BUILDING PERMIT APPLICATION - Brook Park, Ohio



BUILDING PERMIT APPLICATION

Work CANNOT begin on ANY project until the approved permit is in hand

Completed Applications must be returned to the Building Dept. for approval. Allow 4-5 days for processing; approved permits are mailed to the Applicant completing the work.

24 Hour Notice required for ALL inspections

DATE: ______________________ PERMIT TYPE: ( - Residential ( - Commercial

( - Other: ___________________________

PROJECT ADDRESS: ____________________________________________________________________________________

PROPERTY OWNER NAME(S): _____________________________________________________________ PHONE #: __________________________________

|WORK TO BE| |

|COMPLETED |( - PROPERTY OWNER (Must submit “Homeowner’s Permit Certification”) |

|BY: | |

| |( - CONTRACTOR |

| | |

| |DBA NAME: ____________________________________________________________________________________ |

| | |

| |ADDRESS: _____________________________________________________________________________________ |

| | |

| |CONTACT PERSON: _____________________________________________________________________________ |

| | |

| |PHONE #: ___________________________________________________________________ ( - Cell ( - Office |

| | | |

|TYPE OF |( - Demo |Estimated Cost: $ ________________ |

|PROJECT: | | |

| |( - Addition/Alteration/Repair * |Square Footage: _________________ |

| | | |

| |( - New Construction * |Length: _____________ |

| | | |

| |( - Concrete / Asphalt (1) |Width: ______________ |

| | | |

| |( - Other: _______________________ |Height: _____________ |

| |

|BRIEF DESCRIPTION OF PROJECT: ________________________________________________________________________ |

| |

|__________________________________________________________________________________________________________ |

| |

|__________________________________________________________________________________________________________ |

| |

|__________________________________________________________________________________________________________ |

|The undersigned states that he/she is the owner of the property or authorized agent contracted by the owner of the property. This permit will be granted on |

|condition that all work done will be in accordance with the City of Brook Park Ordinances and all Building Code Laws of the State of Ohio. Failure to comply will |

|result in revocation of this permit and additional fines/penalties may be imposed. |

|SIGNATURE: | |

* For Remodeling, Alteration and New Construction projects, the Owner/Contractor must submit for review: 3 sets of Building Plans and a Situation Plan showing all structures on the property and the location of the project in relation to the setback & property lines.

(1) For concrete/asphalt projects, the Owner/Contractor must submit for review: a Situation Plan showing all property lines, structures and the location of the new concrete/asphalt.

SITUATION PLAN

Please complete in INK and include the following:

( Property lines ( All structures on property (house, garage, shed, pool etc.)

( Clearly mark project / area of work and distance(s) from above item(s)

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* For Remodeling, Alteration and New Construction projects, the Owner/Contractor must submit for review: 3 sets of Building Plans and a Situation Plan showing all structures on the property and the location of the project in relation to the setback & property lines.

(1) For concrete/asphalt projects, the Owner/Contractor must submit for review: a Situation Plan showing all property lines, structures and the location of the new concrete/asphalt.

HOMEOWNER’S PERMIT CERTIFICATION

Property Address: ________________________________________________________

Property Owner Name(s): _________________________________________________

PHONE #: _________________________________________ (-Cell (-Home (-Work

ALT. PHONE #: ____________________________________ (-Cell (-Home (-Work

I hereby certify that as the property owner, I personally will perform the work described on the permit application in lieu of securing the services of a registered professional to complete the work, as provided for by the provisions of Section 1311.02 of the Codified Ordinances of the City of Brook Park, Ohio.

I understand, that ALL Electric, HVAC & Plumbing permits must be obtained by a State of Ohio licensed contractor and that, as the permit holder, it is my responsibility to:

• Obtain all required Building Permits and Approvals

• Comply with all applicable Building Codes, Zoning Codes and other Specifications

• Obtain all required Inspections

• Assume responsibility for correcting any deficiencies detected during inspection(s) of the work

I further understand that any misrepresentations or falsifications on a Permit Application or this Certificate, may cause a suspension or revocation of any Permit issued, as provided in the Section 1311.07 of the City of Brook Park Building Code, and may be subject to the penalties provided in Section 1311.99.

SIGNATURE: _______________________________________________________ DATE: _________________________

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OFFICE USE:

BASE: $_________________

ADTL: $_________彟彟彟彟഍䑁䱔›␠彟彟彟彟彟彟彟彟ൟㄍ‥漠⁲㌠㨥†弤彟彟彟彟彟഍佔䅔⁌‽ത倍祡敭瑮›††⠠ⴠ䌠獡⁨††
‭ന‍⠠ⴠ嘠獩⁡†††
‭䍍†††⠠ⴠ䐠卉ൃ‍⠠ⴠ传桴牥张彟彟彟彟彟彟彟彟彟彟彟ൟ഍഍䌍瑩⁹景䈠潲歯倠牡൫桔浯獡䨠‮潃湹⁥慍潹൲഍楃祴漠⁦牂潯慐歲名潨慭⁳⹊䌠祯敮䴠祡牯഍䌍瑩⁹景䈠潲歯倠牡൫桔浯獡䨠‮潃湹⁥慍潹൲഍

________

ADTL: $_________________

1% or 3%: $___________

TOTAL = $

Payment: ( - Cash ( - (

( - Visa ( - MC ( - DISC

( - Other ________________________

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City of Brook Park

Thomas J. Coyne Mayor

City of Brook Park

Thomas J. Coyne Mayor

City of Brook Park

Thomas J. Coyne Mayor

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