Fill - Free fillable A5 Single Family Residential Basement or Attic Date (Lake Land College) PDF form

VILLAGE OF NORTHBROOK

Development & Planning Services

1225 Cedar Lane

Northbrook, Illinois 60062

847 664-4050 FAX: 847 272-5068

www.northbrook.il.us

A5 – Single Family Residential Basement or Attic Date Stamp

Address: _______________________________

For the finishing of any existing basement or attic. This permit type does not include review for any structural

changes.

Application Requirements:

 Permit Application Deposit of $100

 Form 1.1 - Permit Application

 Form 2.4 – Zoning Worksheet – Residential (Needed for Attic Finish Only)

 Form 3.1 - Building Site & Utility Data Worksheet

 Form 3.2 - Water Service & Meter Worksheet

 Form 5.1 - Fire Protection – Letter of Understanding

 Form 6.2 - Contractor of Record

Drawing Requirements: (to be submitted with permit application)

 Construction Drawings

4 copies

FORM 1.1

VILLAGE OF NORTHBROOK

Development & Planning Services

1225 Cedar Lane

Northbrook, Illinois 60062

847 664-4050 FAX: 847 272-5068

www.northbrook.il.us

Permit Application

Permit Address__________________________________________________ Application Date: ______________

Property Type (check one):  Single Family Residential  Multi-Family

 Commercial/Retail  Office  Industrial

 Other:________________________________________________________________

Description of Work _____________________________________________________________________________

_________________________________________________________________________________________________

Estimated Construction Value $ ______________________________ (required)

Primary Contact Information (note: all review correspondence will be emailed to the primary contact)

Name __________________________________________________________________________________________

Email ____________________________________________________________ please print clearly

Phone __________________________________________________________ Fax ___________________________

Check with Permit Coordinators for any submittal questions 847-664-4050.

Property Owner’s Information

Name __________________________________________________________________________________________

Address __________________________________________ City__________________ State______ Zip _____

Telephone________________________ Fax____________________ Email___________________________

Architect’s Information  Not Applicable

Name __________________________________________________________________________________________

Address __________________________________________ City__________________ State_______ Zip ____

Telephone________________________ Fax___________________ Email___________________________

Contractor’s Information  Type of Contractor ______________________________________

Name __________________________________________________________________________________________

Address __________________________________________ City __________________ State_______ Zip _____

Telephone________________________ Fax___________________ Email___________________________

Signature of Applicant: ____________________________________________

Please Print: _________________________________________ Date: ____________________

5-23-13

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FORM 2.4

0BVILLAGE OF NORTHBROOK

Development & Planning Services

1225 Cedar Lane

Northbrook, Illinois 60062

847 664-4050 FAX: 847 272-5068

www.northbrook.il.us

Zoning Worksheet – Residential

New Residence / Addition / Detached Garage / Gazebo / Pool House

Address of Proposed Project____ _ ____ _________________________________________________________________

Type of Project:  New Residence  Addition  Detached Garage  Gazebo/Pool House

Zoning Class_______________________ ____ __  R-1  R-2  R-3  R-4  R-5

Lot Area___________________________ ____ ____ _______________________

Setbacks (Yards)_______________________ __

Min./Aver. Setback Req’d (ft)

Proposed Setback(ft)

Easement/Encroach.

Front

Corner / Side

a

Side

b

Side setbacks must equal 25% width of lot

c

______ x .25 = _____ Req’d

a + b =______

c

Rear

40

C – Vertical/side extension - Side setback may meet the required minimum (not totaling 25% width of lot) with a reduced building height of 27’ (R-5) or 30’ (R-2, R-3, R-4)

Height__________________________ ___ ___ ______ Max. allowed _____ft Stories: Max. allowed ______

Proposed _____ft Proposed _____ft

2BGross Floor Area (FAR)_________________ ______  This section not applicable

40% lot area maximum allowed Allowable Gross Floor Area: __________ x .4 = _________________

Lot Area Max. Allowable Gross Floor Area

Proposed Floor Area Calculation:

Existing (if applicable) (sf)

New/Added (sf)

Total (sf)

Basement (if more out of ground than in)

First Floor (including attached garage)

Second Floor

Attic/Third Floor (finished or unfinished – circle one)

(do not include unfinished space in total floor area)

Detached Garage

Accessory Structure / Shed

Notes: Each 14’ of ceiling height counts as floor area

The first 200sf in an access. storage structure (other than a garage) is exempted from gross floor area.

Total Floor Areas

Gross Floor Area Ratio: _________  ________ = _________________

Total Floor Areas Lot Area Proposed Floor Area Ratio

3BMaximum Building Coverage____________ __  This section not applicable

35% lot area maximum allowed Allowable Bldg. Coverage: ___________ x .35 = ___________

Lot Area Max. Allow. Bldg. Coverage

Proposed Building Coverage Calculation:

Existing (if applicable) (sf)

New Bldg. Cov. Added (sf)

Total

First Floor (including attached garage)

Detached Garage

Accessory Structure / Shed

Total Bldg. Areas

Building Coverage Ratio: ____________  ________ = _________________

Total Bldg. Areas Lot Area Bldg.Coverage Ratio

4BMaximum Lot Coverage (Impervious Surface)  This section not applicable

50% lot area maximum allowed: Allowable Lot Coverage: ____________ x .5 = _____________

Lot Area Max. Allowable Lot Coverage

Proposed Impervious Surface Calculation:

Existing Imp. Surf.

New/Added

Total Imp. Surf. (sf)

Building footprint (Incl. attached garage)

Detached Garage

Driveway

Walks / Stoops

Deck / Patio

Total Impervious Surface Areas

b

a

Net Increase / Decrease (circle): a – b =

Impervious Surface Ratio: _________________  ___________ = _________________

Total Impervious Surface Areas Lot Area Impervious Surface Ratio

Per:

Arch

Eng

Per:

Arch

Eng

Per:

Arch

Eng

Per:

Arch

Eng

Continued on next page 

Compare

5BDriveway or Garage (Accessory Structure) in Required Setback  This section not applicable

30% required setback area max. allowed Allowable Coverage: ________ x ________ = _______ x .3 = _______

Req’d Setback Width or length Req’d Yard Area Max. Allowable Cov.

of lot

Proposed Coverage: __________

Area in Req’d Setback

Driveway Coverage Ratio: ______________  ____________ = ________________

Area in Req’d Setback Req’d Yard Area Driveway Coverage Ratio

Applicant to Complete the Following Information _

For office use only:

UZoning Review NotesU: (Items requiring compliance or verification)

Average Setback Rule (4 lots, typical) Lots to South _______ _______ _______ _______

Lots to North _______ _______ _______ _______

Lots to East _______ _______ _______ _______

Lots to West _______ _______ _______ _______

Date of Architectural Drawings __________ __________ __________ (final approved)

Date of Engineering Drawings __________ __________ __________ (final approved)

Date of Zoning Review __________ __________ __________

Comments:

___________________________________________________________________________________

UReviewer Checklist:

 Zoning Variance Approved ( ZBA # _______________________ , date granted____________________)

Variance for: _______________________________________________________________________

 Plans match ZBA drawings

 Plat of Survey submitted

 Second story projections conform to setbacks

 A/C (Not allowed in required front/ corner side / side setback)

 Window well location

5-23-13

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Page 2 of 2

____________________________________

Name of person completing this worksheet

____________________ ____________

Telephone / Fax Date

 Owner

 Architect

 General Contractor

 Zoning Reviewer

O

Per:

Arch

Eng

O

Print Form

3-26-14

P:\1-Building Permits\Forms (Public & Web)\1-Ready Forms\Utility-Data-Application-3.1 3-25-14.Docx

FORM 3.1

Building Site & Utility Data Worksheet

Property Address

Date

NOTE: If your construction project will result in an increase in impervious surface coverage of greater than four

hundred (400) square feet, all building site and utility data must be depicted on Civil Engineering Drawings. All other

projects may submit this information (if applicable) on a Site Plan or Plat of Survey – See Sample

1. Construction Fencing

Will your project require any excavation?

Yes No

If ‘Yes’, will excavation exceed four (4) feet in depth?

Yes No

Will the property be vacant during construction?

Yes No

If you answered ‘Yes’ to any two (2) questions above, construction fencing (6’ chain-link fencing) must be erected

and displayed on a Site Plan or the Civil Engineering Drawing that encloses the entire construction activity area

1

.

1

Construction activity area is the entire area that will be affected by the construction, including any access route across

both public right-of-way and private property to the area of construction

2. Tree Preservation Requirements

The following tree preservation requirements must be shown on the Site Plan or Civil Engineering

Drawings:

Check if

Applicable

1. All trees on the subject property located within the construction activity area (See Above)

2. All trees located on neighboring properties that may be affected by construction

3. Location of wood slat fencing around all trees greater than six (6) inches in diameter

3. Water Service

Will your project require any plumbing work (i.e. new/change piping or connections)?

Yes No

What is the existing water service size? (Addition/Alteration Only)

inch

Lead Copper

Is there any change to the water service size to be included in this permit application?

Yes No

If ‘Yes’, what is the proposed water service size and show location on a Site Plan or the

Civil Engineering Drawings. Contact Engineering Division, 847/272-4711 for site utility questions

inch

4. Sewer Service

Is there any change, or new connection, to the existing sanitary or storm sewers to be included

in this permit application?

Yes No

If ‘Yes’, please indicate which and show on a Site Plan or the Civil Engineering

Drawings. Contact Engineering Division, 847/272-4711 for site utility questions

Sanitary Storm

If ‘Yes’, please describe (briefly) the change or the new connection:

5. Electrical Service

What is the existing electrical service size? (Add’n/Alt’n Only)

amps

U/Ground O/Head

Is there any change to, or new, electrical service to be included in this permit application?

Yes No

If ‘Yes’, what is the proposed electrical service?

amps

U/Ground O/Head

6. Mechanical (HVAC) Service

Is there any change to, or new, mechanical system, or a new mechanical system to be included

in this permit application?

Yes No

If ‘Yes’, please describe (briefly) the modification or new system:

Person completing this form:

Signature Print Name & Company Date

VILLAGE OF NORTHBROOK

Development & Planning Services

1225 Cedar Lane Northbrook, Illinois 60062

847 664-4050 FAX: 847 272-5068

www.northbrook.il.us

3-26-14

P:\1-Building Permits\Forms (Public & Web)\1-Ready Forms\Building-Site-Utility-Data-Form-3.1.Docx

Building Site & Utility Data Worksheet – Site/Plot Plan Example

FORM 3.2

VILLAGE OF NORTHBROOK

Development & Planning Services

1225 Cedar Lane

Northbrook, Illinois 60062

847 664-4050 FAX: 847 272-5068

www.northbrook.il.us

Water Service & Meter Worksheett

Information from 2004 Illinois State Plumbing Code, Section 890, Appendix A, Tables M & N

Name of person completing this form:______________________________________________________

5-23-2013

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Address

Date

Fixture Load Calculations:

Fixture Type

Unit

Number of Fixtures

Fixture Load

Water Closet

3

x

=

Lavatory

1

x

=

Bathtub/Shower

2

x

=

Kitchen Sink

2

x

=

Dishwasher

1

x

=

Laundry Sink (Laund Tray)

3

x

=

Laundry Machine

2

x

=

Total Fixture Load

=

Water Service Pipe Size Req’d.

Based on chart below

Water Meter Size Req’d.

Based on chart below

Proposed Service Size

Existing Meter Size

Water Supply Fixture Units (W.S.F.U.)

for a supply system with flush tanks

W.S.F.U.

Demand

(GPM)

Pipe Size

(Inches)

Pressure Loss

(PSI/100’ of Pipe)

Velocity

(Ft/Sec)

Meter Size

(Inches)

2

-

3

2

½

4.2

2.7

5

/

8

4

-

5

3

½

8.7

4.2

5

/

8

6

-

7

5

½

22.5

7.0

5

/

8

-

9

6.5

¾

6.3

4.3

5

/

8

10

-

11

8

¾

9.0

5.4

¾

12

-

13

9.2

¾

11.5

6.1

¾

14

-

15

10.4

¾

15.0

6.9

¾

16

-

19

11.6

¾

18.0

7.7

¾

20

-

24

14

1

7.2

5.6

¾

25

-

29

17

1

10.0

6.6

¾

30

-

34

20

1

13.6

8.0

1

35

-

39

22.5

1 ¼

5.8

5.7

1

40

-

44

25

1 ¼

7.0

6.3

1

45

-

49

27

1 ¼

8.2

6.9

1

50

-

59

29

1 ¼

9.5

7.4

1

60

-

69

32

1 ½

5.0

5.8

1 ½

70

-

79

35

1 ½

6.2

6.4

1 ½

80

-

89

38

1 ½

7.0

7.2

1 ½

90

-

99

41

1 ½

8.0

7.5

1 ½

100

-

119

43.5

1 ½

8.7

7.8

2

120

-

139

48

2

2.7

5.0

2

140

-

159

52.5

2

3.1

5.4

2

160

-

179

57

2

3.6

5.8

2

180

-

199

61

2

3.9

6.1

2

200

-

224

65

2

4.5

6.6

2

225

-

249

70

2

5.2

7.1

2

250

-

274

75

2

6.0

7.7

3

275

-

299

80

2 ½

2.6

5.5

3

300

-

349

85

2 ½

2.9

5.8

3

350

-

399

95

2 ½

3.5

6.5

3

400

-

449

105

2 ½

4.2

7.1

3

Print Form

FORM 5.1a

VILLAGE OF NORTHBROOK

1BDevelopment & Planning Services

1225 Cedar Lane

Northbrook, Illinois 60062

847 664-4050 FAX: 847 272-5068

www.northbrook.il.us

Fire Protection

Letter of Understanding

Permit Address:_______________________________________________________________

Please complete this sheet for all building construction permit applications by marking

( or ) the appropriate category:

 New Building, Additions & Major Renovations (see Single Family Residence Addition Exception

in box below with new municipal amendment Sec 6-63:27. R313.2 Automatic Fire Sprinkler Systems

Required for Major Renovations)

Fire protection systems for all new buildings and additions to existing buildings, are

required. Submit a separate Fire Protection Permit Application for review and

separate permit issuance.

Please be aware that Fire Sprinkler permit must be approved/issued prior to

scheduling “Rough Framing” inspection . Failure to have received this approval will

result in the immediate cancellation of this inspection until approval is granted.

 Alterations

Please check the appropriate box indicating:

 YES, there is an existing

fire sprinkler system

 NO, there is not an existing

fire sprinkler system

If there is an existing fire protection system, then a separate fire protection permit

application and documents are required to be submitted.

Please be aware that Fire Sprinkler permit must be approved/issued prior to

scheduling “Rough Framing” inspection . Failure to have received this approval will

result in the immediate cancellation of this inspection until approval is granted.

Please read and sign below:

I acknowledge and understand there are separate permit submittals required for any new or altered fire

protection systems as indicated above; and that the failure to follow the submittal requirement may affect the

granting of any occupancy of the structure or space.

_________________________________________________________________________________________________

Name (print) Signature Company Name (print) Date

K:\1-Building Permits\Forms (Public & Web)\1-Ready Forms\FP-Letter-Of-Understanding (Residential) - 4-21-21.Docx

Single Family Residence Addition Exception:

Additions to single family residences that are not equipped with fire protection are not

required to be sprinklered unless the amount of added habitable floor area

(excluding basement area) exceeds 115 percent of the habitable floor area

(excluding basement area) of the existing dwelling, in which case an automatic

residential sprinkler system shall be required for the entire residence. Such

permits shall be classified as Major Renovation Permits.

 Check this box if this is for an addition to a single family residence that does not

have a fire protection system (fire sprinklers) and does not qualify as a Major

Renovation

Page 1 of 2

FORM 6.2

Village of Northbrook

Development & Planning Services

1225 Cedar Lane

Northbrook, IL 60062

847 664-4050

Fax 847 272 5068

www.northbrook.il.us

CONTRACTOR(S) OF RECORD

**IMPORTANT – Must be completed before permit can be Issued**

This completed form can be submitted anytime during review process or at permit pick up. It is the applicant’s

responsibility to COLLECT ALL REQUIRED DOCUMENTS (requirements of each contractor are listed below) and

submit all together to the Village. You can now check that status of your Contractors registration on our Village

website (www.northbrook.il.us). On home page click Permit Center icon on right; then click “Contractor’s

Corner” on left side. Licenses are broken down by trades.

Permit Address: __________________________________________ Date: _________

Please Check all Boxes that apply to this Job:

Required Not Required Required Not Required

General Contractor   Sewer Contractor  

Concrete Contractor   Electrical Contractor  

Plumbing Contractor   Electrical Contractor  

(Interior Work Only) (Electrical Service Only)

Plumbing Contractor   Mechanical Contractor  

(Water Service Only)

Concrete Contractor:  Contractor must have a current

Village Contractor License

Name:

Address:

City, State, Zip:

Phone: Email:

Village Assigned Acct #

Plumbing Contractor: INTERIOR WORK ONLY

 Provide copies of Plumber’s State Plumbing License and State Registration

 Contractor must have a current Village Contractor License

 Submit a Letter of Intent (letter to bear corporate seal if incorporated OR notary seal if not incorporated)

Name:

Address:

City, State, Zip:

Phone: Email:

Village Assigned Acct #

General Contractor: Contractor must have a current

Village Contractor License.

Name:

Address:

City, State, Zip:

Phone: Email:

Village Assigned Acct #

Page 2 of 2

Plumbing Contractor: WATER SERVICE ONLY

 Provide copies of Plumber’s State Plumbing License and State Registration

 Contractor must have a current Village Contractor License

 Submit a Letter of Intent (letter to bear corporate seal if incorporated OR notary seal if not incorporated)

Name:

Address:

City, State, Zip:

Phone: Email:

Village Assigned Acct #

Electrical Contractor:

Provide copy of current Electrical License or Registration

Contractor must have a current Village Contractor License

Name:

Address:

City, State, Zip:

Phone: Email:

Village Assigned Acct #

Electrical Contractor (ELECTRICAL SERVICE ONY)

Provide copy of current Electrical License or Registration

Contractor must have a current Village Contractor License

Name:

Address:

City, State, Zip:

Phone: Email:

Village Assigned Acct #

Sewer Contractor  Contractor must have a current Village Contractor License

Name:

Address:

City, State, Zip:

Phone: Email:

Village Assigned Acct #

Mechanical Contractor  No Village License required

Name:

Address:

City, State, Zip:

Phone: Email: Village Assigned Acct #

5-23-2013

P:\1-Building Permits\Forms (Public & Web)\1-Ready Forms\Contractor-Of-Record-Form‐6.2.Docx

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FORM 6.1

VILLAGE OF NORTHBROOK

Development & Planning Services

1225 Cedar Lane

Northbrook, Illinois 60062

847 664-4050

www.northbrook.il.us

Contractor Business License Application

This application is required to be completed for all new and renewal licenses

COMPANY NAME

D/B/A

ADDRESS SUITE

CITY, STATE ZIP

PHONE CELL PHONE

EMAIL (required)

(please print email address legibly!!)

TYPE OF CONTRACTOR _________________________________________

(choose from list below)

General Contractor $100

Concrete Contractor $70

Plumbing Contractor No Village License required; Provide copy of current State Registration (055)

Sewer Contractor $70

Electrical Contractor $70 Provide copy of current Electrician’s license

Paving/Asphalt Contractor $70

Sealcoat Contractor $70

Has the applicant(s) ever been convicted of or pleaded no contest to a crime of moral turpitude? (___) yes (___) no.

Has the applicant(s) ever been convicted of a felony or unsuccessfully defended a criminal or civil proceedings

charging fraud, misrepresentation or unscrupulous business conduct (____ yes (___) no.

A F F I D A V I T

I (we) swear and affirm that all work performed pursuant to this business license application shall be in strict

compliance with all provisions of the Northbrook Building Code and all other applicable statutes, laws, rules,

regulations and ordinances. I (we) understand that, in the event noted code violations are not corrected during the

construction of a permitted improvement, the Village of Northbrook reserves the right to revoke this license.

DATE__________________ SIGNATURE OF OWNER ___________________________________________

*******************************************************************************************************

FOR OFFICE USE ONLY

License no.______________

04-28-21

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