2. Application Date
   Application Date
4. Job Location*
   Address, Apt/Suite # (Optional), City, State, Zip Code
6. Owner Name
8. Owner Address
   Address, Apt/Suite # (Optional), City, State, Zip Code
10. Owner Phone Number
14. Contractor's Name
16. Contractor's License Number*
    If owner is performing the work, put owner as contractor.
18. Contractor's Phone Number
20. Contractor's Email
22. Statement

    1. As Master Agent, I hereby acknowledge that I have read this application and know the same to be true. I agree to comply with all City ordinances and state laws regulating building construction and use
26. Estimated Cost*
    Materials and Labor. (Contract price if commercial)
28. If the estimated cost is greater than $25,000, the contractor will also need to apply for a business license with the City of Colonial Heights.
30. VA Power Number
    (if electrical release)
32. Work Description*
    Please list specified work for this trade.
36. Submit: When submitting plans/specifications, please select one of the following options.

    1. Mail to/Bring in: Building Inspections Department, 201 James Ave, Colonial Heights, VA 23834
    2. Email to: siteplans@colonialheightsva.gov
    3. Submit below (can only submit one document)
38. Plan/Specification Upload

    If submitting more than one document, please email all documents to siteplans@colonialheightsva.gov

42. Payment
    Checks may be mailed in or dropped off, and made out to the City of Colonial Heights. For credit payments, we will send you a link upon approval of permit application. Please call 804-520-9297 with any questions.
Leave This Blank:


44. 1. Receive an email copy of this form.
45. Email address

    This field is not part of the form submission.

46. Submit

* indicates a required field