<p> Village of Lansing</p><p>Cook County</p><p>3141 Ridge Road Lansing, Illinois 60438</p><p>BUILDING PERMIT APPLICATION (SMALL PROJECT) </p><p>JOB SITE ADDRESS: PERMIT #: ______</p><p>PROPERTY OWNER: PHONE #: ______</p><p>ADDRESS (IF DIFFERENT FROM JOB SITE): </p><p>DESCRIPTION OF WORK: ______</p><p>VALUE OF WORK INCLUDING MATERIALS AND LABOR______</p><p>CARPENTER:______PHONE:______CONCRETE:______PHONE:______ELECTRICAL:______PHONE:______FENCE:______PHONE:______HEATING: ______PHONE:______MASONRY______PHONE:______PLUMBING:______PHONE:______ROOFING:______PHONE:______SIDING/GUTTERS:______PHONE:______WINDOWS:______PHONE:______OTHER CONTRACTOR______PHONE:______</p><p>I HEREBY CERTIFY THAT ALL THE INFORMATION PROVIDED HEREIN IS TRUE</p><p>SIGNATURE: DATE: </p><p>Permit Fee: $______Post Hole: $______Final Plumbing: $______Elec. Service: $______Pre-Pours: $______Service Charge: $______Rough Framing $______Sewer/Water: $______Late Fee: $______Rough Electric $______Final Building: $______Security Deposit: $______Rough Plumbing $______Final Electric: $______TOTAL: $______</p>