Fillable Application for Certificate of Occupancy (State of Ohio)

Fill Online, Printable, Fillable, Blank Application for Certificate of Occupancy (State of Ohio) Form

Use Fill to complete blank online STATE OF OHIO (OH) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Application for Certificate of Occupancy (State of Ohio)

On average this form takes 13 minutes to complete

The Application for Certificate of Occupancy (State of Ohio) form is 4 pages long and contains:

  • 0 signatures
  • 13 check-boxes
  • 46 other fields

Country of origin: US
File type: PDF

U.S.A. forms for State of Ohio

BROWSE STATE OF OHIO (OH) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Bureau of Building Code Compliance
6606 Tussing Road
Reynoldsburg, OH 43068-9009
An Equal Opportunity Employer and Service Provider
614-644-2622
Fax 614 -644-3145
TTY/TDD 800-750-0750
com.ohio.gov
Application for Certificate of Occupancy
Introduction:
Section 111.1 Ohio Building Code states that no building or structure, in whole or in part,
shall be used or occupied until the building official has issued an approval in the form of a
certificate of occupancy. The certificate of occupancy shall indicate the conditions under
which the building shall be used. The building owner shall only use the structure in
compliance with the certificate of occupancy and any stated conditions. The structure and
all approved building service equipment shall be maintained in accordance with the
approval. When a building or structure is entitled thereto, the building official shall issue a
certificate of occupancy provided there are not violations of law or orders of the building
official pending or as permitted in this section.
Please note that when an application for plan approval for a new building
construction, alteration, addition, or change of occupancy is filed, a certificate of use
and occupancy will be issued automatically at the completion of all required
inspections in accordance with section 109 Ohio Building Code. The permit applicant
does not need to submit this application form (DIC3019). However, it the applicant
wishes to occupy a portion of building prior to the completion of the entire approved
scope of work, please follow the procedures for APPLICATION FOR PARTIAL
OCCUPANCY in another bureau policy.
Certificate of Occupancy qualifications:
The certificate of use and occupancy can be obtained for the following occupancy types:
• EXISTING BUILDING CERTIFICATE OF OCCUPANCY: According to the Ohio Building
Code Section 111.4, the owner of an existing building may request the issuance of a
Certificate of Use and Occupancy. Upon written request from the owner, the building
official shall issue a certificate of occupancy, provided there are not violations of law
or orders of the building official pending, and it is established after inspection and
investigation that the alleged occupancy of the building or structure has heretofore
existed. Please be aware that an existing building with proposed change of
occupancy, alterations, or addition, according to Ohio Building Code is not
qualified for this application.
• TIME-LIMITED CERTIFICATE OF OCCUPANCY: According to Ohio Building Code
Section 111.1.1.4, a time-limited Certificate of Occupancy can be issued for a building or
structure changed in part from one occupancy to another for a limited time period.
The building official may stipulate any special conditions under which the building may be
occupied for the specified time.
Required supporting documents for each type of certificate of occupancy:
EXISTING BUILDING OCCUPANCY:
(Please review carefully the “change of occupancy” policy form 3016B to ensure
that your application is qualified for an existing building occupancy rather than
change of
occupancy).
Ohio Department of Commerce
Application for certificate of occupancy
1. C
ompleted application for certificate of occupancy (DIC 3019),
2. Payment for application fees,
3. A most recent building fire safety inspection report showing that there are n
o
v
iolations of law or orders pending in the building must be submitted with this
application,
4. A written request from the owner of the building stating the use occupancy of t
he
building as it has been known to the public for a minimum of 2 years and
doc
uments of proof such as copies of utility bills, insurance statements, etc., wit
h
t
he name of business.
5. A copy of the floor plans for the building showing all exits, room name, occupant
load, and dimension of each room.
6. For a day care center in an existing building application, Include a floor plan draw
n
on
a minimum 8 ½ x 11 sheet of paper for each floor that indicates the following:
• Room name and dimension of each room,
• Number and age of children in each room
• If there are dividers of any kind within the room, indicate type & height
• Location & width of all exit doors w/ exit signs or indicated on the drawings.
• If rooms have doors directly to the outside, indicate whether there are steps or
ramp outside of the exit doors
• Indicate location & number of toilet fixtures.
TIME-LIMITED OCCUPANCY:
1. C
ompleted application for certificate of occupancy (DIC 3019),
2. Payment for application fees,
3. A most recent building fire safety inspection report showing that there are n
o
violations of law or orders pending in the building must be submitted with this
application,
4. A copy of the floor plans for the building showing all exits, room name, dimension,
and occupant load of each room.
How to apply for this certificate of occupancy:
1. Apply online through web portal: https://icportal.com.ohio.gov/web/ohio/login
If you have not registered as a member in the web portal, you must complete the
r
egistration process first. Once you are registered, you can follow the screen instructions
to apply for the certificate of occupancy and upload all required supporting documents (in
.PDF format) in the attachment tab.
2. Apply in paper format:
Complete the application form (DIC 3019) and mail in, fax in (614) 644-3145, or e-mail in
(BDCCPlans@com.state.oh.us
) the application form along with all required supporting
documents.
Inspection and certificate issuance procedures:
Once documentation has been reviewed and application has been processed, you will
receive notification in the mail or e-mail or download the acceptance letter from web
portal regarding the procedure to schedule the appropriate structural and electrical safety
inspections. Allow up to 5 business days for the processing of the application. Additional
questions may be directed to Building Code Compliance at 800/523-3581 or 614/644-
2622.
Ohio Department of Commerce
Application for certificate of occupancy
I
f DIC structural inspectors determine that a plumbing inspection is required for the day
care center requesting for certificate of occupancy, an additional plumbing inspection f
ee
o
f $175.00 shall be paid for the plumbing inspection and plumbing inspection shall
be
c
ompleted prior to the issuance of the certificate of use and occupancy.
Once ALL required inspections are completed, a certificate of use and occupancy will be
i
ssued and mailed to the owner. The certificate of occupancy can also be downl
oaded
t
hrough web portal.
Revised 04/02/2019
Bureau of Building Code Compliance
6606 Tussing Road
Reynoldsburg, OH 43068-9009
A
n Equal Opportunity Employer and Service Provider
614-644-2622
Fax 614 -644-3145
TTY/TDD 800-750-0750
com.ohio.gov
APPLICATION FOR CERTIFICATE OF USE AND OCCUPANCY
DIC 3019 Revised 04/02/2019
1
Type of Certificate of Occupancy: (check one; see definition in the policy or instruction sheet)
Existing Building (Including daycare) Time-Limited Occupancy for days
2 Is this building located in an incorporated city, township, or village? Yes No
3
Name of Business:
County:
Building Address:
City
Zip
Direction to building:
4
Building owner
Attention
Address
City
State
Zip
Phone
Fax
E-mail:
5
Applicant
Attention
Address
City
State:
Zip
Phone
Fax
E-Mail:
6
Building Information: (Required to be shown on the certificate of occupancy)
Use group(s)
Construction type:
Building area (sf)
Mixed use groups?
Yes
No
Separated
Non-Separated
Building height (ft)
No. of Stories?
Storage height (ft)?
Occupant Load?
Type of fire protection system: (Provide names of system; i.e., NFPA 13, NFPA72, etc.)
Building sprinkler:
Sprinkler demand @ base of riser (PSI):
Limited area sprinkler
Type 1 hood sprinkler?
In-rack sprinkler:
Building fire alarm:
Fire detection system?
Smoke detection?
7
Required supporting documents: (All documents are required; see instructions for details)
X
Proof of building use group
X
Most recent fire safety inspection report
X
Floor plans
8
For Time-Limited Occupancy application only:
Current building use group:
Proposed new use group:
9
Fees to be Paid (Minimum 2 inspections)
10
I hereby certify that I am the (check one)
Structural safety inspection:
$150.00
Owner
Agent for the owner
Electrical safety inspection
$150.00
and all information contained in this application is
Board of Building Standards fees
$10.00
true, accurate, and complete to the best of my
Total fee due:
$310.00
Knowledge.
Signature:
11
Fee Paid by: (check one applicable)
Cash Check Credit card ISTV
Print name
Date
12
THIS AREA IS FOR OFFICIAL USE ONLY
Date Received:
CPA No.
Mail-In
Walk-In
Check Number:
Verification No.:
Processed by:
Ohio Department of Commerce Application for certificate of use and occupancy
DIC-3019
Revised 04/02/2019
INSTRUCTIONS FOR COMPLETING
APPLICATION FOR CERTIFICATE OF USE AND OCCUPANCY (DIC #3019)
Application Directions: All boxes, 1 through 11, must be completed in full or the application will be
returned. Please type or print legibly (in blue or black ink). Application forms are also available on our
website: www.com.ohio.gov/
1. Check the type of certificate of use and occupancy that you are requesting.
• Time-Limited occupancy: For an existing building or structure that you wish to use or occupy a portion
of the building for a use occupancy purpose other than what it was originally approved for a limited
period of time per section 111.1.5 Ohio Building Code. You must specify how many days that you wish
to occupy the building or structure for the new use occupancy purpose.
• Existing building occupancy: For an existing building that you wish to receive a new certificate of use
and occupancy because you have misplaced or lost the original one or as required by other local
authorities. Existing buildings with alterations, additions, or change of use and occupancy to an
existing building are not qualified for this application.
2. Is the building located in a city, township, or village?
3. List exact title of project or name of business. Provide specific address and location including tenant
space, suite numbers, floor number, crossroads, landmarks or any other directional guides.
4. List the owner of project, their address, telephone, and a contact person.
5. List the name of submitter, their address, and telephone. Correspondence will be sent to submitter.
6. Provide all required building information; these are necessary for the new certificate of use and occupancy
7. Provide all necessary supporting documents for any existing building.
• Proof of use group can be past utility bills, lease agreement, insurance statement showing the
use purpose of the existing building in the past.
• Fire safety inspection conducted by the local fire authority showing no outstanding violations.
• Floor plans must contain all exits, room name, dimension, and occupant load for each room;
For daycare center, it must also show the age range of children being cared for in each room.
8. For time-limited occupancy application only; provide the use group classification for the existing building
and the proposed use group classification.
9. Fees to be paid at the time of application submission.
10. Application cannot be processed without the signature of the owner or agent for the owner.
11. Please list method of payment. Make check payable to: Treasurer, State of Ohio if paid by a check.
12. This space is reserved for official use only.
• Mail completed application form along with payment and plans to “State of Ohio, Department of
Commerce, Division of Industrial Compliance, Bureau of Building Code Compliance, 6606 Tussing
Road, Reynoldsburg, Ohio 43068-9009.” or,
• Fax appli
cation and all supporting documents to 614-644-3145, e-mail to
(BDCCPlans@com.state.oh.us
) and pay by credit cards. DO NOT WRITE CREDIT CARD NUMBER
ON THE APPLICATION. Include a phone number where you can be reached for the credit card
information. Once documentation has been reviewed and approved, you will receive notification in
the mail regarding the procedure to schedule inspections, or
• Go onto online web portal: https://icportal.com.ohio.gov/web/ohio/login to complete the application
form and upload all required supporting documents.
Once all required safety inspections are conducted and passed, a certificate of use and occupancy
will be issued and mailed to the applicant. The certificate of use and occupancy will also be available
on the web portal for downloading.
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Application for Certificate of Occupancy (State of Ohio)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 1 August 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document