Applicant Certification
The applicant certifies that all information on this application is correct and the work will be completed in
accordance with the "approved" construction documents and PA Act 45 (Uniform Construction Code) and
any additional approved building code requirements or zoning ordinance adopted by the Municipality.
The property owner and applicant assumes the responsibility of locating all property lines, setback lines,
easements, rights-of way, flood areas, etc. Issuance of a permit and approval of construction documents
shall not be construed as authority to violate, cancel or set aside any provisions of the codes or ordinances
of the Municipality or any other governing body. The applicant certifies he/she understands all the
applicable codes, ordinances and regulations. Application for a permit shall be made by the owner or
lessee of the building or structure, or agent of either, or by the registered design professional employed in
connection with the proposed work.
I certify that the code administrator or the code administrator's authorized representative shall have the
authority to enter areas covered by such permit at any reasonable hour to enforce the provisions of the
code(s) applicable to such permit.
I certify that I am aware of the municipality’s inspection requirements and have received a copy of the
required inspections. Furthermore, I am aware that all inspections must be completed before a certificate
of occupancy will be issued. I may not occupy the structure, for any purpose, prior to the issuance of a
certificate. The installation of finishing materials or pouring of concrete slabs prior to the completion of
required rough inspections will result in the need to remove any material to gain access to allow the
inspection. Neither the jurisdiction nor the building official is liable for expenses entailed in the removal
or replacement of any material required to allow inspection.
I certify that I am aware that a copy of the approved plans must remain at the construction site at all times
until the project is complete and a certificate of occupancy has been issued. Additionally, I am aware that
a copy of the building permit shall be kept on the site of the work until the completion of the project.
________________________________________ ________________________________________
Signature of Owner or Authorized Agent Print Name of Owner or Authorized Agent
__________________________________________________________ _________________________
Address Date:
I would like to receive my permit electronically (residential permits only)
Email Address: __________________________________________________________________
Required Project Documents:
The following must be submitted to be considered a complete application:
A plot plan must accompany the application indicating location of new construction and
measurements to all lots lines.
A Certificate of Insurance showing proof of General Liability Insurance for work performed by a
contractor.
An Affidavit of Exemption or Proof of Workers Compensation Insurance.
Payment of the required Application Fee.
Construction Documents: non-residential projects must have construction documents prepared,
signed, and sealed by an Architect or Engineer. Construction documents shall not exceed 24”x36” in
size. Three (3) copies of the construction documents must be submitted for non-residential projects.
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