PERMIT TYPE: (fyi- OBC changes to 2015 in November, 2017)
original permit #
Description of work:
$
To be signed by APPLICANT:
Street Address:
Lot Number & Subdivision:
The owner of this building and undersigned, do hereby covenant and agree to comply with all the
laws of the State of Ohio and the ordinances of this jurisdiction, pertaining to building and
buildings, and to construct the proposed building or structure or make the proposed change or
alteration in accordance with the plans and specifications submitted herewith, and to the best of
my knowledge, the information and statements given on this application, drawings and
specifications are to the best of their knowledge true and correct.
Name of Applicant:
Applicant's e-mail:
Applicant's Phone #:
BUILDER/CONTRACTOR INFORMATION: (Company)
Hilliard Contractor Registration #:
Builder/Contractor Company Name:
OTHER INFORMATION:
Architect/Engineer Company Name:
WATER & SEWER
PROJECT COST
estimated
SQUARE FOOTAGE
estimated
Separate permits are required for electric wiring, heating and ventilating,
plumbing, moving, wrecking, shoring, and sewer systems are needed. Building
permits shall not be issued until these permits have been obtained.
Owner/Tenant Information:
APPLICANT INFORMATION: (individual)
CERTIFIED ADDRESS INFORMATION:
Multi-Family 4+ (OBC 2011)
New Build
Addition/Alteration/Tenant Finish
Demolition
Revision/Response to Correction
Onsite SEPTIC
Residential (RCO 2013)
Commercial (OBC 2011)
Multi-Family 2-3 (RCO 2013)
Onsite WELL
ExIstIng WATER TAP
ExIstIng SEWER TAP
Permit number assigned:
Inspection Line: 614-334-2466
Call by 2pm for next business day inspection.
Becomes a Building Permit when signed
below:
Issuing Authorities Approval & Date
Permit #:
Description:
Route to:
Target Date:
It is the responsibility of the homeowner to obtain any required Homeowner’s Association Approval.
3800 Municipal Way, Hilliard, OH 43026
www.hilliardohio.gov
614.334.2557
NEW BUILD - New Taps
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