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    BLDG Permit App

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    myt9955
    The document is an application for a building permit from the City of Philadelphia Department of Licenses and Inspections. It requests information such as the applicant and property owner's contact information, description of the work being done, and estimated costs. It outlines prerequisite approvals needed from other agencies. The examiner section indicates whether the permit is approved and notes fees, construction type, and use of the building or space.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    BLDG Permit App

    Uploaded by

    myt9955
    23 views2 pages
    The document is an application for a building permit from the City of Philadelphia Department of Licenses and Inspections. It requests information such as the applicant and property owner's contact information, description of the work being done, and estimated costs. It outlines prerequisite approvals needed from other agencies. The examiner section indicates whether the permit is approved and notes fees, construction type, and use of the building or space.

    Original Description:

    Permit app PA

    Original Title

    Bldg Permit App

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    The document is an application for a building permit from the City of Philadelphia Department of Licenses and Inspections. It requests information such as the applicant and property owner's contact information, description of the work being done, and estimated costs. It outlines prerequisite approvals needed from other agencies. The examiner section indicates whether the permit is approved and notes fees, construction type, and use of the building or space.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    23 views2 pages

    BLDG Permit App

    Uploaded by

    myt9955
    The document is an application for a building permit from the City of Philadelphia Department of Licenses and Inspections. It requests information such as the applicant and property owner's contact information, description of the work being done, and estimated costs. It outlines prerequisite approvals needed from other agencies. The examiner section indicates whether the permit is approved and notes fees, construction type, and use of the building or space.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    CITY OF PHILADELPHIA

    APPLICATION FOR BUILDING PERMIT DEPARTMENT OF LICENSES AND INSPECTIONS


    MUNICIPAL SERVICES BUILDING – CONCOURSE
    APPLICATION # ____________________________________________ 1401 JOHN F. KENNEDY BOULEVARD
    PHILADELPHIA, PA 19102
    (Please complete all information below and print clearly) For more information visit us at www.phila.gov/li

    ADDRESS OF PROPOSED CONSTRUCTION:

    APPLICANT: APPLICANT’S ADDRESS:

    _________________________________________________________ _____________________________________________________________
    COMPANY NAME:
    _________________________________________________________ ______________________________________________________________

    PHONE # FAX # LICENSE # E-MAIL:


    PROPERTY OWNER’S NAME: PROPERTY OWNER’S ADDRESS:
    _______________________________________________ _________________________________________________

    PHONE # FAX #
    ARCHITECT/ENGINEER IN RESPONSIBLE CHARGE: ARCHITECT/ENGINEERING FIRM ADDRESS:
    ___________________________________________________________ ______________________________________________________________
    ARCHITECT/ENGINEERING FIRM :
    ______________________________________________________________
    ___________________________________________________________

    PHONE # FAX # LICENSE # E-MAIL:


    CONTRACTOR: CONTRACTING COMPANY ADDRESS:

    ___________________________________________________________ ______________________________________________________________
    CONTRACTING COMPANY:
    ______________________________________________________________
    ___________________________________________________________

    PHONE # FAX # LICENSE # E-MAIL:


    USE OF BUILDING/SPACE: ESTIMATED COST OF WORK

    $ ______________________
    BRIEF DESCRIPTION OF WORK:
    ____________________________________________________________________________________________________
    ____________________________________________________________________________________________________
    ____________________________________________________________________________________________________
    ____________________________________________________________________________________________________
    ____________________________________________________________________________________________________
    ____________________________________________________________________________________________________
    ____________________________________________________________________________________________________
    ____________________________________________________________________________________________
    ___________________________________________________________________________________________________
    TOTAL AREA UNDERGOING CONSTRUCTION: _______________________________square feet
    COMPLETE THESE ITEMS IF APPLICABLE TO THIS APPLICATION:

    # OF NEW SPRINKLER HEADS (suppression system permits only): _____________ LOCATION OF SPRINKLERS: _________________________
    # OF NEW REGISTERS/DIFFUSERS (hvac/ductwork permits only): ______________ LOCATION OF STANDPIPES: _________________________

    IS THIS APPLICATION IN RESPONSE TO A VIOLATION? ¨ NO ¨YES VIOLATION #: ________________________

    All provisions of the building code and other City ordinances will be complied with, whether specified herein or not. Plans approved by the Department form a part of this
    application. I hereby certify that the statements contained herein are true and correct to the best of my knowledge and belief. I further certify that I am authorized by the owner to
    make the foregoing application, and that, before I accept my permit for which this application is made, the owner shall be made aware of all conditions of the permit. I understand
    that if I knowingly make any false statement herein I am subject to such penalties as may be prescribed by law or ordinance.

    APPLICANT’S SIGNATURE: DATE: _______/_______/_______

    (81-3 Rev 5/04)


    PRE-REQUISITE APPROVALS FOR:

    ADDRESS: APPLICATION #:

    DIF REQ’D AGENCY INITIALS DATE REMARKS


    ART COMMISSION
    TH
    13 FLOOR – 1515 ARCH STREET
    CITY PLANNING COMMISSION
    TH
    13 FLOOR – 1515 ARCH STREET

    FAIRMOUNT PARK COMMISSION


    … CITY … STATE
    AIR MANAGEMENT / HEALTH DEPT
    HISTORICAL COMMISSION
    ROOM 576 – CITY HALL
    STREETS DEPARTMENT
    ROOM 940 – M.S.B.
    WATER DEPARTMENT
    ND
    2 FLOOR –1101MARKET STREET
    CONTRACTUAL SERVICES UNIT
    ROOM 1140 – M.S.B.

    ZONING

    EXAMINER’S APPROVAL (OFFICE USE ONLY)


    APPROVED USE OF BUILDING SPACE:

    ____________________________________________________________________________________________________

    ____________________________________________________________________________________________________

    ____________________________________________________________________________________________________

    PERMIT TO READ:
    ____________________________________________________________________________________________________
    ____________________________________________________________________________________________________
    ____________________________________________________________________________________________________
    ____________________________________________________________________________________________________

    CODE/EDITION USED FOR REVIEW:

    WAS VIOLATION FOR WORK WITHOUT A PERMIT? F NO F YES (INSPECTION FEE MUST BE ADDED TO PERMIT FEE)

    VIOLATION # ___________________________________________

    OTHER BUILDING PERMITS REQUIRED: … FIRE SUPPRESSION … HVAC/DUCT … FUEL GAS


    PLAN # CONSTRUCTED AREA FEE ITEM AMOUNT
    F NEW CONSTRUCTION
    BLDG. PERMIT/C.O./L.O.
    __________________SQ FT
    F ALTERATION INSPECTION FEE
    CONSTRUCTION CO REQUIRED NEW DWG UNITS: WATER METERS
    TYPE: __________________ … NO … YES CONSTRUCTION WATER
    VARIANCES PROJECT TYPE
    USE: ___________________
    … NO … YES
    TOTAL FEES
    This is to certify that I have examined the within detailed statement, together with a copy of the plans relating thereto, and find the same to be in accordance
    with the provisions of the law relating to buildings in the City of Philadelphia, that the same has been approved and entered into the records of this
    Department.
    EXAMINER: _____________________________________________________________ DATE APPROVED: __________________________________

    PERMIT # ______________________ DATE ISSUED: __________________ CHECK # ___________________

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