Zoning Permit #:
Power Co.
( ) New Building: ( ) Addition: ( ) Alteration: ( ) Repair/Replacement:
( ) IA ( ) IB ( ) IIA ( ) IIB ( ) IIIA ( ) IIIB ( ) IV ( ) VA ( ) VB
Zip
Plan Review
Structural
Mechanical Contact Name:
Electrical
Contact Phone No.:
Sprinkler
Contact E-Mail:
Total
In consideration of the issuance of the permit, the owner & his agent or contractor, do hereby covenant and agree to comply with all laws of State of OH & the Building Code & Zoning
Resolution of Miami County, OH, & to install the proposed building and/or work, or make the proposed change or alteration or do the work described above, in accordance with the plans &
specifications as approved by the Building Official, & certify that the information and statements given on this application, specifications, & accompanying drawings are true & correct to the
best of their knowledge. Legal Applicant applying for plan approval is stating that he/she is the owner or agent of the owner of the address specified.
USE GROUP CLASSIFICATION:
Heating
( ) Four or More Family, No. of Units
( ) Transient Motel / Hotel, No. of Units
Fire Alarm
Sprinkler
Architect
Electrical
Owner
Contractor
Square footage in each story:
Total Square Footage:
Identification
Name
Street Address
City & State
MIAMI COUNTY DEPARTMENT OF DEVELOPMENT
510 W. Water Street; Suite 120; Troy, Ohio 45373
(937) 440-8121
FAX: (937) 440-5486
Permit #:
Business Name:
Town/Township:
Project Address:
( ) Group A - Assembly
( ) Group B - Business
( ) Group F - Factory & Industrial
( ) Group H - High Hazard
( ) Group I - Institutional
( ) Group M - Mercantile
( ) Group R - Residential
( ) Group S - Storage
( ) Group T - Temporary & Misc.
( ) Group U - Utility
( ) Group E - Education
NO REFUNDS: PLEASE CHECK YOUR SUBMITTALS BEFORE PAYING FOR THEM
Fees: Processing Fee: $283.25
Fire Alarm / Monitor
$
$
$
$
$
$
Kitchen Hood Suppression
Refrigeration Piping
Occupancy Permit
3% Sur Charge
$
$
$
$
$
Type of Improvement:
Type of Construction:
Number of Stories:
Describe briefly proposed use:
Estimated cost of improvement: