Fillable Commercial Property Information Form printable pdf download

COMMERCIAL PROPERTY INFORMATION FORM

(office use) VCF N/C t#_________

Phone 440.247.5050 Village of Chagrin Falls Zoning Department Fax 440.247.2082

Property owner & Tenant information:

Date of application: ______________

Property Owner: __________________________ ________Address:____________________________________________________

Phone #_______________ email: _______________________

Occupant / Tenant:___________________________________ Ph# :___________________email:____________________________

Address or suite no. where work is taking place:____________________________________________________________________

Scope of work:____________________________________________________________Est. Cost of construction $_____________

B. Contractor

Information::

Contractors must be registered with the Village of Chagrin Falls

General

Contractor:______________________________ Ph # ______________email:_________________________

Mechanical (HVAC) Contractor:______________________________ Ph #:______________ email:________________________

Plumbing Permit:

Contractor:______________________________ Ph #:______________ email:_______________________

Electrical permit:

Contractor: ______________________________Ph #:______________email:________________________

OTHER:

Contractor: _____________________________________Ph #:____________________

B. Commercial Permit Information:

Any construction work being performed it is the owner, or owner representative responsibility to contact the Department of Industrial

compliance at 1-800-523-3581, to ascertain whether they will require permits for; structural, electrical, mechanical, permits.

For plumbing contact the Cuyahoga County Board of Health 216-201-2000,

Regardless a zoning occupancy permit will need to be applied for and approved for new uses and / or change of use prior to applying to the

state or county permits.

Complete the section below and return it to the Village of Chagrin Falls Zoning Department.

I ___________________________________________________ representing: _________________________________________________

Address: _______________________________________

Phone number: ________________________

have contacted the above agencies in regards to obtaining permits for the following

Structural

Mechanical

Electrical

Other:__________________________________

Name of the person that you spoke to from Division of Industrial Compliance and it has been deemed that no permits will be necessary for the project

mentioned above. Name; ______________________________________Phone #______________________________________Date:____________

I have also contacted the County Board of Health for,

plumbing permit, and it also has been deemed that no plumbing permit is necessary for the

project mentioned above. Name: _________________________________ Phone # ________________________________Date:____________

If permits deemed to be required please submit a copy of your approved plans

for fire prevention & zoning approval to the village

zoning department prior to starting work.

Dumpster Information:

Will a dumpster be required for job? _____ Date of placement: _______________ Date removed:___________.

where will dumpster be placed:

public property

private property. Size of dumpster: ______ yd.

If on public property, you will need to ascertain permission from the police department. Please indicate whom you spoke

with:________________________ A misc. permit will be required for dumpster placed in public right of way: $20.00 + $1000 cash bond will be

required. It is the applicants responsibility to provide

I further acknowledge that I am aware that failure to obtain proper permits and the registering of all contractors with the Village will result in

administrative action by the village of Chagrin Falls.

Signature: _____________________________________________________Date_____________

updated 11/2015

Commercial Property Information Form

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