Fillable Application for an Alternative Solution For use by (City of Guelph)

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Application for an Alternative Solution For use by (City of Guelph)

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Building Services Page 1 of 4
519-837-5615, building@guelph.ca November 2020
Application for an
Alternative Solution
For use by Principal Authority
Application number:
Date received:
Project Address
Project address; including unit number:
Plan number/lot/other description:
A. Applicant Information
Last name: First name:
Corporation or partnership (if applicable):
Mailing address:
Unit number: Municipality:
Postal code: Province:
Telephone number: E-mail:
Cell number:
Qualifications:
BCIN # if applicable:
B. Owner Information (if different from applicant)
Last name: First name:
Corporation or partnership (if applicable):
Mailing address:
Unit number: Municipality:
Postal code: Province:
Telephone number: E-mail:
Cell number:
Page 2 of 4
C. Summary of Proposed Alternative solution
☐ New construction ☐ Addition to an existing building
☐ Alteration/repair ☐ Conditional permit ☐ Demolition
Proposed use of building:
Current use of building:
Description of alternative solution:
D. Applicable Division B Provisions
Sentence
Summary of provision
E. Applicable Objectives and Functional Statements
Sentence
Functional
statement
Objective
Summary of area of performance
Page 3 of 4
F. Confirmation of Level of Performance
Division B requirement
i
Alternative solution
ii
G. Supporting Documentation/Attachments
Please list the author and the title of the document(s) here:
1.
2.
3.
4.
5.
6.
H. Reason for Proposed Alternative Solution
I. Declaration of Applicant
I (print name) certify that:
1. As per the requirements of Division A, Article 1.2.1.1., by using the
Alternative Solution proposed, the Level of Performance required by the
applicable Acceptable Solutions in respect of the Objectives and Functional
Page 4 of 4
Statements attributed to the Acceptable Solutions in Supplementary
Standard SA-1 will be achieved.
2. The information contained in this application, attached plans and
specifications, and other attached documentation is true to the best of my
knowledge.
3. I have authority to bind the corporation or partnership (if applicable).
Date:
Signature of applicant:
For use by Principal Authority
Fee total:
Fee collected by:
Collection of Personal Information
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.
Alternate formats of this document are available as per the Accessibility for Ontarians with
Disabilities Act by contacting Building Services at 519-837-5615 or email
building@guelph.ca.
i
Description of level of performance Div. B Achieved
ii
Description of alternative solution level of performance achieved
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Application for an Alternative Solution For use by (City of Guelph)

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Completed 6 May 2021

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