___ Building ___ Sprinkler System ___ Repairs ___ Foundation to Grade
___ Mechanical ___ Fire Alarm ___ New Construction ___ White Box only
___ Electrical ___ Gas Piping ___ Alteration (Certificate of Completion)
___ Plumbing ___ Commercial Roof/Re-Roof ___ Building Addition ___ Use Group
___ Change of Occupancy ___ Construction Type
___ Mechanicals Only Construction Value
__________ __________________
Contract Cost
__________________
PROJECT/BUILDING LOCATION: (OBC 107.2.2)
Name: ______________________________________ Street Address: ________________________________
City: ______________________________________ Zip Code: _________ County: ______________
_____ Has flood plain administrator been contacted for requirements? _____
_
__
__
BRIEF DESCRIPTION OF SCOPE OF WORK: (OBC 107.2.1)_____________________________________________________
_________________________________________________________________________________________________________
__________________________________________________________________________________________________________
_________________________________________________________________________________________________________
BUILDLING OWNER INFORMATION:
Owner Name: _________________________________ Street Address: ________________________________
City: _______________________________________ State: ____________ Zip Code: _____________
Phone No: ___________________ Fax: ____________ Email Address: ________________________________
CONTRACTOR INFORAMTION:
Owner Name: _________________________________ Street Address: ________________________________
City: _______________________________________ State: ____ Zip Code: ______ Registration No.________
Phone No: ___________________ Fax: ____________ Email Address: ________________________________
DESIGN PROFESSIONAL: ___ Architect ___ Engineer ___ Certificed Fire Protection Designer (OBC 107.4.4)
Registration / Certificate / License Number: _____________
Designer:____________________________________ Street Address: ________________________________
City: _______________________________________ State: ____________ Zip Code: _____________
Phone No: ___________________ Fax: ____________ Email Address: ________________________________
Aisle Width (ft) Storage Height Occupant Load No. of Stories Building Height (ft)
Non-Separated Construction typeSeparated Yes No Mixed use group
General Building Information (the following information applies to the entire building, not just the construction area)(OBC 107.2.3)
Use Group(s)
Occupancy Description:
BUILDING CODE INFORMATION (OBC 106)
(Information applies to construction area in a mixed use groups building, or the entire building if a single use group) Current Use
Group(s) ___________________ ____________________________________
______ ___ ___ ___ ___ _________________
______ _____ ______ _____ _____
FIRE PROTECTION SYSTEMS (Enter the type of system such as NFPA 13, NFPA 72, etc., if known.
Building Sprinkler System: ___________________ Sprinkler demand @ base of riser (PSI) ______________________
Type 1 Hood Suppression: _____ In Rack Sprinker System: _____ Limited Area Sprinker System: _____
Building Fire Alarm System: _____ Fire Detection System: _____ Smoke Detection System: _____
Office Use Only
Date Received: _________ Iworqs No. ______
Check No. ________ Cash _____ Credit Card _____
Processed By: ______________________________
Walk in_________ Mail in _________
Is Project in flood plain?
Authorized Agent
All information contained in this application is true, accurate, and complete to the best of
my knowledge. All official correspondence in connection with this application should be
sent to my attention at the address shown above.
Signature: ________________________________ Date: _________
Owner
Certification: (OBC 107.2.5)
I certify that I am the ____ ____
SCOPE OF PROJECT: (obc 107.2.1)
Total Square Footage of Project
City of Springfield, Ohio
76 E. High Street * Springfield, Ohio 45502 * Phone (937) 324-7389 * Fax (937) 328-3558
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING REGULATIONS DIVISION
SUBMIT ELECTRONIC PLANS TO: plans@springfieldohio.gov
PLAN APPROVAL APPLICATION FOR NON-RESIDENTIAL
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