CITY OF CLARKSON VALLEY
15933 CLAYTON RD., STE. 105
BALLWIN, MO 63011
636-227-8607 -- 636-227-1914 Fax
Project Address _______________________________ Subdivision _____________________
Lot No. _______ Have Subdivision Trustees approved plans? Yes ___________ No ________
TYPE OF WORK: Provide Detailed Description of Project: ____________________________
Owner ______________________________________________ Phone __________________
E-Mail Address ________________________________________________________________
Builder ______________________________________________ Phone __________________
Architect ____________________________________________ Phone __________________
Is project site located in a flood plain? Yes ________ No ________
Will this project require a dumpster? Yes ________ No _______ If yes, the dumpster must be on the landowner's property. Permission to place dumpster is good for thirty (30) days. If additional time is necessary, approval must be obtained from the Director of Solid Waste Management.
Will this project require a portable storage unit, PODS, or similar device? Yes ________ No _______ If yes, the unit must be located on the homeowner's property per all provisions stated in the Clarkson Valley Code and must be approved by the Building Commissioner.
Will this project require a temporary non-sewered sanitation unit (porta-potty)? Yes ______ No _______ If yes, the location must be approved by the Building Commissioner.
NOTE: Plumbing, electrical, mechanical and elevator work must be done by Contractors registered in St. Louis County. Permits are to be secured from and inspections made by St. Louis County.
OCCUPANCY IS PERMITTED ONLY IF AN OCCUPANCY PERMIT IS ISSUED. OCCUPANCY PERMITS ARE ISSUED ONLY AFTER THE FINAL INSPECTION IS MADE AND APPROVED.
As a matter of policy, the City of Clarkson Valley will issue a single Building Permit for external construction, i.e., decks, patios, tie walls, etc. when they are in a single request and can be illustrated by a single drawing or set of drawings filed at the same time. Inspections will be combined where possible and appropriate. If this is not possible, then a separate permit is required on each item. Each sheet of the four (4) sets of construction plans that are required to accompany this Building Permit Application must be “signed” and “sealed” by an architect or engineer registered in the State of Missouri. The plot (site) plan must also be “signed” and “sealed” by a licensed surveyor or engineer registered in the State of Missouri. In most instance PATIOS and INTERIOR FINISH jobs do not need plans that are “signed” and “sealed” by a registered architect. Provide complete plan layout of roof trusses including connections and any modifications for openings, with the truss diagrams, all approved and sealed by a registered architect/engineer.
Please supply the following information:
1. The dollar valuation of all construction covered by this specific Building Permit. $ ______________. Note: The definition of “valuation” is the total cost to the homeowner for this construction, excluding the cost of the land.
2. The total square footage of all living space that will be constructed under this specific Building Permit, including the garage and finished basements in the house and in house additions. _____________________Total square feet.
3. The total square footage of pools (water surface), decks, patios, tennis/handball courts and accessory buildings constructed under this specific Building Permit. _________________________Total square feet.
No representation in this Application, nor any statement, schedule or exhibit furnished by the Applicant or Owner pursuant to this Application shall contain any untrue statement of a material fact or shall omit a material fact necessary to make the statements, schedules or exhibits contained therein not misleading.
In the event a Building Permit is issued pursuant to this Application, said Building Permit is valid for one (1) year from date approved and is contingent upon the Applicant proceeding with due diligence to complete the Project. In the event the City determines that due diligence in the completion of the Project is not being exercised, said Building Permit shall, upon ten (10) days written Notice to Applicant, be rescinded and all work thereunder shall cease.
Submission of any untrue statement or omission of a material fact shall herein be grounds for the immediate revocation of any Building Permit or Occupancy Permit issued pursuant to this Application.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, THAT THE INFORMATION GIVEN IS CORRECT AND THAT I AM THE OWNER OR DULY AUTHORIZED TO ACT IN THE OWNER’S BEHALF AND HEREBY AGREE TO COMPLY WITH THE APPLICABLE REQUIREMENTS OF THE FIRE PREVENTION AND BUILDING CODES OF THE CITY OF CLARKSON VALLEY, MISSOURI. IT IS FURTHER UNDERSTOOD THAT THIS APPLICATION DOES NOT CONSTITUTE A PERMIT.
Signed __________________________________________________ Title _________________
Received by ______________________________________________ Date ________________
Approved by _____________________________________________ Date _________________
Fru-Con Center, 15933 Clayton Road, Ballwin, MO 63011 – City Hall - 636-227-8607
*Jack Schenck, CBO