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CONSTRUCTION DETAILS (must be shown on plans)
Woodstove Slab Heating System:
Factory fireplace Crawl space Electric Baseboard
Masonry fireplace Finished Basement Heat Pump
Gas fireplaces Unfinished Basement Forced Air
Gas appliances Other In-floor Radiant
Masonry chimney Not applicable None
Factory Built chimney
Has or will blasting be carried out on the subject property?
Has or will fill been placed on site?
Distance to North Lot Line (metres):
Distance to South Lot Line (metres):
Distance to East Lot Line (metres):
Distance to West Lot Line (metres):
Property Contains and/or Adjacent to:
Sea Lake/Pond River/Stream
Ditch Cliff/Bank None
Acknowledgement of Responsibility and Undertakings
The undersigned being the owner/agent for the owner of the property herein described hereby makes application for a permit to undertake
the work as set forth in this application. I agree to conform to all requirements as may be specified by the Regional District of Nanaimo Building
Bylaw and any other applicable Bylaw or Regulation in force in the Regional District of Nanaimo.
Neither the issuance of the Permit nor the approval of the drawings and specifications submitted as part of this application, by the Regional
District of Nanaimo Building Inspection Department or designates thereof, shall, in any way relieve the applicant from the responsibility of
ensuring the construction for which this permit issued, is carried out in conformity with the requirements of the Building Bylaw and any other
applicable Bylaws and Regulations, nor prevent the Building Inspector, or his designate from requiring correction of any errors in construction
or violation of the Building Bylaw or other applicable Bylaw or Regulations.
The issuance of a building or occupancy permit is not a warranty that the building complies in every respect with the Building Code or meets
any particular standard of construction, and that the owner is responsible for ensuring that the building for which application is made complies
with the Building Code and other applicable enactments.
The undersigned owner/authorized agent of the owner makes an application as specified herein, and declares that the information submitted in
support of the application is true and correct in all respects.
Personal information collected on this form is collected for the purposes of processing this building permit application and for administration and enforcement. The
personal information is collected under the authority of the Local Government Act, the Regional District’s Building Bylaw and pursuant to section 26 of the Freedom
of Information and Protection of Privacy Act.