Russellville, AR - Official Website

Step One

Checklist for Building Permit Application
Is the proposed project located in a historic district or on the historical register?*
This will affect your permit application.
1. Yes
1. No
Checklist
1. Application
2. Scaled Drawing
3. Platted Lot (Final plat must be filed with a copy of the survey and the legal description)
4. Proof of Agency (ownership verification)
5. Waivers requested (variances, etc.)
6. Written intent of construction
7. Storm water drainage requirements
8. Half street improvement requirements
9. Over $20,000 needs state contractor's license on commercial projects
10. Copy of liability insurance and workers compensation
11. Health Department approval for plumbing for all commercial projects
12. Copy of perk test if not on a sewer system
13. City Corporation Approval for Site Plan and Plumbing Plan for ALL Commercial Projects
No permits will be issued without this information.
Plans Approved By*
Date*
Date
After Approval Permit Issued By*
Date*
Date
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Section 1

Section 1: General Provisions
Applicant to read and sign. <ul> <li>No work may start until permit is issued.</li> <li> This permit may be revoked if any false statements are made herein.</li> <li> If revoked, all work must cease until permit is re-issued.</li> <li> Development shall not be used or occupied until a Certificate of Occupancy is issued by the Office of Community Development.</li> <li> The permit will expire if no work is commenced within 6months of issuance.</li> <li> Applicant is hereby informed that other permits may be required to fulfill local, state, and federal regulatory requirements.</li> <li>Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable inspections to verify compliance.</li> </ul>
Applicant to read and sign.
- No work may start until permit is issued.
- This permit may be revoked if any false statements are made herein.
- If revoked, all work must cease until permit is re-issued.
- Development shall not be used or occupied until a Certificate of Occupancy is issued by the Office of Community Development.
- The permit will expire if no work is commenced within 6months of issuance.
- Applicant is hereby informed that other permits may be required to fulfill local, state, and federal regulatory requirements.
- Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable inspections to verify compliance.
I, the applicant, certify that all statements herein and in attachments to this application, are true and accurate.
Signature*
Date*
Date
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Section 2 Verification of Ownership

Verification of Ownership or Appointment of Agent
I,
(name of applicant)
certify by my signature that I am the owner of the property described below.
Property described as follows:
Address*
Legal Description*
Signature of Property Owner(s)*
Date*
Date
I,
(name of applicant)
certify by my signature below, that I hereby authorize
(name of authorized agent)
to act as my agent regarding the
(type of action taken)
of the below described property.
Property described as:
Signature of Property Owner(s)*
Date*
Date
After completing this section, applicant should submit form to Building Official for review.
There are other portions of this process that will be reviewed by the Building Official and by a local administrator before approval.

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Building Permit Application

Steps

Step One

Section 1

Section 2

Verification of Ownership

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