Fillable 20286 - Gas Piping Permit

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20286 - Gas Piping Permit

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The 20286 - Gas Piping Permit form is 2 pages long and contains:

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  • 16 check-boxes
  • 43 other fields

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File type: PDF

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BROWSE CITY OF GAHANNA (OH) FORMS

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PAGE 1 of 1 | BUILDING PERMIT APPLICATION | REV. 3.6.2018
BUILDING DIVISION
200 S. Hamilton Road
Gahanna, Ohio 43230
Phone: 614-342-4010
Fax: 614-342-4117
building@gahanna.gov
www.gahanna.gov
PERMIT NO. __________________________
MP No. ______________________________
☐ No Master Permit
RECD. BY _________ DATE: _____________
INTERNAL
GAS PIPING PERMIT APPLICATION
TO REQUEST AN INSPECTION, CALL 614-342-4010 & PRESS 1, OR SCHEDULE ONLINE AT HTTPS://OHGA.ONLAMA.COM/
☐ COMMERCIAL/MULTI-FAMILY (4 or more units) ☐ RESIDENTIAL (1, 2, 3 FAMILY)
JOB SITE ADDRESS:
PARCEL ID NO(S).
Estimated Cost of Entire Project:
Square Footage for Project Scope of Work:
Occupancy Description: (reference Use Group table) -commerical only
Type of Construction: (reference Construction Type table)-commerical only
DESCRIPTION/SCOPE OF WORK:
PROPERTY OWNER Name:
Commercial Tenant Name (if applicable):
Property Owner Address:
Property Owner E-mail:
CONTRACTOR Name:
Contractor Address:
Contractor E-mail:
REGISTERED DESIGN PROFESSIONAL Name:
Registered Design Professional Address:
Registered Design Professional E-mail:
CERTIFICATION
I certify that I am the property owner or the authorized agent representing the owner, and that the information
on this application is complete and accurate to the best of my knowledge, and that the information contained on
drawings and text are a true and accurate representation of the dimensions and facts applicable to this request,
and that there are no deed restrictions that prohibit this work.
Name: ______________________________________________________ Title: ___________________________________________
Signature: ___________________________________________________ Date: ___________________________________________
THIS FORM IS AVAILABLE TO BE SUBMITTED ONLINE: HTTPS://OHGA.ONLAMA.COM
click to sign
signature
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PAGE 2 of 2 | BUILDING PERMIT APPLICATION | REV. 3.6.2018
BUILDING DIVISION
200 S. Hamilton Road
Gahanna, Ohio 43230
Phone: 614-342-4010
Fax: 614-342-4117
building@gahanna.gov
www.
g
ahanna.
g
ov
PERMIT NO. __________________________
MP No. ______________________________
☐ No Maste
r Permit
RECD. BY
_________
DATE:
_____________
INTERNAL
GAS PIPING PERMIT APPLICATION CONTINUED
TO REQUEST AN INSPECTION, CALL 614-342-4010 & PRESS 1, OR SCHEDULE ONLINE AT HTTPS://OHGA.ONLAMA.COM/
☒
This application is NOT a permit. No work may begin until a permit is issued.
☒
When each phase of work is complete, an inspection is required. To request an inspection, call 614-342-
4010 & press 1,
or schedule online at https://ohga.onlama.com/.
☒
3 sets of construction documents for commercial; 2 sets for residential to be submitted. If submitted with Master Permit
Application, do not resubmit with this application.
☒
1 PDF digital copy of construction documents to be submitted. If submitted with Master Permit Application, do not resubmit
with this application.
☐
Check box if project includes use of an industrialized unit.
☐
Check box if project includes use of an assembly of individually listed or labeled products.
COMMERCIAL/MULTI-FAMILY (4 or more units)
$200
☐ GAS PIPING PERMIT (includes 2 inspections)
$150/ea. =
☐ ADDITIONAL INSPECTIONS: _______ no. of additional inspections purchased (only the specified
included number of inspections are allotted with the permit; all additional inspections must be purchased prior
to scheduling inspections.) NOTE: there will be no refunds for unused inspections.
$
TOTAL FEES - payment due at time permit is issued
reference: Building & Zoning Fee Schedule
INTERNAL USE: PAID ☐
PAYMENT: ________________________
RECD. BY/DATE: ___________________
☒
If work is determined to be more extensive than represented on this application, additional fees may be required.
RESIDENTIAL (1, 2, 3 FAMILY)
$100
☐ GAS PIPING PERMIT (includes 2 inspection)
$150/ea. =
☐ ADDITIONAL INSPECTIONS: _______ no. of additional inspections purchased (only the specified
included number of inspections are allotted with the permit; all additional inspections must be purchased prior
to scheduling inspections.) NOTE: there will be no refunds for unused inspections.
$
TOTAL FEES - payment due at time permit is issued
reference: Building & Zoning Fee Schedule
INTERNAL USE: PAID ☐
PAYMENT: ________________________
RECD. BY/DATE: ___________________
☒
If work is determined to be more extensive than represented on this application, additional fees may be required.
THIS FORM IS AVAILABLE TO BE SUBMITTED ONLINe: HTTPS://OHGA.ONLAMA.COM
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20286 - Gas Piping Permit

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Completed 12 July 2020

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