APPLICATION FOR BUILDING PERMIT

City of DeRidder

200 South Jefferson Street
DeRidder, Louisiana 70634
(337) 462-8900
Fax 462-8908
city@cityofderidder.org

 

Name of Owner_____________________________________________________
Address___________________________________________________________
Construction Address______________________________________________
Legal Description of Lot__________________________________________

I. FILL IN THE FOLLOWING BLANKS

a. Zoning class of your property (from Code of Ordinances)________
b. Yard Requirements (from DeRidder Code of Ordinances)
1. Front Yard_____________________________________________________
2. Rear Yard______________________________________________________
3. Side Yard______________________________________________________
c. Yard Requirements (from Subdivision Restrictions)
1. Front Yard_____________________________________________________
2. Rear Yard______________________________________________________
3. Side Yard______________________________________________________
d. I understand the Subdivision restrictions.___Yes___No
e. Has property been surveyed?___Yes___No.If yes, by whom and date
_______________________________________________________________
f. Building Contractor's Name/Address_____________________________
_______________________________________________________________
State Licensed___Yes___No #_______________________________________

II. BUILDING PERMIT FEE

a. Cost of Construction - Fee_____________________________________
b. Square Footage_________________________________________________
___Residential___Commercial
c. Class of Work___NEW___ADDITION___ALTERNATION___REPAIR

III. PLUMBING PERMIT

Plumbers Name/Address_____________________________________________
City License___Yes___No___= One Time Job Fee______________________
___Inside City Limit___Outside City Limit
Rough In__________________________________________________________
Final/Topout______________________________________________________
Gas_______________________________________________________________
Sewer_____________________________________________________________
Number of Fixtures___X 2.00 = $___________________________________
Size of Water Service___/$________________________________________
Valve Charge______________________________________________________
Deposit___________________________________________________________
Boring Fee________________________________________________________
Cutting Fee_______________________________________________________
Sewer Tap_________________________________________________________
Water Tap_________________________________________________________

IV. ELECTRIC PERMIT

Electricians Name/Address_________________________________________
City License___Yes___No=One Time Job Fee__________________________
Temporary Pole____________________________________________________
Rough In__________________________________________________________
Meter Loop________________________________________________________
Final_____________________________________________________________

V. MECHANICAL PERMIT

Contractors Name/Address__________________________________________
City License___Yes___No=One Time Job Fee__________________________
Inspection Fee____________________________________________________
Repairs over $500-$15 00__________________________________________
AC/H 3 Ton-$13.00_________________________________________________
AC/H 3 1/2 Ton-$15.00_____________________________________________
AC/H 4 Ton-$17.50_________________________________________________
AC/H 5 Ton-$19.50_________________________________________________
AC/H over 5 Ton-$ 3.90 per/T______________________________________

VI. TOTAL BUILDING AND PERMIT FEES________________________________

VII. CONSTRUCTION SITE

___Is___Is Not  in a flood hazard zone.
If so, base flood elevation is____________________________________
Owner has been informed___Yes ___No

VIII. INSTRUCTIONS TO OWNER/CONTRACTOR

For your own protection, this application must be filled out completely and approved,
before construction begins on property located inside the City Limits.

The Owner/contractor is responsible to insure that the construction is according to the
2006 International Building Code, 2006 Residential Building Code and the building on the property 
is in compliance with all zoning regulations.

The Owner or Contractor must attach a plot plan to this application, drawn to scale, showing the following:

• Length and width of lot
• Location of Lot, showing streets
• Diagram of building or addition to building
• Distance from curb to front of houses adjacent to your property
• Distance of back property line to proposed structure
• Distance of side property line to proposed structure
• Distance of front property line to proposed structure.

IX. SPECIAL INSTRUCTIONS 
  • All commercial construction/modification requires prior approval from the
    Louisiana State Fire Marshal's Office.
  • Plans must be reviewed and accepted before permit is issued.
  • Provide names, licenses, and proof of insurance on all trade groups performing work on structure.

    SIGNATURE OF APPLICANT____________________________________________

    Date______________________________________________________________

    Reviewed by_______________________________________________________

    Date______________________________________________________________

    Approved by_______________________________________________________

    Date______________________________________________________________