Western Taney County Fire Protection District



Western Taney County Fire Protection District

Fire Prevention Division

221 Jefferson Rd, Branson, MO 65616 417-334-3440

PLAN REVIEW/CONSTRUCTION PERMIT APPLICATION

Office Use Only

|Project Name: |Project Address: |Date Application Received |

|Nearest Intersection (or Direction to Job): |Frame Type: Wood ( Steel ( Mass ( Cone ( Other ( |Date Permit Issued |

|Owner: |Phone: |Square Feet: |To be Completed by Inspector Call for Inspections:|Date Permit Expires: |

| | | |( Rough-in | |

| | | |( Fire Stopping | |

| | | |( Sprinkler System | |

| | | |( Underground | |

| | | |Underground Hydro. | |

| | | |( Rough – in | |

| | | |( Fire Alarm | |

| | | |( Rough - in | |

| | | |( LPG | |

| | | |( Rough – in | |

| | | |Air Test | |

| | | |( Commercial Kitchen | |

| | | |( Rough – in | |

| | | |Acceptance Test | |

| | | |( Other _________________ | |

| | | | | |

| | | |( Final __________________ | |

| | | | | |

| | | |Denotes Before Covering | |

| | | | | |

| | | |2018 International Fire Code | |

| | | | | |

| | | |For Inspection (or Reinspection) Call 334-3440 (24| |

| | | |Hr. Recording Number) Please Provide 24 Hr. Notice| |

| |Fax: | | | |

|Mailing Address: |Zip: |Use Group | |Reviewed By: |

|Architect: |Phone: |Construction Type | |Issues By: |

|Address: |Zip: |Alarms Required | |Fee Calculation: |

| | | | | |

| | | | |________ Square Ft. |

| | | | | |

| | | | |x ________ ICC Factor |

| | | | | |

| | | | |= ________ |

| | | | | |

| | | | |x ________ District Constr. |

| | | | |Factor |

| | | | | |

| | | | |= ________ Construction Cost |

| | | | | |

| | | | |( 1000 . |

| | | | | |

| | | | |x 3.00 . |

| | | | | |

| | | | |= __________ Permit Fee |

|Contractor: |Phone: |Sprinklers Required | | |

|Address: |Zip: |Fire Protection Water Supply | | |

|List Source of |Gas Co. |Domestic Water | | | |

|Utilities | |Public ( | | | |

| | |Private ( | | | |

| |Elec Co. | | | | |

|Comments: | | |

|I hereby certify that I am the owner or duly authorized owner’s agent, that I have read this application and that all | | |

|information is correct. I further certify that I have read, understand and will comply with all the provisions outlined| | |

|hereon. I also certify that the plot plan submitted is a complete and accurate plan showing any and all existing and | | |

|proposed structures on the subject property. | | |

| | | |

|PROVISIONS: The issuance of this permit shall not be construed to release the owner or owner’s agents from the | | |

|obligation to comply with the provisions of all laws and ordinances, including federal, state and local jurisdictions, | | |

|which regulate construction and performance of construction. This permit becomes null and void if the construction work| | |

|authorized has not begun within 180 days from the date of issue or if at any time prior to final inspection and | | |

|approval the work is suspended or abandoned for a period of 180 day. If not begun, suspended or abandoned, a new | | |

|application and permit fee will be required, based on the then current adopted codes. | | |

| | | |

|Signature: ___________________________________________ Date: ________________________ | | |

| |

-----------------------

Building Permit #

CofO Issued: ________________

Dated: __________________

Issued By: ________________

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