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Residential / Multi-Family Building Permit Application

  1. Roosevelt City Corporation Building Department

    255 State Street
    Roosevelt, UT 84066
    Phone: 435-722-5001
    Fax: 435-722-5000

  2. Job Site Information

  3. Permit Type

  4. Owner Occupied

  5. Renter Occupied

  6. Garage

  7. Attached Garage

  8. Water Meter Size

  9. Carport

  10. Attached Carport

  11. Sewer Type

  12. Secondary Water Service on Property

  13. All residential plans with multiple dwellings units of four(4) or more must have an architect and/or engineer seal.

  14. Contractor Information

  15. If Owner/Builder (Same as Property Owner Name)

  16. Decisions relative to this application are subject to review by the chief executive officer of the municipal or county entity issuing this building permit and appeal under the International Building Code as adopted by Legislature. This permit becomes null and void if work or construction authorized is not commenced I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local authority regulating construction or performance of construction and that I make this statement under penalty of perjury.

  17. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

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  19. This field is not part of the form submission.