Fillable RESIDENTIAL BUILDING PLAN APPROVAL APPLICATION (Clark County Board of Commission)

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RESIDENTIAL BUILDING PLAN APPROVAL APPLICATION (Clark County Board of Commission)

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BROWSE CLARK COUNTY BOARD OF COMMISSION (OH) FORMS

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G:\BUILDING REGS\Forms - Masters\Applications\Updated Forms 11/6/19
RESIDENTIAL BUILDING PLAN APPROVAL APPLICATION
PLEASE PRINT OR TYPE APPLICATION NUMBER_______________________
PLEASE SEE SUBMITTAL REQUIREMENTS PART B
1. PROJECT INFORMATION:
Street Address_______________________________________________
City/State/Zip________________________________________________
Parcel No.__________________________________________________
Jurisdiction (City, Village, or Township project is in)__________________
Project Description:___________________________________________
___________________________________________________________
Cost of Project $______________________________________________
Living Area (habitable space) (Sq. Ft.)_____________________________
Non Living (garage, porch, decks) (Sq. Ft)__________________________
#of Bedrooms (new dwelling only)______ Fireplace
Yes
No
Crawl Space
Basement
Slab
Public Sewer
Public Water
Private Septic
Well
Unheated Space
Heated Space
FEMA Flood Area?
Yes
No
Method of Demonstrating Energy Code Compliance
(Please check the method being used)
2018 IECC
Prescriptive IECC /RCO Table 1102.1 (OHBA)
Trade-off Software/ RESCheck
Performance Analysis Software
4. APPLICANT/PERSON RESPONSIBLE:
Company Name________________________________________________
Contact Person________________________________________________
Address______________________________________________________
City, State, Zip Code____________________________________________
Phone__________________________Cell__________________________
E-Mail_______________________________________________________
I hereby certify that I am the Owner of Record or that the proposed work is
authorized by the Owner of Record, that I have been authorized by the
Owner to make this application as his Agent, and that we agree to conform
to ALL laws of the County and the State, and that all information on this
application is truthful to the best of my knowledge. I also understand that
UPFRONT FEES ARE NON-REFUNDABLE AND NON-TRANSFERABLE
Applicant Signature_____________________________________
Date_______________________________
2. PROPERTY OWNER
Name_______________________________________________________
Address_____________________________________________________
City, State, Zip Code___________________________________________
Phone_______________________Cell____________________________
3. CONTRACTOR
Company Name______________________________________________
Name______________________________________________________
Address____________________________________________________
City, State, Zip Code__________________________________________
Phone_______________________ Fax__________________________
Cell _________________________________
E-Mail____________________________________________________
OFFICE USE ONLY
Intake Person____________________ Date__________________
Upfront Fee Paid $_____________________
Plan Reviewed by__________________Date__________________
Plan Review Comments___________________________________
Plans Approved by________________Date____________________
Balance Due $________________________
Notified Permit Ready__________________ Date_______________
Date Picked Up_______________________
G:\BUILDING REGS\Forms - Masters\Applications\Updated Forms 11/6/19
INSTRUCTION AND GENERAL NOTES PART B
1. Numbers 1 – 4 must be filled out completely. This application will not be accepted without all necessary information as indicated.
2. Zoning Certificate/Approval if applicable.
3. Two sets of the specifications and plans shall be submitted.
4. Construction plans must contain the minimum information per RCO 106.
5. Contact the Clark County Auditor/Real Estate Office to obtain their requirements.
6. Contact the Clark County Combined Health District to obtain their requirements.
7. Filing of an application for plan approval does not constitute permission to proceed with work
8. The approval of documents is invalid if construction, erection, alteration, or other work has not commenced within twelve months. RCO
105.3
9. Once the application is approved the staff will call the applicant indicating approval and balance of permit cost. It is the applicant’s
responsibility to check periodically on the status of this application.
10. The Community and Economic Development Office shall be notified of inspection not less than twenty-four (24) hours in advance.
Residential Plan Approval Upfront Application fees*
Non Living (garage, porch, decks, etc.). . . . . . . . . $70.70
Living Area (habitable space) . . . . . . . . . . . . . . . .$101.00
*Balance will be due once the application has been approved.
NOTE: FAILURE TO SUBMIT PLANS THAT CONFORM TO THE ABOVE WILL RESULT IN ADJUDICATION OF THE PLANS AND
APPLICATION. A PLAN APPROVAL WILL NOT BE ISSUED UNTIL PLANS ARE IN COMPLIANCE TO THE ABOVE.
Contact Information:
Clark County Community & Economic Development
Springview Government Center
3130 E. Main St., Suite 1A
Springfield, OH 45505 General E-mail: communitydevelopment@clarkcountyohio.gov
937-521-2160
937-328-2621 fax Website: www.clarkcountyohio.gov/communitydevelopment
Office Hours:
Monday through Friday
Office opens at 7:30 am
Front Counter closes at 4:00 pm
Office closed at 4:30 pm
Clark County Combined Health District Clark County Utilities Department Clark County Auditor
Plumbing and Site Approvals Water/Sewer Real Estate Office
529 E. Home Road 3130 E. Main Street 31 N. Limestone Street
Springfield, OH 45503 Springfield, OH 45505 Springfield, OH 45501
937-390-5600 937-521-2150 937-521-1891
health@cchd.com utilities@clarkcountyohio.gov
auditor@clarkcountyohio.gov
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RESIDENTIAL BUILDING PLAN APPROVAL APPLICATION (Clark County Board of Commission)

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Completed 17 July 2020

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