Application for a Permit to Construct or Demolish
This form is authorized under subsection 8(1.1) of the Building Code Act.
For use by Principal Authority
Application number: Permit number (if different):
Date received: Roll number:
Application submitted to:
(Name of Municipality, Upper-Tier Municipality, Board of Health or Conservation Authority)
A. Project information
Building number, street name Unit number Lot/con.
Municipality Postal code Plan number/other description
Project value est. $ Area of work (m
2
)
B. Purpose of application
New Construction Addition to an
ex
isting building
Alteration/repair Demolition Conditional
Permit
Proposed use of building Current use of building
Description of proposed work
C. Applicant Applicant is:
Owner or Authorized agent of owner
Last name First name Corporation or partnership
Street address Unit number Lot/con.
Municipality Postal code Province E-mail
Telephone number
( )
Fax
( )
Cell number
( )
D. Owner (if different from applicant)
Last name First name Corporation or partnership
Street address Unit number Lot/con.
Municipality Postal code Province E-mail
Telephone number
( )
Fax
( )
Cell number
( )
E. Builder (optional)
Last name First name Corporation or partnership (if applicable)
Street address Unit number Lot/con.
Municipality Postal code Province E-mail
Telephone number
( )
Fax
( )
Cell number
( )
F. Tarion Warranty Corporation (Ontario New Home Warranty Program)
i. Is proposed construction for a new home as defined in the Ontario New Home Warranties
Plan Act? If no,
go to section G.
Yes No
ii. Is registration required under the Ontario New Home Warranties Plan Act?
Yes No
iii. If yes to (ii) provide registration number(s): ____________________________________
G. Attachments
i. Attach Schedule 1 for each individual who reviews and takes responsibility for design activities.
ii. Attach Schedule 2 where application is to construct on-site, install or repair a sewage system.
H. Completeness and compliance with applicable law
i. This application meets all the requirements of clauses 1.3.1.3(5)(a) to (d) of Division C of the
Building Code (th
e application is made in the correct form and by the owner or auth
orized agent,
all applicable fie
lds have been completed on the application and all required schedul
es are
submitted). Pa
yment has been made of all fees that are required, under the applicable by-law
,
resolution or reg
ulation made under clause 7(1)(c) of the Building Code Act, 1992, to be paid w
hen
the application is made.
Yes No
ii. This application is accompanied by the plans and specifications prescribed by the applicable by-
law, resolution or regulation made under clause 7(1)(b) of the Building Code Act, 1992.
Yes No
iii. This application is accompanied by the information and documents prescribed by the applicable
b
y-law, resolution or regulation made under clause 7(1)(b) of the Building Code Act, 1992 w
hich
enable the chief building official to
determine whether the proposed
building, construction or
demolition w
ill contravene any applicable law.
Yes No
iv. The proposed building, construction or demolition will not contravene any applicable law.
Yes No
I. Declaration of applicant
I __________________________________________________________________________________________certify that:
(print name)
1. The information contained in this application, attached schedules, attached plans and specifications, and other attached
documentatio
n is true to the best of my know
ledge.
2. I have authority to bind the corporation or partnership (if applicable).
___________________________ _________________________________________________________________
Date Signature of applicant
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.
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