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CHARTER TOWNSHIP OF WATERFORD BUILDING DEPARTMENT (Charter Township of Waterford)

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CHARTER TOWNSHIP OF WATERFORD BUILDING DEPARTMENT
5200 Civic Center Drive, Waterford, Michigan 48329-3773
Telephone: (248) 674-6238 Fax: (248) 674-4097
www.waterfordmi.gov
APPLICATION FOR PLAN EXAMINATION AND BUILDING PERMIT
APPLICATION DATE
IS OWNER APPLICANT?
YES NO
1. PROPERTY INFORMATION
STREET ADDRESS OF PROJECT
PARCEL I.D. NUMBER
ZONING
2. PROPERTY OWNER INFORMATION
LAST NAME OR BUSINESS NAME
FIRST NAME
PHONE NUMBER
STREET ADDRESS
CITY
STATE
ZIP CODE
3. BUILDING AND PROPERTY CHARACTERISTICS
A. STRUCTURES
B. BUILDING UNITS
C. BOARD OF APPEALS
D. ZBA HEARING DATE
E. RESIDENTIAL
SINGLE FAMILY
MULTIPLE FAMILY
STORAGE/ACCESSORY
GARAGE
MISC., SPECIFY:
__________________________________
F. NONRESIDENTIAL
CONSTRUCTION
TYPE
USE GROUP
I-A A-1 H-1 M
II-A A-2 H-2 S-1
III-A A-3 H-3 S-2
IV A-4 H-4 U
V-A A-5 H-f
I-B B I-1
II-B E I-2
III-B F-1 I-3
V-B F-2 I-4
G. TYPE OF IMPROVEMENT
NEW CONSTRUCTION
ALTERATION
ADDITION
MOVE STRUCTURE
DEMOLITION
REPAIR
SWIMMING POOL
GARAGE
ACCESSORY STRUCTURE
H. DESCRIBE IN DETAIL WORK TO BE DONE
I. COST OF IMPROVEMENT
____________________________
4. SELECTED CHARACTERISTICS OF BUILDING
PROPERTY FRONTAGE
(FEET)
EXISTING RESIDENTIAL UNITS
(NUMBER)
SIZE OF ADD. OR
STRUCTURE
REAR FRONTAGE (FEET)
STORIES (NUMBER)
BUILDING AREA (SQ FT)
FRONT SETBACK FROM
PROP. LINE
BEDROOMS (NUMBER))
LIVING AREA (SQ FT)
REAR SETBACK FROM PROP.
LINE
FULL BATHS (NUMBER)
BASEMENT AREA (SQ FT)
RIGHT SETBACK FROM
PROP. LINE
PARTIAL BATHS (NUMBER)
GARAGE AREA (SQ FT)
LEFT SETBACK FROM PROP.
LINE
GARAGES (NUMBER)
OFFICE/SALES (SQ FT)
HEIGHT ABOVE GRADE
(FEET)
FIREPLACES (NUMBER)
SERVICE (SQ FT)
NEW RESIDENTIAL UNITS
(NUMBER)
LOT AREA (SQ FT)
MANUFACTURING (SQ FT)
BOND NUMBER (FOR OFFICE USE ONLY)
PERMIT NUMBER (FOR OFFICE USE ONLY)
BB20-
PB20-
For office use onl
y
USE
GROUP: __________
CONSTRUCTION TYPE:
__________
5. IDENTIFICATION (TO BE COMPLETED BY APPLICANT)
Owner or Lessee
Contractor
Architect/Engineer
Company Name
Contact Name
License Number
--------------------------------
Street Address
City/State/Zip
Phone
Email
Fax
Federal Employer ID Number
Workers Comp. Insurance Carrier
MESC Number
CONSTRUCTION BOND RETURN AND FORFEITURE POLICY
RETURN: Upon satisfactory completion of all final inspections required, and the issuance of a Certificate of Occupancy, if
applicable, the construction bond will be returned without interest.
FORFEIT
URE: By the execution hereof, the applicant agrees that in the event the depositor of the fee(s) does not
properly complete the inspection requirements within 90 days following the expiration date of the permit(s), the deposit
fee(s) deposited hereunder shall be automatically forfeited to the Township. The Building Department shall provide notice
by First Class Mail of the forfeiture policy as adopted by the Township Board.
I hereby cer
tify that the proposed work is authorized by the owner of record and that I have been authorized by the owner
to make this application as his/her authorized agent; and we agree to conform to all applicable laws of this jurisdiction.
Prior to signing this application, please read the above Construction Bond Return and Forfeiture Policy. The signing of the
application indicates that you are aware of the forfeiture Policy adopted by the Township Board. The applicant signing this
application is aware that (s)he assumes full responsibility for insuring that all work done complies with all applicable codes
and ordinances.
Cancellations and Refunds
Application and Plan Review Fees are non-refundable.
Building Permit Fees may be partially refunded to the Permit holder in accordance with the following:
* Permit cancelled within 3 months of issue with no work or inspections performed 80%
* Permit cancelled within 6 months of issue with no work or inspections performed 50%
* Permit cancelled within 1 year of issue with no work or inspections performed 25%
* Permit cancelled after 1 year of issue with no work or inspections performed 0%
* Permit cancelled after work has commenced or inspections performed 0%
Section 23a of the state construction code act of 1972 , 1972 PA 230, MCL 125.1523a, prohibits a person from
conspiring to circumvent the licensing requirements of this state relating to persons who are to perform work
on a residential building or a residential structure. Violators of section 23a are subjected to civil fines.
Plac
ing a check in the box serves two purposes:
(1) The person filing this application is the actual applicant.
(2) The person filing this application understands and agrees to the above provisions.
Applicants Name
Phone
Address, City, State, Zip
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CHARTER TOWNSHIP OF WATERFORD BUILDING DEPARTMENT (Charter Township of Waterford)

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Completed 17 July 2020

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