Building Permit Violation Referral
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COMPLAINANT
!
PLEASE CHECK TO REMAIN ANONYMOUS
NAME:
AGENCY OR COMPANY NAME:
STREET ADDRESS:
CITY:
COUNTY:
STATE:
ZIPCODE:
PHONE NUMBER:
EMAIL ADDRESS:
CONTRACTOR INFORMATION
CONTRACTOR NAME:
PRIME
SUB
DBA:
LICENSE NUMBER:
STREET ADDRESS :
CITY:
COUNTY:
STATE:
ZIPCODE:
LICENSE NUMBER:
WERE EMPLOYEES PRESENT?
YES
NO
IF YES, HOW MANY?:
PROJECT INFORMATION (if available)
OWNER OF CONSTRUCTION SITE AND/OR AWARDING BODY:
STREET ADDRESS:
CITY:
STATE:
ZIPCODE:
PHONE NUMBER:
DID YOU NOTIFY THE LOCAL BUILDING DEPARTMENT OF WORK BEING DONE WITHOUT A PERMIT?
YES
NO
PROJECT STREET ADDRESS :
CITY:
STATE:
ZIP CODE:
RESIDENTIAL
COMMERCIAL
APPROX DATE OF WORK:
DESCRIPTION OF WORK:
Submit