Application To Build, Alter, Or Remove - County Of Lee Department Of Building Inspection
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1COUNTY OF LEE
DEPARTMENT OF BUILDING INSPECTION
APPLICATION TO BUILD, ALTER, OR REMOVE
OWNER’S NAME____________________________________________________________
MAILING ADDRESS_________________________________________________________
PHYSICAL ADDRESS________________________________________________________
CITY_________________________________STATE_______________________________
ZIP_____________________
PHONE____________________________________________
NEW_________ADDITION__________REMODEL___________DEMOLISH__________
CHANGE OF USE_________MOVE STRUCTURE_______OTHER__________
BUILDING SPECIFICATIONS:
USE OF BUILDING___________________AREA (SQ. FT)__________________
DIMENSIONS OF BUILDING:
WIDTH:_________LENGTH:________
BASEMENT:_______FINISHED____UNFINISHED_____CARPORT/GARAGE________
NUMBER OF FLOORS:___________ESTIMATED VALUE OF WORK $______________
ELECTRIC
PLUMBING
MECHANICAL
SERVICE SIZE_________
#OF BATHS________
# FURNACE_________
IF ADDITION WILL ELECT
#OF FIXTURES_____
# HEATPUMP_______
BE INCREASED? _______
WATER HEATER_____
FIREPLACE_______
WATER AVAILABLE__________SEWER AVAILABLE_______ OTHER___________ HEALTH DEPT. ID
#________________________________# OF BEDROOMS_________
TAX MAP REFERENCE #________________________________________
Building Contractor____________________________ License # _______________________
Address______________________________________ Class A ( ) Class B ( ) Class C ( )
_______________________________________ Phone #________________________
Electrical Contractor___________________________ License #________________________
Address_______________________________________ Phone # ________________________
_______________________________________
Plumbing Contractor___________________________ License #________________________
Address______________________________________ Phone # ________________________
______________________________________
Heat Pump Contractor _________________________ License # _______________________
Address______________________________________ Phone # ________________________
______________________________________
Project Location:______________________________________________________________
_____________________________________________________________________________
____________________________________________________________________________
Was Lot Sold From a Large Tract? ___________
If Yes, Who Purchased From: _____________________________
Is Applicant Developing a Subdivision? __________
Is Building Located in a Subdivision? ___________
Is Applicant Engaged in Land Disturbing Activity Of More Than 10,000 SQ FT? ________
Is Building Located in Within a Flood Hazard Area? ________
An Affirmative Answer To Any Of The Above May Require The Applicant To Building In Accordance With The Ordinances
Of The Lee County Governing The Special Circumstances. Application For Certain Types Of Buildings Are Required By
State Law To Be Accompanied By Blueprints Bearing The Seal Of Virginia Registered Architect Or Engineer. Please Inquire
With This Department Before Submitting An Application, As Failure To Submit The Required Documents Will Result In
Rejection Of This Application.
APPLICANT’S SIGNATURE_______________________________DATE_______________
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