Building Permit Application

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City of Clarksdale

Orlando W. Paden, Mayor

Public Works Office 121 Sunflower Ave 662-621-8142

Building Permit Application

This permit and any plans will need to be submitted to the Permitting Office in person at 121 Sunflower Avenue, by e-mail at publicworks@cityofclarksdale.org, or by fax at 662-621-8140.

Address of Project

Street Address City State / Province / Region ZIP / Postal Code Country

Applicant's Name

Applicant's Address

Street Address City State / Province / Region ZIP / Postal Code Country

Telephone Number

Fax Number

E-mail Address

Property Owner's Name

Property Owner's Address

Street Address City State / Province / Region ZIP / Postal Code Country

Telephone Number

Fax Number

E-mail Address

Building Contractor Information

Builder's Name:

Builder's Address:

Street Address City State / Province / Region ZIP / Postal Code Country

Telephone Number:

Fax Number:

City of Clarksdale Privilege License Number:

Exp. Date:

Mississippi Board of Contractors License Number:

Exp. Date:

MPC Number:

Brief description of work to be performed:

Type of work performed:

Remodel

Repair

Build

Install

Move

Remove

Reroof

Demolition

If you checked build or install, please fill in the information below:

Living Space in Square Feet:

Basement/Storage:

Porches:

Garage:

Other:

If you are moving a structure, please indicate the following:

Existing Address:

Street Address City State / Province / Region ZIP / Postal Code Country

Future Address:

Street Address City State / Province / Region ZIP / Postal Code Country

Starting Date:

Ending Date:

If you are demolishing a structure, please indicate the following:

Starting Date:

Completion Date:

Construction Cost (labor and materials) $:

If the structure is 5,000 square feet or more, primarily used for assembly, educational, Institutional or 3 or more stories, please indicate name and address of the architect below

Applicant's Name:

Architect's Address:

Street Address City State / Province / Region ZIP / Postal Code Country

Intended use of structure upon completion:

Upload any additional information here

Drop files here or

Accepted file types: pdf, jpg, png, Max. file size: 60 MB, Max. files: 4.

Signature(Required)

In order to receive a building permit, we may need to have a plot plan drawing and/or 2 sets of plans. This will be at the discretion of the Inspections Department. This permit will have a State of Mississippi $1.00 document filing fee added.