Fillable Form 248 Mechanical Application (City of Dayton)

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Form 248 Mechanical Application (City of Dayton)

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  • 34 check-boxes
  • 98 other fields

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File type: PDF

U.S.A. forms for City of Dayton

BROWSE CITY OF DAYTON (OH) FORMS

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371 W. SECOND STREET, 2
ND
FLOOR
DAYTON, OHIO 45402
CITY OF DAYTON
DIVISION OF BUILDING INSPECTION
ONE STOP CENTER (937) 333-3883/FAX (937) 333-4284
MECHANICAL APPLICATION PERMIT TYPE ELECTRICAL
HVAC
PLUMBING SEWER WATER
BUILDING INFORMATION BUILDING PERMIT #
Address of Work
Occupant
Owner
Owner Address State Zip Code
Contractor/Applicant
License #
Address City State
Federal ID #
Zip Code
PERMIT FEES ARE CALCULATED AUTOMATICALLY BY THE COMPUTER BASED ON THE COST OF SERVICE LISTED BELOW.
APPROVED DRAWINGS ARE REQUIRED FOR BACKFLOW PREVENTORS & IRRIGATIONS SERVICES.
PLUMBING
(937)333-3892
Backflow Preventor
Water Heater
Water Closet
Lavatory
Bathtub
Sink
Water Distribution
Auto. Clothes
Washer
Dishwasher
Softener
Garbage Disposal
Shower Stall
Sump Pump
Urinal
Floor Drain
Laundry Tray
Grease Trap
Drinking Fountain
JOB COST $
GAS PIPING
(937)333-3892
Furnace
Boiler
Water Heater
Unit Heater
Space Heater
Range Connection
Clothes Dryer
Fireplace
JOB COST $
ELECTRICAL
(937)333-3881
Service Size
Sub Panel
Transformers
JOB COST $
HVAC
(937)333-3980
Furnace A/C BOILER
MFG
SIZE
JOB COST $
WATER
(937) 333-3892
DOMESTIC
FIRE
COMBO
$
$
$
SEWER
(937) 333-3892
SANITARY STORM
City to Dig
On Premise
Under Walk
Stub-In
Service Size
Tap Size
$
JOB COST
$
CREDIT CARD INFO
ACCOUNT NUMBER
EXPIRATION DATE SECURITY CODE
/
Description of Work
TYPE OF BUILDING RESIDENTIAL Single Residence 2-Family 3-Family Garage Shed
COMMERCIAL
4-Family
5-Family or more
Rooming House/Group Home
Parking Lot
Hotel/Motel
Hospital/Nursing Home
Theater/Recreational Hall
Tent
Church
Office/Bank
Factory/Warehouse
Vacant Lot
Public Works
Auto Repair Garage
Parking Garage
School
Retail Sales
Gas Station
Advertising/Billboard
Restaurant
Other
I certify that the information contained in this form is complete and accurate; and the work will be done as described hereon in accordance with the
Unified Building Code and all other applicable laws and ordinances of the City of Dayton.
SIGNATURE DATE
BPIO - - LOT#
Revised 11/2018
# STORIES
DAYTON CITY LIMITS
Yes No
OTHER JURISDICTION
GAS
Zip Code
Phone #
City
Phone #
click to sign
signature
click to edit
11/2018
MECHANICAL PERMIT FEES
Mechanical permit fees (electrical, heating, plumbing, gas, sewer, an
d water) are based
on the system cost. These costs are defined as “The fair market value for labor and
material(s) to complete each service”.
ELECTRICAL, HEATING, PLUMBING & GAS PERMIT FEE CALCULATIONS:
For system costs of $4,500 or less, the permit fee shall be $60.00 + State of Ohio
surcharge (see note below).
For system costs greater than $4,500 but less than $100,000, the fee shall be $60.00
plus 1% of the cost in excess of $4,500 + State of Ohio surcharge (see note below).
For system costs $100,000 or more, the fee shall be $1015.00 plus 0.5% of the cost
in excess of $100,000 + State of Ohio surcharge (see note below).
NOTE: In addition to the above City of Dayton permit fees there is a State of Ohio
surcharge of 3% on commercial permits and 1% on residential permits. Multiply
the City of Dayton fee by .03 for commercial permits or by .01 for residential
permits.
Investigation Fee: An investigation fee of $25.00 minimum for 1, 2, & 3 family residences
and $50.00 minimum all other structures with a $500.00 maximum is charged when work is
performed without a permit. In addition, the regular permit fee will still be due.
Re-inspection Fee: A re-inspection fee of $50.00 shall be charged when additional
inspections or trips are made necessary by incomplete or faulty work, or because of an
incorrect address given, or failure of the owner or agent to keep an appointment, or similar
reasons. No fee shall be charged for one additional inspection. The re-inspection fee
shall be charged for each subsequent additional inspection performed on that project.
Non-sufficient Fund Penalty: A non-sufficient fund penalty of $25.00 will be charged
on all returned checks.
SEWER AND WATER PERMIT FEE CALCULATIONS:
For system costs of $2000 or less, the permit fee shall be $35.00 + State of Ohio
surcharge (see note below).
For system costs greater than $2000 but less than $100,000, the fee shall be $35.00
plus 1% of the cost in excess of $2000.
For system costs $100,000 or more, the fee shall be $1015.00 plus 0.5% of the cost in
excess of $100,000.
ADDITIONAL FEES:
NOTE: Water and sewer permits are not subject to the state surcharge fee.
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Form 248 Mechanical Application (City of Dayton)

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Completed 19 July 2020

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