Construction Permit Application Short Form (Page 2 of 2) in pdf

The applicant certifies that all information on this application is correct and the work will be completed in accordance with the

approved construction documents and PA Act 45 (Uniform Construction Code) and any additional approved building code

requirements adopted by the Municipality. The property owner and applicant assumes the responsibility of locating all property

lines, setback lines, easements, rights-of-way, flood area, etc. Issuance of a permit and approval of construction documents shall

not be construed as authority to violate, cancel or set aside any provisions of the codes or ordinances of the Municipality of other

governing body. The applicant certifies he/she understands all the applicable codes, ordinances and regulations.

Application for a permit shall be made by the owner or lessee of the building or structure, or agent of either, or bb the registered

design professional employed in connection with the proposed work.

Certificate of Occupancy:

§403.46(a) A building, structure, or facility may not be used or occupied without a certificate of occupancy issued by a building

code official.

§403.46(d) A building code official may suspend or revoke a certificate of occupancy when the certificate was issued in error, on

the basis of incorrect information supplied by the permit applicant or in violation of the Uniform Construction Code. Before a

certificate of occupancy is revoked, a building owner may request a hearing before the board of appeals under §403.122 (relating

to appeals, variances and extensions of time).

I certify that the code administrator or the code administrator’s authorized representative shall have

the authority to enter areas covered by such permit at any reasonable hour to enforce the provisions of

the code(s) applicable to such permit.

_______________________________________

______________________________________

Signature of Owner or Agent

Print Name of Owner or Agent

_______________________________________

Date

Directions to site:

Application Submittal:

Application to be filled out completely with all required supporting documents.

Drawings:

 Shall specify all site information such as address, owner’s name, type of work proposed, site location

(proposed work on site).

 Shall include sufficient detail to allow official to ensure conformity with 2006 International Residential

Code.

 Shall show new construction in relation to existing construction, and include footing detail, bearing location,

header sizes and all other pertinent information.

 Pre-manufactured products shall have manufacturers engineered design and specifications.

 All electrical components shall be indicated.

 All designs shall conform with the 2006 International Residential Code.

Swimming Pools:

 Provide swimming pool construction specifications

 Swimming pool enclosures and barriers shall be shown and include fence, gate and gate device details.

APPROVALS

***********(For Administrative Use Only)***********

Building Permit Issued By:______________________________ Date: ______________________

Building Permit Denied By: _____________________________ Date: ______________________

Reason for Denial: ___________________________________________________________

Total Sq. Ft. used for fee:

_____________________________

Building Fee ____________Electric Fee ______________ Plumbing Fee ______________

Mechanical Fee ___________ Energy Fee ______________ Admin. Fees ________________

State Fee $ ______

COG Fee_______

Total Fees _____$_____________________

Construction Permit Application Short Form Page 2

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