APP
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JOB
PRO
A
P
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CO
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A
C
DES
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COS
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L
ICATION
D
SITE ADDR
E
PERTY OW
N
A
DDRESS(if di
f
P
HONE #:____
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E
MAIL:_____
N
TRACTOR
:
_
A
DDRESS:___
_
C
ONTACT PE
R
[
ELECTRI
C
[ ] New Con
s
[ ] Temp. Po
l
[ ] Temp. Se
r
[ ] Remodel/
R
[ ] Pool/Hot
T
[ ] Pool Bon
d
[ ] Sign Wiri
n
[ ] Multi-Un
i
FIRE
[ ] Alarm
[ ] Sprinkler
[ ] Undergro
u
[ ] Hood Su
p
C
RIBE THE
W
_
__________
_
_
__________
_
T
OF IMPR
O
PE
R
D
ATE
:_______
_
E
SS
:________
_
N
ER/TENAN
T
f
ferent from job
_
___________
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____________
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____________
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____________
_
R
SON:______
_
PL
E
[
] COMME
R
C
AL
s
truction
l
e
r
vice
R
ewire/Upgra
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T
ub Wiring
d
ing (Ingroun
d
n
g
i
t Structure
System
u
nd Fireline
p
pression
W
ORK THA
T
_
_________
_
_
_________
_
O
VEMENTS:
_
PLEASE
R
MIT A
P
Building
535
0
Fairf
i
PH
(
FAX
_
___________
_
_
____________
_
T
OR NAME
site address):_
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____________
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____________
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_______
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__________
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_
_
E
ASE C
H
R
CIAL
HVA
C
[ ] Heat
[ ] Coo
l
[ ] Heat
d
e [ ] Hoo
d
[ ] Mis
c
d
) [ ] Mul
t
[ ]
GA
S
SIGN
S
[ ] Per
m
[ ] Pro
m
[ ] Gra
n
[ ]
TE
N
T
IS TO BE
D
_
__________
_
_
__________
_
____________
SEE RE
V
P
PLICAT
I
& Zoning
D
0
Pleasant
A
i
eld, OH 4
5
(
513) 867-
5
(513) 867-
__
_
____________
_
OF BUSINE
S
_
____________
_
_
_ CONTACT
P
_
_________
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___________
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____________
_
_
____________
_
H
ECK TH
E
C
i
ng Only
l
ing Only
i
ng & Coolin
g
d
c
. Equipmen
t
t
i-Unit Structu
r
S
PIPING
S
m
anen
t
m
otional
n
d Opening
N
T
D
ONE:
______
_
_________
_
_
_________
_
_____________
V
ERSE S
I
I
ON SHE
E
D
ivision
A
ve
5
014
5
318
5310
_
___________
_
S
S
:__________
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_
____________
_
P
ERSON:____
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____________
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____________
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___________
__
E
APPR
O
[ ] RE
S
[
[
g
[
r
e
[
[
[
[
[
_____________
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_________
_
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_________
_
_______
SQ.
F
I
DE FOR
E
T
PE
R
CO
S
ZO
N
US
E
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____________
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___________
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___________
_
_
___________
_
_
____________
_
__
______ PHO
N
_
_
_
EMAIL:___
_
O
PRIATE
S
IDENTIAL
[
]
FENCE
_
_
_
[
]
SHED
__
_
[
]
DECK
[
]
POOL
[
]
ROOF
__
_
[
]
CHANG
E
[
]
DEMOLI
T
[
]
OTHER (
P
____________
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__________
_
_
__________
_
F
OOTAGE
___
MORE I
N
OFFI
C
R
MIT#_____
_
S
T:_______
_
N
ING:_____
_
E
GROUP:_
_
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____________
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____________
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______
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____
_
NE #:_______
_
_
___________
_
BOX(ES
)
(1, 2 OR 3
F
_
________HE
I
_
_______
SQ.
_
_______
#
O
E
OF OCCU
P
T
ION
Please expla
i
_____________
_
_________
_
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_________
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_____________
N
FORM
A
C
E USE O
N
_
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_________
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____________
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____________
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____________
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____________
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_
____________
_
)
:
F
AMILY)
I
GHT
FOOTAGE
O
F LAYERS
P
ANCY
i
n below)
____________
_
_________
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_________
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____________
A
TION
N
LY
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buildingandzoning@fairfieldoh.gov
FOR PROMOTIONAL SIGNS AND TENTS, PLEASE LIST STARTING AND ENDING DATES:
_________________THRU__________________ ________________THRU _______________
_________________THRU__________________ ________________THRU________________
_________________THRU__________________ ________________ THRU_______________
SQ. FOOTAGE OF SIGN/BANNER:___________________
FOR ELECTRICAL PERMITS, PLEASE PROVIDE THE FOLLOWING INFORMATION:
Voltage:_______________ Phase:__________________ # of Main Disconnects:_________________
Amps:________________ # of Meters:______________ Service Conductors:___________________
Sets of Conductors:__________________ Approved by:_____________________________________
FOR HVAC PERMITS, PLEASE PROVIDE THE FOLLOWING INFORMATION:
BTU/H Output:______________________ Heat Loss/Gain:__________________________
Type of Fuel:________________________ Approved by:____________________________
FOR GAS PIPING PERMITS, PLEASE PROVIDE THE FOLLOWING INFORMATION:
Number of Outlets:___________ Number of Meters:____________ Pipe Material:___________________
Approved by:________________________________
FOR COMMERCIAL BUILDING PERMITS, PLEASE PROVIDE THE FOLLOWING:
Type of Construction:_____________________ Occupancy Load (OBBC Sect. 1008)__________________
Sprinkler System Provided:_________________ Total Floor Area:__________________________________
Architect/Engineer Responsible for Plans:______________________________________________________
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