Fillable Application for a Permit to Construct or Demolish (Township of Oro Medonte)

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Application for a Permit to Construct or Demolish (Township of Oro Medonte)

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Application for a Permit to Construct or Demolish – Effective January 1, 2014 Page 1 of 4
Application for a Permit to Construct or Demolish
This form is authorized under subsection 8(1.1) of the Building Code Act,1992
For use by Principal Authority
Application number:
Permit number (if different):
Date received:
Roll number:
Application submitted to:
(Name of municipality, upper-tier municipality, board of health or conservation authority)
A. Project information
Building number, street name
Unit number
Lot/con.
Municipality
Postal code
Project value est. $
B. Purpose of application
New construction
Addition to an
existing building
Alteration/repair
Demolition
Conditional
Permit
Proposed use of building
Current use of building
Description of proposed work
C. Applicant
Applicant is: Owner or Authorized agent of owner
Last name
First name
Street address
Unit number
Lot/con.
Municipality
Postal code
Province
E-mail
Telephone number
Fax
Cell number
D. Owner (if different from applicant)
Last name
First name
Street address
Unit number
Lot/con.
Municipality
Postal code
Province
E-mail
Telephone number
Fax
Cell number
Application for a Permit to Construct or Demolish – Effective January 1, 2014 Page 2 of 4
E. Builder (optional)
Last name
First name
Street address
Unit number
Lot/con.
Municipality
Postal code
Province
E-mail
Telephone number
Fax
Cell number
F. Tarion Warranty Corporation (Ontario New Home Warranty Program)
i. Is proposed construction for a new home as defined in the Ontario New Home Warranties
Plan Act? If no, go to section G.
Yes
No
ii. Is registration required under the Ontario New Home Warranties Plan Act?
Yes
No
iii. If yes to (ii) provide registration number(s):
G. Required Schedules
i) Attach Schedule 1 for each individual who reviews and takes responsibility for design activities.
ii) Attach Schedule 2 where application is to construct on-site, install or repair a sewage system.
H. Completeness and compliance with applicable law
i) This application meets all the requirements of clauses 1.3.1.3 (5) (a) to (d) of Division C of the
Building Code (the application is made in the correct form and by the owner or authorized agent, all
applicable fields have been completed on the application and required schedules, and all required
schedules are submitted).
Payment has been made of all fees that are required, under the applicable by-law, resolution or
regulation made under clause 7(1)(c) of the Building Code Act, 1992, to be paid when the
application is made.
Yes
Yes
No
No
ii) This application is accompanied by the plans and specifications prescribed by the applicable by-law,
resolution or regulation made under clause 7(1)(b) of the Building Code Act, 1992.
Yes
No
iii) This application is accompanied by the information and documents prescribed by the applicable by-
law, resolution or regulation made under clause 7(1)(b) of the Building Code Act, 1992 which enable
the chief building official to determine whether the proposed building, construction or demolition will
contravene any applicable law.
Yes
No
iv) The proposed building, construction or demolition will not contravene any applicable law.
Yes
No
I. Declaration of applicant
I declare that:
(print name)
1. The information contained in this application, attached schedules, attached plans and specifications, and other attached
documentation is true to the best of my knowledge.
2. If the owner is a corporation or partnership, I have the authority to bind the corporation or partnership.
Date Signature of applicant
Personal information contained in this form and schedules is collected under the authority of subsection 8(1.1) of the Building Code Act, 1992, and will be
used in the administration and enforcement of the Building Code Act, 1992. Questions about the collection of personal information may be addressed to: a)
the Chief Building Official of the municipality or upper-tier municipality to which this application is being made, or, b) the inspector having the powers and
duties of a chief building official in relation to sewage systems or plumbing for an upper-tier municipality, board of health or conservation authority to whom
this application is made, or, c) Director, Building and Development Branch, Ministry of Municipal Affairs and Housing 777 Bay St., 2nd Floor. Toronto, M5G
2E5 (416) 585-6666.
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Application for a Permit to Construct or Demolish – Effective January 1, 2014 Page 3 of 4
Schedule 1: Designer Information
Use one form for each individual who reviews and takes responsibility for design activities with respect to the project.
A. Project Information
Building number, street name
Unit no.
Lot/con.
Municipality
Postal code
Plan number/ other description
B. Individual who reviews and takes responsibility for design activities
Name
Firm
Street address
Unit no.
Lot/con.
Municipality
Postal code
Province
E-mail
Telephone number
Fax number
Cell number
C. Design activities undertaken by individual identified in Section B. [Building Code Table 3.5.2.1. of
Division C]
House
Small Buildings
Large Buildings
Complex Buildings
HVAC – House
Building Services
Detection, Lighting and Power
Fire Protection
Building Structural
Plumbing – House
Plumbing – All Buildings
On-site Sewage Systems
Description of designer’s work
D. Declaration of Designer
I declare that (choose one as appropriate):
(print name)
I review and take responsibility for the design work on behalf of a firm registered under subsection 3.2.4.of Division
C, of the Building Code. I am qualified, and the firm is registered, in the appropriate classes/categories.
Individual BCIN: __________________________________________
Firm BCIN: __________________________________________
I review and take responsibility for the design and am qualified in the appropriate category as an “other designer”
under subsection 3.2.5.of Division C, of the Building Code.
Individual BCIN: __________________________________________
Basis for exemption from registration: ________________________________________________________
The design work is exempt from the registration and qualification requirements of the Building Code.
Basis for exemption from registration and qualification: ___________________________________________
I certify that:
1. The information contained in this schedule is true to the best of my knowledge.
2. I have submitted this application with the knowledge and consent of the firm.
Date Signature of
Designer
NOTE:
1. For the purposes of this form, “individual” means the “person” referred to in Clause 3.2.4.7(1) (c).of Division C, Article 3.2.5.1. of
Division C, and all other persons who are exempt from qualification under Subsections 3.2.4. and 3.2.5. of Division C.
2. Schedule 1 is not required to be completed by a holder of a license, temporary license, or a certificate of practice, issued by the Ontario
Association of Architects. Schedule 1 is also not required to be completed by a holder of a license to practise, a limited license to practise,
or a certificate of authorization, issued by the Association of Professional Engineers of Ontario.
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Application for a Permit to Construct or Demolish – Effective January 1, 2014 Page 4 of 4
Schedule 2: Sewage System Installer Information
A. Project Information
Building number, street name
Unit number
Lot/con.
Municipality
Postal code
Plan number/ other description
B. Sewage system installer
Is the installer of the sewage system engaged in the business of constructing on-site, installing, repairing, servicing, cleaning or
emptying sewage systems, in accordance with Building Code Article 3.3.1.1, Division C?
Yes (Continue to Section C)
No (Continue to Section E)
Installer unknown at time of
application (Continue to Section E)
C. Registered installer information (where answer to B is “Yes”)
Name
BCIN
Street address
Unit number
Lot/con.
Municipality
Postal code
Province
E-mail
Telephone number
Fax
Cell number
D. Qualified supervisor information (where answer to section B is “Yes”)
Name of qualified supervisor(s)
Building Code Identification Number (BCIN)
E. Declaration of Applicant:
I declare that:
(print name)
I am the applicant for the permit to construct the sewage system. If the installer is unknown at time of application, I shall
submit a new Schedule 2 prior to construction when the installer is known;
OR
I am the holder of the permit to construct the sewage system, and am submitting a new Schedule 2, now that the installer is
known.
I certify that:
1. The information contained in this schedule is true to the best of my knowledge.
2. If the owner is a corporation or partnership, I have the authority to bind the corporation or partnership.
Date Signature of
applicant
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Municipal Form 6
Building Permit Fee Calculation Form
This form must be completed in order to calculate permit fees associated to the
proposed renovations or new construction.
Building Type: ___________________________ No. of Bedrooms: ______________
(i.e. Single Family Dwelling, Accessory Building, Agricultural Building)
Construction Type:
(i.e. New Construction, Renovation/Alteration)
Heating System: Primary: __________________________________________________
Secondary: ________________________________________________
Building Size:
Basement:
Main Floor:
Second Floor:
Detached /Attached Garage:
Fixtures: (incl. roughed-in plumbing)
Fixtures related to the proposed renovation or new construction
New Construction Renovation Sq. Ft
Description
Fixture Count
Bathtub
Showe
r
Vanit
y
sinks
Water closet
Kitchen sink
Washin
g
Machine
Laundr
y
Tub
Dishwashe
r
Othe
r
Total Fixtures
BP #
No. of Solid Fuel Burning Woodstoves /
Fireplaces:
Deck / Porch / Veranda Size:
Water Meter & Trench Inspection
Engineered Lot Grading
_______________________
Sq. Ft.
Sq. Ft.
I certify the above information is correct and corresponds with the permit drawings and documents, and
acknowledge I shall notify the Chief Building Official of all revisions.
Si
g
nature
(
Owner or A
g
ent
)
Print Name Date
0
0
0
0
0
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Revised: December 18, 2019
TECHNICAL BULLETIN - Engineered Lot Grading Requirements
The following is a summary of when Engineered Lot Grading plans are required for review and
approval by Development Engineering as part of a Building Permit Application.
Engineered Lot Grading – is the Site Plan providing Grading / Drainage and Servicing detail,
completed by a Competent Designer – Professional Engineer (P.Eng.), a Certified Engineering
Technologist (C.E.T.) or an Ontario Land Surveyor (OLS) and approved by the Township’s
Development Engineering Department. * Design Checklist Attached
When Engineered Lot Grading Shall Be Required:
For Single Detached, Semi-Detached & Townhouse Dwellings, Detached Accessory Buildings
and Additions to Existing Buildings:
1. All Lots contained within an Unassumed Plan of Subdivision;
2. All Lots contained within an Assumed Plan of Subdivision;
3. All Lots defined as Infill Development – Urban / Settlement Areas / Rural (see 3.20.2);
4. All Lots defined as Waterfront / Shoreline Development Areas (see 3.20.3);
5. All Lots less than 0.20 hectares (0.5 acres) in size;
6. Additions having a ground floor area in excess of 22.3m
2
(240sq. ft.);
7. Accessory buildings having a ground floor in excess of 22.3m
2
(240sq. ft.);
8. Construction closer than 3.0 m (10 feet) to the property line;
9. Changes to existing grades (shaping / cut / fill) of more than 30cm (12”) in elevation within
3.0m (10ft.) of the Property Line;
10. Changes to Driveway - location / width / length / grade;
11. Changes to Septic System - location / size / grade;
12. Any lot where the Chief Building Official / Manager, Development Engineering determines
Engineered Lot Grading is required as part of a Planning Application or due to existing grades,
driveway extensions, topography, slope stability issues, etc.
When Engineered Lot Grading IS NOT required:
1. On all other lots where the lot has an area greater than 0.2 ha / 0.5 acre
and
2. Where the proposed dwelling, addition or accessory building is greater than
3.0m / 10 ft. from a lot line;
and
3. Where the addition or accessory building is less than 22.3m
2
(240sq. ft.);
4. On lots where only decks or porches / sun decks that are elevated (constructed above
grade) are being applied for;
5. On lots where a building is being replaced (whether by fire or demolition) and is located
on the same footprint and at the same elevations and grade;
6. For Agricultural buildings.
Process:
Upon Township approval of and issuance of the Zoning Certificate and where applicable,
Development Services staff will advise land owners or their agent of the following:
1. A Building Permit application is submitted;
2. The Engineered Lot Grading Plan is required at the time of Building Permit Application;
3. A Competent Designer (P.Eng., OLS, C.E.T.) is required to complete the Engineered Lot
Grading Plan;
4. Engineered Lot Grading Plans are to be prepared in accordance with the Township of Oro-
Medonte Development Engineering Policies, Process, and Design Standards (By-law 2016-068 –
Revised Sept. 2019). The Township’s internal design checklist is attached;
5. The fee of $1,000.00 (or as the most recent Fees and Charges By-law requires) is payable
upon submission of the Building Permit Application;
Fees and Refund:
As per the amended fees by-law the applicable fee is $1,000.00 (or as the most recent Fees and
Charges By-law requires).
Once Final Lot Grading is completed, the Township shall undertake a Site Inspection for Final
Grading Approval; any remaining portion of the fee shall be refunded to the Applicant.
Engineered Lot Grading Design Checklist
Applicants
Name:________________________________________________________________
Contact Information of Designer
/ Consultant:__________________________________________
Lot Info / Municipal Address________________________________________________________
Submission
Date:______/_______/_________ Submission / Revision #:________________
Description
Yes
No
N/A
Signature / Seal of Lot Grading Plan Designer * Notice of Review and Approval by
Engineer of Record in accordance with a Subdivision Agreement (if required) *
Design Date and Submission #
North Arrow and Key Plan
Metric Scale of Drawing - of a typical engineering scale
Geodetic Benchmark - Location and Elevation
Dimensioned Property Limits / Boundaries and Lot Corner Elevations
Location and Typical Detail of Silt and Sediment Control Measures
Typical Swale Cross Section(s) – Side yard, Mid-yard and Cut-off (as req’d)
Location, Elevation, Flow Direction and % Grade of all Swales
Location of Engineered Fill
Location of Environmentally Protected Areas / Waterbodies / Shoreline
Location of Existing Trees to be Retained
Top and Bottom of Slope / Topographic Detail (For Septic Location - As Necessary)
Location and Type of all Utility Services (Natural Gas, Bell, Hydro and Cable TV etc.)
Location of Municipal Water Service OR
Location of Private Well and 15.0m Setback Radius
Location of Municipal Sanitary Sewer Service OR
Location of Private Sewage System – Septic Bed, Tank and Grade Elevations
Location and Dimensions of Municipal or Utility or Drainage Maintenance Easements
Driveway - location, proposed % grade, width and curb cut locations
Driveway Culvert – location, size, length, material, elevations and % grade
Elevations of Road Grade (edge of road and centre line) adjacent to all Lot Lines
Elevations of and % grade of Road Side Ditches adjacent to all Lot Lines
Street Furniture – Hydrants, Streetlights, Bell / Cable Hydro Pedestals / Poles, etc.
Building(s) Location - Lot Line Setback Distances and Building Grade Elevations
House Type / Lot Type e.g.: Walk-out Basement / Split Lot
Location of Internal Catch Basins / Soak Away Pits inc. Grate and Invert Elevations
Location of Sump Pump discharge (not discharging to driveway or over septic tank)
Location of all Rainwater Leaders / Downspouts (not discharging to driveway)
Finished First Floor elevation (F.F.F.)
Top of Foundation Wall elevation (T.F.W.)
Finished Basement Floor elevation (F.B.F.)
Underside of Footings elevation (U.S.F.)
Finished Garage Floor elevation (F.G.F.)
Underside of Footings Garage elevation (U.S.F.G.)
Location and Elevation of all Entrances including # of Risers
Location and Elevation of all Walkways, Patios, Deck and Porches
Location and Elevation of Retaining Walls (Top of Wall and @ Grade)
Revision :Sept. 2018
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Application for a Permit to Construct or Demolish (Township of Oro Medonte)

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