Application For Occupancy And/or Building Permit Page 2
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1
2BOROUGH USE ONLY
ZONING
Zoning District
Type of Proposed use
Type of Permit
_______
Overlay Districts
Occupancy _____ Structure_____
Occupancy
[
]
Historic District
[
]
Alteration
[
]
Flood Plain
[
]
Code: 1=New 2=Change 3=Enlargement
Extension/Addition [
]
4=Continuation 5=Reinstatement
New Building
[
]
Use Reference Section No. __________________________
THIS OCCUPANCY IS FOR: _________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
APPROVALS / DISAPPROVAL
(
)
This application is DISAPPROVED for Zoning by: ____________________________________
Date: ______________
Variance ________________
Special Exception___________________
Review _________________
This application is authorized in whole or in part by:
(
)
Zoning Hearing Case No. _____________________ Approved (
)
Denied (
)
Date: _______________
Planning Commission
(
)
Conditional Use No.__________________________ Approved (
)
Denied (
)
Date: _______________
(
)
Subdivision No. _____________________________ Approved (
)
Denied (
)
Date: _______________
(
)
Site Plan No. _______________________________ Approved (
)
Denied (
)
Date: _______________
(
)
HARB BOARD _____________________________ Approved (
)
Denied (
)
Date: _______________
(
)
Borough Council ___________________________ Approved (
)
Denied (
)
Date: _______________
(
)
Ordinance No. __________________________________________________
Effective Date: _______________
(
)
Subject to the following conditions: ________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
(
)
This application is APPROVED FOR ZONING by: ____________________________________
Date: ________________
BUILDING PERMIT
VIOLATION NOTICES
CONSTRUCTION TYPE
IBC/ IRC USE GROUP
Dangerous Cond. [
]
I [
] II [
] III [
] IV [
] V [
]
A [
] B [
] E [
] F [
] H [
] I [
]
Occupancy Vio. [
]
A [
]
B [
]
M [
] R [
] S [
] U [
]
Property Maint.
[
]
1 [
] 2 [
] 3 [
] 4 [
] 5 [
]
Condemned
[
]
CONSTRUCTION CODE 2009 IBC [
] IRC [
]
SPRINKLERED
Yes [
]
No [
]
BUILDING PERMIT WORK: __________________________________________________________________________
_________________________________________________________________________________________________
THIRD PARTY REVIEW AGENCY _____________________________________________________
DATE: _______________
FEES
PERMIT NO.
DATE ISSUED
ESTIMATED COST OF WORK
Occupancy
$______________
__________
____________
Commercial Bldg.
$______________
__________
____________
_________________________
Residential Bldg.
$______________
__________
____________
Accessibility Insp.
$______________
__________
____________
Energy Insp.
$______________
__________
____________
TOTAL SQ. FT. OF FLOOR AREA
Plan Fee
$______________
Scanning Fee
$______________
____________________________
Document Storage $______________
INVOICE NO.
____________
PA UCC Fee
$______________
Penalty
$______________
TOTAL FEE
$______________
CHECK NO.
____________
Approved by: _________________________________________________________
Date: ______________________
BUILDING CODE OFFICIAL
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