Systems Description Form (Page 3 of 4) in pdf

Systems Description Form Page 3

Ohio Residential Plan Submittal Form

Part A

(Example 2)

Address of Project

City/Township

Project Description

Contractor/DBA

Address

State License No

Phone No

Cell Phone No

Owner

Address

Phone No

Cell Phone No

Electrical Design

Service Size

Panel Location in dwelling

Size of Service Entrance Cable

Location of Service

Overhead

Underground

Provide additional details or drawings below

HVAC Design

Equipment Type/Size

Location of Equipment

Type of Fuel

Heat Loss/Gain

Sq. Ft. of Conditioned Space

Duct Size (Supply/Return)

Equipment Efficiency Ratings

Provide additional details or drawings below

As the legal owner/agent of the property above, I am performing the electrical/HVAC work described above.

_______________________________

Date___/___/___

NOTE: Per section 106.1 the Residential Building Official may require additional drawings, technical data or documentation in

order to verify compliance.

Building Department Only

Residential Plans Examiner/Building Official

Date of Approval

Application/Permit No

Systems Description Form Page 3