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2. COST BREAKDOWN AND CONTRACTOR LIST
4. Statement
   IN ADDITION TO THIS FORM, ALL CONTRACTORS WILL HAVE TO SUBMIT A PROPOSAL SIGNED BY THE HOMEOWNER. ALL PLUMBERS ARE REQUIRED TO SUBMIT A LETTER OF INTENT AS REQUIRED BY THE STATE OF ILLINOIS 225 ILCS 320/
6. Property Address*
   List the property address of the proposed construction located within the City of Waukegan limits
7. Zip Code*
11. General Contractor Name*

    Required

12. GC Email Address*
13. Phone #*
14. General $*
    Amount
16. General Contractor Mailing Address*

    Address, City, State, Zip

18. General Scope of Work / Signed Contract
22. Roofing Contractor Name

    Required if roofing work is included in your project.

23. Roofer Email Address
24. Phone#
25. Roofing $
27. Roofing Contractor Mailing Address

    Address, City, State, Zip

29. Roofing Scope of Work / Signed Contract
33. Excavator/Sewer Contractor Name

    Required if excavating/sewer work is included in your project

34. Excavator/Sewer Email Address
35. Phone #
36. Excavation $
38. Excavator/Sewer Contractor Address

    Address, City, State, Zip

40. Excavator/Sewer Scope of Work / Signed Contract
44. Plumbing Contractor Name

    Required if plumbing is included in your project

45. Plumbing $
46. Plumber Email Address
47. Phone #
49. Plumber Address

    Address, City, State, Zip

51. Plumbing Scope of Work / Letter of Intent

    Per 225 ILCS 320/37 (Ch.111, par. 1135)

    A letter intent shall be included with all plumbing permit applications. The letter shall be written on the license plumber of record's business stationery and shall include the license holder's signature and, if the license holder is incorporated, the license holder's corporate seal. If the license holder is not incorporated, the letter must be notarized

55. Electrical Contractor

    Required if electrical work is included in your project

56. Electrical $
57. Electrician Email Address
58. Phone #
60. Electrician Address

    Address, City, State, Zip

62. Electric Scope of Work / Signed Contract
66. HVAC Contractor

    Required if HVAC work is included in your project

67. HVAC $
68. HVAC Email Address
69. Phone #
71. HVAC Contractor Address
73. HVAC Scope of Work / Drawing
77. CONTRACTOR REGISTRATION
    ALL CONTRACTORS MUST REGISTER WITH THE CITY OF WAUKEGAN

    Full list of requirements can be found by clicking the above link
Leave This Blank:


79. 1. Receive an email copy of this form.
80. Email address

    This field is not part of the form submission.

81. Submit Submit and Print

* indicates a required field