Plan Application Form - City Of Berea Codes Enforcement Office
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1
2PLAN APPLICATION FORM
CITY OF BEREA
CODES ENFORCEMENT OFFICE
212 CHESTNUT STREET
BEREA, KY 40403
PHONE 859.986.8528 FAX 859.986.7657
Today’s Date:____________________
Complete all applicable spaces.
Name of person submitting plans__________________________________ Company_______________________________
Mailing Address__________________________________ City_____________________ State_________ Zip__________
Is the Plan Review Fee included with the plans? yes [ ]
no [ ]
Phone________________________
Business & Project Name _______________________________________________
Project Location _________________________________ City_____________________ State_________ Zip__________
Owner (Individual & Company) ___________________________________________________
Phone_____________________
Mailing Address__________________________________ City_____________________ State_________ Zip__________
Architect (Name & Firm) ____________________________________________________ Phone______________________
Mailing Address__________________________________ City_____________________ State_________ Zip__________
As the architect listed above, I am responsible for construction contract administration yes [ ]
no [ ]
NOTE: DESIGN CERTIFICATION REQUIRED. All buildings or structures requiring professional design (Architect or Engineer) by
Section 122 of the 2013 KBC shall include a statement from the design professional in responsible charge indicating the
Seismic Design Category for this specific site and the applicability of seismic bracing requirement for architectural,
mechanical and electrical components and a statement to that effect shall be included with the initial construction
documents submitted to the building code official.
Engineer (Name & Firm) ____________________________________________________ Phone______________________
Mailing Address__________________________________ City_____________________ State_________ Zip__________
Project Contractor
______________________________________________________
Phone______________________
Mailing Address__________________________________ City_____________________ State_________ Zip__________
BUILDING INFORMATION
Number of buildings in this submittal _________
Use of building(s) i.e. restaurant, office, storage, or other (please specify) ___________________________
Building(s) in this project is/are [ ] new freestanding [ ] addition to existing building
[ ] renovation
[ ] renovation & addition
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