"Application for Building Permit" - Municipality of Penn Hills, Pennsylvania

Application for Building Permit is a legal document that was released by the Code Enforcement Department - Municipality of Penn Hills, Pennsylvania - a government authority operating within Pennsylvania. The form may be used strictly within Municipality of Penn Hills.

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APPLICATION FOR BUILDING PERMIT
MUNICIPALITY OF PENN HILLS
CODE ENFORCEMENT DEPARTMENT
12245 FRANKSTOWN ROAD
PENN HILLS , PA 15235
OFFICE # (412)798-2132 / FAX # (412)798-2160
Page # 1
Note: Please Print or Type This Application
IMPORTANT - Applicant to complete all sections.
LOCATION OF BUILDING
Start here:
(At location) (No.)
(Street or Road)
(Zoning District)
(Subdivision)
(Lot)
(Lot & Block)
TYPE OF IMPROVEMENT
PROPOSED USE FOR RESIDENTIAL
CHECK BLOCK FOR TYPE OF WORK BEING DONE.
(WRECKING MOST RECENT U
New building
one family
Addition (if residential enter No. of new housing units
two or more family-enter no. of units___________
added, if any in two or more family units.
Transient hotel, motel or dormitory enter
Alteration
number of units
Repair, Replacement
Garage
Wrecking (if multi-family residential enter no. of units
Carport
in building
Portable pools ($50 )
Moving or Relocation of building
Inground pool
Foundation only
Decks ($50)
Other-Specify
OWNERSHIP
NON-RESIDENTIAL
Private(individual, corporation, nonprofit institution etc.)
Amusement, recreational
Public (federal, state, or local goverment)
Church, other religious
Industrial
COST
Parking Garage
Cost of Improvement
$
Service Station,Repair garage
To be installed but not included in above cost.
Hospital
Electrical
$
Office, bank, professional
Plumbing
$
Public Utility
Heating
$
School, library, other educational
Other (elevator, etc.)$
Stores, mercantile
Tanks, towers
TOTAL COST OF IMPROVEMENT
$
Other-Specify
Decribe in detail proposed use of buildings, etc.
If addition location side yard, front yard, rear yard and size of addition.
APPLICATION FOR BUILDING PERMIT
MUNICIPALITY OF PENN HILLS
CODE ENFORCEMENT DEPARTMENT
12245 FRANKSTOWN ROAD
PENN HILLS , PA 15235
OFFICE # (412)798-2132 / FAX # (412)798-2160
Page # 1
Note: Please Print or Type This Application
IMPORTANT - Applicant to complete all sections.
LOCATION OF BUILDING
Start here:
(At location) (No.)
(Street or Road)
(Zoning District)
(Subdivision)
(Lot)
(Lot & Block)
TYPE OF IMPROVEMENT
PROPOSED USE FOR RESIDENTIAL
CHECK BLOCK FOR TYPE OF WORK BEING DONE.
(WRECKING MOST RECENT U
New building
one family
Addition (if residential enter No. of new housing units
two or more family-enter no. of units___________
added, if any in two or more family units.
Transient hotel, motel or dormitory enter
Alteration
number of units
Repair, Replacement
Garage
Wrecking (if multi-family residential enter no. of units
Carport
in building
Portable pools ($50 )
Moving or Relocation of building
Inground pool
Foundation only
Decks ($50)
Other-Specify
OWNERSHIP
NON-RESIDENTIAL
Private(individual, corporation, nonprofit institution etc.)
Amusement, recreational
Public (federal, state, or local goverment)
Church, other religious
Industrial
COST
Parking Garage
Cost of Improvement
$
Service Station,Repair garage
To be installed but not included in above cost.
Hospital
Electrical
$
Office, bank, professional
Plumbing
$
Public Utility
Heating
$
School, library, other educational
Other (elevator, etc.)$
Stores, mercantile
Tanks, towers
TOTAL COST OF IMPROVEMENT
$
Other-Specify
Decribe in detail proposed use of buildings, etc.
If addition location side yard, front yard, rear yard and size of addition.
Page #2
PRINCIPAL TYPE OF FRAME
TYPE OF MECHANICAL
Masory (wall bearing)
Will there be central air conditioning ?
Wood frame
Yes ________
No ______
Structural steel
Will there be an elevator ?
Re-inforced concrete
Yes _________
No _______
Other-Specify________________________
PRINCIPAL TYPE OF HEATING FUEL
DIMENSIONS
Gas
Number of stories________
Oil
Total sq. ft. of floor area ( all floors based on exterior
Electricity
dimensions)
Coal
Total land area, sq. ft._________________________
Other-Specify________________________
TYPE OF SEWAGE PROPOSAL
NUMBER OF OFF STREET PARKING SPACES
Public or private company
Enclosed
Private (Septic tank, etc.)
Outdoors
TYPE OF WATER SUPPLY
RESIDENTIAL BUILDING ONLY
Public or private company
Number of bedrooms___________
Private (well, cistern)
Number of bathrooms__________
(full)________
(partial)_________
IDENTIFICATION-To be completed by all applicants
NAME/OWNER
MAILING ADDRESS
ZIP CODE
TELEPHONE NO.
LESSEE
ARCHITECT OR ENGINEER
CONTRACTOR
I hereby certify that the proposed work is authorized by the owner of record.I am either the owner of record or have
been authorized by the owner to make this application and we agree to conform to all applicable laws of the
Municipality of Penn Hills.I also certify that I have read and understand the attached building permit matters of advice
and that all information in this application is true and correct.
Signature of applicant
VALIDATION (FOR DEPARTMENT USE ONLY)
USE GROUP BUILDING CODE
BUILDING PERMIT NO.
B-
R-1
RECEIPT NUMBER
R-2
BLDG.PERMIT FEE
$
R-3
OCCUPANCY PERMIT
$
R-4
TAP-IN FEE
$
B
CONTRACTOR REG.
$
A
STATE LAW FEE
$2 DOLLARS ALL PERMITS
OTHER- SPECIFY____________________________
TOTAL
$
CONDITIONS ATTACHED:
YES
NO
APPROVED BY_____________________________________
PERMIT ISSUED DATE:_____________________
Title:______________________________________________
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