Application submitted to (specify name of municipality, upper-tier municipality, board of health or conservation authority):

A. Project Information

Street Name:

Unit Number:

Lot/Con.:

Municipality:

Postal Code:

Plan Number:

Project Value Est. $:

Area of Work (m²):

B. Purpose of Application

Purpose of Application:
New ConstructionAddition to an Existing BuildingAlteration/RepairDemolitionConditional Permit

Proposed Use of Building:

Current Use of Building:

Description of Proposed Work:

C. Applicant Information

Applicant is:
OwnerAuthorized Agent of Owner

Last Name:

First Name:

Corporation or Partnership:CorporationPartnership

Street Name:

Unit Number:

Lot/Con.:

Municipality:

Postal Code:

Province:

Email:

Phone:

Fax:

Cell:

D. Owner Information (if different from applicant)

Last Name:

First Name:

Corporation or Partnership: CorporationPartnership

Street Name:

Unit Number:

Lot/Con.:

Municipality:

Postal Code:

Province:

Email:

Phone:

Fax:

Cell:

E. Builder Information (Optional)

Last Name:

First Name:

Corporation or Partnership: CorporationPartnership

Street Name:

Unit Number:

Lot/Con.:

Municipality:

Postal Code:

Province:

Email:

Phone:

Fax:

Cell:

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.:YesNo

ii. Is registration required under the Ontario New Home Warranties Plan Act?:YesNo

iii. If yes to (ii) provide registration number(s):

G. Required Schedules

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 (the application is made in the correct form and by the owner or authorized agent, all applicable fields have been completed on the application and required schedules, and all required schedules are submitted).
Payment has been made of all fees that are required, under the applicable by-law, resolution or regulation made under clause 7(1)(c) of the Building Code Act, I992, to be paid when the application is made.:YesNo

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.:YesNo

iii. This application is accompanied by the information and documents prescribed by the applicable by-law, resolution or regulation made under clause 7(1)(b) of the Building Code Act, 1992 which enable the chief building official to determine whether the proposed building, construction or demolition will contravene any applicable law.:YesNo

iv. The proposed building, construction or demolition will not contravene any applicable law. The proposed building, construction or demolition will not contravene any applicable law.:YesNo

I. Declaration of Applicant

I, (first, last name) , declare that:

1. The information contained in this application, attached schedules, attached plans and specifications, and other attached documentation is true to the best of my knowledge.

2. If the owner is a corporation or partnership, I have the authority to bind the corporation or partnership.

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.