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unofficial consolidation, the official version is held by the municipal clerk.
Town of Bon Accord
PO Box 779
BON ACCORD AB T0A 0K0
Phone: 780 921 3550
Fax:
780 921 3585
www.bonaccord.ca
BUILDING PERMIT APPLICATION FORM
Development Permit Number:
Application Date: DD / MMM / YYYY
Estimated Project Completion Date: DD / MMM / YYYY
Applicant Type:
Homeowner
Contractor
Cost of Installation (Market Value) $
The Permit Holder hereby certifies that this installation will be completed in accordance with the Alberta Safety Codes Act. A permit may expire if the undertaking to which it applies: (a) is not commenced within 90 days
of issue of the permit, (b) is suspended or abandoned for a period of 120 days. An extension can be considered when applied for in writing prior to permit expiry date.
**2 Sets of plans / specifications & payment must accompany this application**
Owner Name:
Mailing Address:
City:
Prov:
Postal Code:
Phone:
Fax:
Cell:
Email:
Owner's Signature / Declaration (Single Family Residential Only)
"I hereby declare I am the owner of the premises in which the work will be conducted, and reside or will reside on the property. I am doing the work myself, and assume responsibility
for compliance with the applicable Act and Regulations"
Company Name:
Mailing Address:
City:
Prov:
Postal Code:
Phone:
Fax:
Cell:
Email:
Contractor/Architect/Engineer Name
Signature
Project Location in the Town of Bon Accord:
Work:
not started
in progress
complete
Street Address:
Tax Roll #:
Legal Subdivision: Part of:
Section:
Township:
Range:
West of:
Subdivision Name:
Lot:
Block:
Plan:
Directions:
BUILDING TYPE:
Dwelling Unit
Detached/Attached Garage
Accessory Building
Basement Development
Deck
Wood Burning Stove/Fireplace
Certification #
Foundation Type
Other (specify)
TYPE OF WORK:
New Construction
Relocation
Addition
Renovation
Demolition
Change of Occupancy
Manufactured Home*
Modular Home*
*CSA #
Development #
BUILDING USE:
Farm
Single/Multi Residential
Commercial
Industrial
Institutional
Oil & Gas
Other (specify)
BUILDING AREA IN SQ. FT.:
Number of stories
Main area
2nd floor
Basement
Garage
Total Area
Deck
Basement developed at time of construction?
Yes
No
Description of Work:
Energy Compliance Method:
Performance
Trade-Off
Prescriptive
*Manufactured Home - transportable in single or multiple sections; is ready for residential occupancy upon completion of setup.
*Modular Home - assembled at site in sections; sections have no chassis, running gear nor its own wheels.
Payment Type:
Cash
Cheque
Interac
M/C
Visa
Permit Fee: $
+ SCC Levy*: $
Total Cost: $
Receipt #:
*$4.50 or 4% of the permit fee maximum $560.00
The Inspections Group Inc.
14310 - 111 Avenue NW
Edmonton AB T5m 3Z7
Phone:
(780) 454 5048
Toll Free: (866) 554 5048
Fax:
(780) 454 5222
Toll Free: (866) 454 5222
www.inspectionsgroup.com
REMIT PAYMENT AND APPLICATION TO THE INSPECTIONS GROUP INC.
PLEASE CONTACT THE INSPECTIONS GROUP INC. FOR INSPECTIONS ALLOWING 2 - 5 WORKING DAYS NOTICE AND PROVIDE SAFE ACCESS.
The personal information collected on this application is authorized under the Safety Codes Act, the Municipal Government Act, and section 4(c) of the Protection of Privacy Act. The information may be disclosed to third party contractors providing services on
behalf of the Town. The information is required for the Inspections Group and the Town of Bon Accord and will be used for issuing permits, safety codes compliance verification and monitoring, and property assessment purposes. The name of the permit
holder and the nature of the permit is available to the public upon request. The Town will take all reasonable steps to ensure that personal information is treated confidentially and is only used for the purposes it was collected. If you have any questions about
the collection or use of the personal information provided, please contact the Town of Bon Accord at 5025 - 50th Avenue, Bon Accord, AB, T0A 0K0 or by calling (780) 921-3550.
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