VILLAGE OF KELLIHER
Building Permit
(Application Form A)
P.O. Box 190
Kelliher, SK
S0A 1V0
Tel:(306) 675-2226 Fax: (306) 675-2240
Date: _______________
Erect
□
Demolish
Lot: _______________
Building Permit Number: _____________________
□
Move-In
Block: ________
□
□
Renovate
Plan: ____________________________
Owner: _____________________________
Civic Address: ____________________
Contract With: _______________________
Mailing Address: ___________________
___________________
___________________
Application for permit to: ___________________________________________________
______________________________________________________________________
Size of Building:
a)
House______X______=__________ sq. ft.
Garage_____X______=__________ sq. ft.
Deck ______ X______=__________ sq. ft.
Other______ X______=__________ sq. ft.
Size of Lot (frontage) ___________________
Number of Stories__________________
Basement: ___________________________
Estimated Cost: House: _________________
Garage: ________________
Renovation: _____________
Permit Fee Paid: _______
Occupancy: _______________________
Deck: ____________________________
Other: ___________________________
Receipt Number: ___________________
Total: ___________________
Regulations that must be adhered to:
a) No work is to be undertaken until application has been approved and a permit
issued by the Municipality.
b) The undersigned agrees to comply with all Building, Fire, Health and any other
provincial codes and to comply with any caveats or Liens registered against said
lands or property.
c) No excavation may be started until location of foundation is approved by the Village
of Kelliher’s authorized inspector.
d) A copy of the floor plan and building plans must be submitted with the application.
A registered survey certificate and site plan must be submitted upon request of the
Village of Kelliher’s authorized inspector. For move in permits, at least two (2)
photos of the building must be attached to the application.
e) The elevation of the residence shall be eighteen (18) inches more or less above the
sidewalk and the builder must notify the Village of Kelliher prior to pouring footings
in order that the Village of Kelliher may verify the elevations.
Page 1/2
VILLAGE OF KELLIHER
Building Permit
(Application Form A)
P.O. Box 190
Kelliher, SK
S0A 1V0
Tel:(306) 675-2226 Fax: (306) 675-2240
f) Sask Power and Sask Tel must be notified prior to construction to locate
underground services.
g) The undersigned agrees that the construction, demolition, move-in, or renovation
will be completed within six (6) months of the date of issue of the permit and they
will clean up all debris and material resulting from the work.
h) Construction is completed when all painting, siding and roofing is finished. Used
material may only be used with permission of the inspector (PBI) and all conditions
stipulated by the inspector (PBI) are adhered to.
i) No building can be permanently occupied until a final inspection is completed by
the Village of Kelliher’s contracted building inspector and an occupancy permit is
issued.
SUBCONTRACTORS AND SUPPLIERS OF MATERIALS
Excavation: _________________________
Cabinets: _________________________
Cement: ___________________________
Fireplace: ________________________
Framing: ___________________________
Other: _____________________________
Roofing: ___________________________
Application Has ___________ Approved
Siding: ____________________________
Insulators: _________________________
Drywall: ___________________________
Floor Covering: _____________________
Masonry: __________________________
Eavestroughing: ____________________
Request for Building Occupancy Permit
I hereby acknowledge that I have read this
application and state that the information
contained herein is correct and agree to comply
with all the Village of Kelliher’s and/or Provincial
laws regulating Building and Occupancy.
It being expressly understood that issuing of a
Permit does not relieve the applicant from
complying with all Bylaws though not called for in
the Specifications or shown on plans and/or
applications submitted. The Building permit is
issued to the owner.
Owner or Authorized Agent
____________________ __________________
Plumbing: _________________________
(Please Print)
Electrical: _________________________
________________________
(Date)
Painting: __________________________
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(Signature)