Building Permit Request Form

Please Enter the Following Information:

Name of Person or Business Who Owns the Property for Which This Permit is Being Issued:

Is This Property Inside The Corporation Limits of the Town of Big Stone Gap?:

Yes No

Applicant Address

Applicant City

Applicant State

Applicant Zip

Applicant Telephone

Please Enter the Information About the Contractor Performing the Work, and the Details of the Work Being Performed:

Name of the Contractor:

(If You are doing the work you self, please enter "self")

Address

City

State

Zip

Telephone

Brief Description Of Work Being Performed:
Please Include the following information:

For All Permits:	For Plumbing:	For Electrical:	For Building or Demolition:	For Mechanical:
The Estimated Completion Date. The Estimated Cost of the Work Being Performed. A Description of All Work Being Performed	The Number of Fixtures Involved. (either the number of fixtures being Installed, or the number of fixtures in a home if it is being moved into the Town)	If a New Service is Being Installed, Please Specify the Amperage. (200 amp, 300 amp, etc) Please Specify if Service is only being upgraded.	The Dimensions of the Building, and the Total Number of Square Feet. The Type of Building. (house, deck, garage, etc) Tax ID # for the property involved. Distances from property lines to edges of new construction.	The Type of Heating/Cooling Equipment Being Installed. The Price/Value of the Unit Being Installed.

If You Are Not Doing the Work Yourself, Is Your Contractor Bonded and Certified in the State of VA, and Has a Current License to Operate a Business in the Town of Big Stone Gap?

Yes No

Contractor E-Mail Address

The Town of Big Stone Gap has offered this service free of charge as an easier means of requesting a building permit. The filling out of, and submission of this form does in no way guarantee the acknowledgement of a request for building permit by the Permit Clerk, nor does it imply that a building permit of any type has been issued. All of the personal information disclosed on this form is subject to possible interception (as are all web-based forms) by third parties, and should not be considered private or sensitive information.

If you agree to these terms, and have checked over the form to make sure all information is correct, please press the submit button.