainage Engineering NISP Parks and Tree Fee Public Arts Fee The information given on this application is accurate to the best of my knowledge. All provisions of laws and ordinances governing this work will be complied with, whether specified on this application or not. Granting a permit does not give authority to violate or cancel provisions of any other state or local law regulating construction or construction performance. The Permit must be paid for within 45 days of approval. The applicant agrees to pay the plan review fee whether permit is purchased or not. Service Expansion Sewer Tap Storm Water Water Rights Water Tap Fee’s Signature Date Total Fee’s