Address, Apt/Suite # (Optional), City, State, Zip Code
Materials and Labor. (If commercial, contract price.)
Please list specified work for this trade.
If submitting more than one document, please email all documents to firstname.lastname@example.org
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.
Complete this section only if you are an OWNER doing your own work, and are not subject to licensure as a contractor or subcontractor. If you are an owner and intend to do the work or subcontract the work, an Owner Affidavit is required certifying that
you are the owner of this tract or parcel of land, that you have applied for this permit, and are not subject to licensing
as a contractor or subcontractor. Signing the Owner Affidavit, and in turn obtaining the permit in your name,
designates you, as the owner, responsible for the quality of the work and compliance with applicable state and local
codes. This “Owner Affidavit” must be completed, with the signature of a person who witnessed your signature to this
document, acknowledging your compliance with Section 54.1-1111 of the Code of Virginia. (Note: Lessees are
owners per state law.)
By typing your name, you are agreeing to sign and take responsibility for the work on this permit. Tenant or Lessee may act as owner.
This field is not part of the form submission.
* indicates a required field