Building Permit Application Form Page 2
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PRINCIPAL TYPE OF FRAME
TYPE OF MECHANICAL
Masory (wall bearing)
Will there be central air conditioning ?
Wood frame
Yes ________
No ______
Structural steel
Will there be an elevator ?
Re-inforced concrete
Yes _________
No _______
Other-Specify________________________
PRINCIPAL TYPE OF HEATING FUEL
DIMENSIONS
Gas
Number of stories________
Oil
Total sq. ft. of floor area ( all floors based on exterior
Electricity
dimensions)
Coal
Total land area, sq. ft._________________________
Other-Specify________________________
TYPE OF SEWAGE PROPOSAL
NUMBER OF OFF STREET PARKING SPACES
Public or private company
Enclosed
Private (Septic tank, etc.)
Outdoors
TYPE OF WATER SUPPLY
RESIDENTIAL BUILDING ONLY
Public or private company
Number of bedrooms___________
Private (well, cistern)
Number of bathrooms__________
(full)________
(partial)_________
IDENTIFICATION-To be completed by all applicants
NAME/OWNER
MAILING ADDRESS
ZIP CODE
TELEPHONE NO.
LESSEE
ARCHITECT OR ENGINEER
CONTRACTOR
I hereby certify that the proposed work is authorized by the owner of record.I am either the owner of record or have
been authorized by the owner to make this application and we agree to conform to all applicable laws of the
Municipality of Penn Hills.I also certify that I have read and understand the attached building permit matters of advice
and that all information in this application is true and correct.
Signature of applicant
VALIDATION (FOR DEPARTMENT USE ONLY)
USE GROUP BUILDING CODE
BUILDING PERMIT NO.
B-
R-1
RECEIPT NUMBER
R-2
BLDG.PERMIT FEE
$
R-3
OCCUPANCY PERMIT
$
R-4
TAP-IN FEE
$
B
CONTRACTOR REG.
$
A
STATE LAW FEE
$2 DOLLARS ALL PERMITS
OTHER- SPECIFY____________________________
TOTAL
$
CONDITIONS ATTACHED:
YES
NO
APPROVED BY_____________________________________
PERMIT ISSUED DATE:_____________________
Title:______________________________________________
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