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2. Village of Skokie
   Community Development Department - Building Division
3. 
5. Changing Contractors? You must let us know!
7. Job Name:*
9. Job Address:*
11. Permit Number:*
13. Trade:*
15. Change From:*
17. New Contractor:*
19. Address:*
21. Phone:*
22. Fax:
24. Effective:*
26. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
28. Electronic Signature*
30. Building Div. Phone: (847) 933-8223
    Fax: (847) 933-8230
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit Submit and Print

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