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Welcome to the Community City, OH, Action Line
Today is Friday, May 24, 2019.
Development Permit

Purpose. This form is used to communicate with city personnel to request services and request information.

* Information is required.

Contact Information

First Name:
Last Name:
Business Name:
Email:
Daytime Phone: (
Fax: (
Address:
City:
State:
ZIP:

PROJECT LOCATION
Business/Property Name
 
Lot Number
 
Ward
 
Parcel No.
 
Subdivision
 
Zoning District
 
Address
 

2
 
Improvement Type


3
 
Improvement Type


3
 
Check all improvement typles applicable to this project.






7
 
Start Date of Temporary Improvement
 
End Date of Temporary Improvement
 
For commercial projects indicated construction type





6
 
IMPROVEMENT IMPACT

Valuations

Existing Value of Building Improvements
 
Proposed Value of Building Improvements
 
Square Footages of Interior Spaces

Existing Unfinished/Mechanical Areas
 
Proposed Unfinished/Mechanical Areas
 
Existing Dwelling/Living/Lodging Areas
 
Proposed Dwelling/Living/Lodging Areas
 
Existing Classroom Areas
 
Proposed Classroom Areas
 
Existing Business/Office Areas
 
Proposed Business/Office Areas
 
Existing Warehouse/Storage Areas
 
Proposed Warehouse/Storage Areas
 
Existing Manufacturing/Processing Areas
 
Proposed Manufacturing/Processing Areas
 
Existing Sales Display Areas
 
Proposed Sales Display Areas
 
Existing Assembly/Repair Areas
 
Proposed Assembly/Repair Areas
 
General Information

Existing Number of Dwelling Units
 
Proposed Number of Dwelling Units
 
Existing Number of Sleeping/Guest Rooms
 
Proposed Number of Sleeping/Guest Rooms
 
Existing Number of Employees
 
Proposed Number of Employees
 
Valuations

Existing Value of Land Improvements
 
Proposed Value of Land Improvements
 
Square Footages of Exterior Spaces

Existing Building Footprint Areas
 
Proposed Building Footprint Areas
 
Existing Sales Display Areas
 
Proposed Sales Display Areas
 
Existing Storage Areas
 
Proposed Storage Areas
 
Existing Parking/Drive Areas
 
Proposed Parking/Drive Areas
 
Existing Loading/Unloading Areas
 
Proposed Loading/Unloading Areas
 
Existing Sidewalk/Patio/Deck/Porch Areas
 
Proposed Sidewalk/Patio/Deck/Porch Areas
 
Existing Natural Vegetation Areas
 
Proposed Natural Vegetation Areas
 
Existing Landscape/Yard Areas
 
Proposed Landscape/Yard Areas
 
Company Vehicles Stored On Site

Existing Number of Cars/Pickups
 
Proposed Number of Cars/Pickups
 
Existing Units of Heavy Equipment-Tractors
 
Proposed Units of Heavy Equipment-Tractors
 
Existing Units of Heavy Equipment-Trailers
 
Proposed Units of Heavy Equipment-Trailers
 
IMPROVEMENT SCOPE (Check boxes applicable to the improvements to be made with this project and fill in quantity information requested)

Building Improvements

Footer/Foundation




5
 
Frame





6
 
Exterior Finishes




5
 
If you selected other in the question about please specify.
 
Mechanical Improvements

Fireplace





6
 
Components
Furnace Quantity
 
Central A/C Condenser Quantity
 
Boiler Quantity
 
Air Handler Quantity
 
Duct Extension Quantity
 
Fuel Source





6
 
If you selected other in the question above please specify
 
Electrical Improvements

Service





6
 
Components
>200 Amp Panel Quantity
 
<200 Amp Panel Quantity
 
Sub Panel Quantity
 
110V Circuits Quantity
 
120V Circuits Quantity
 
Electric Heater Quantity
 
Pool (Above Ground) Quantity
 
Pool (In Ground) Quantity
 
Generator Quantity
 
Plumbing Improvements

Components

Water Heater Quantity
 
Water Closet Quantity
 
Urinals Quantity
 
Lavatory Quantity
 
Bath Tub Quantity
 
Shower Quantity
 
Sink Quantity
 
Mop Sink Quantity
 
Washing Machine Quantity
 
Dishwasher Quantity
 
Drinking Fountain Quantity
 
Sewage Injector Quantity
 
Grease Trap Quantity
 
Sump Pump Quantity
 
Back Flow Device Quantity
 
Floor Drain Quantity
 
Disposal Quantity
 
Connections to Public Utility Distribution Systems




5
 
IMPROVEMENT USES (First, check the box next to all existing use types currently found on the premises. Next check the box to all proposed use types that will exist upon completion of the proposed improvements.)

EXISTING

Residential










11
 
Institutional









10
 
Agriculture



4
 
Commercial Entertainment






7
 
Public Recreation



4
 
Retail Service Uses

















18
 
Road Service













14
 
Land


3
 
Business and Professional





6
 
Industrial












13
 
Transportation and Utilities






7
 
Accessory










11
 
IMPROVEMENT USES (First, check the box next to all existing use types currently found on the premises. Next check the box to all proposed use types that will exist upon completion of the proposed improvements.)

PROPOSED

Residential










11
 
Institutional









10
 
Agriculture



4
 
Commercial Entertainment






7
 
Public Recreation



4
 
Retail Service Uses

















18
 
Road Service













14
 
Land


3
 
Business and Professional





6
 
Industrial












13
 
Transportation and Utilities






7
 
Accessory










11
 
USE GROUP CLASSIFICATION (First, check the box next to all existing classifications currently found on the premises. Next check the box to all proposed classifications that will exist upon completion of the proposed improvements.)

EXISTING

Residential Use Classifications




5
 
Commercial Use Classifications










11
 
USE GROUP CLASSIFICATION (First, check the box next to all existing classifications currently found on the premises. Next check the box to all proposed classifications that will exist upon completion of the proposed improvements.)

PROPOSED

Residential Use Classifications




5
 
Commercial Use Classifications










11
 
Design/Construction Team (Fill in the design consultant and/or contractor information for all applicable elements/systems.)

Element/System

Buliding Design Professional
 
Building Design Professional Phone
 
Building Contractor
 
Building Contractor Phone
 
Structural Design Professional
 
Structural Design Professional Phone
 
Structural Contractor
 
Structural Contractor Phone
 
Electrical Design Professional
 
Electrical Design Professional Phone
 
Electrical Contractor
 
Electrical Contractor Phone
 
Mechanical Design Professional
 
Mechanical Design Professional Phone
 
Mechanical Contractor
 
Mechanical Contractor Phone
 
Fire Protection Design Professional
 
Fire Protection Design Professional Phone
 
Fire Protection Contractor
 
Fire Protection Contractor Phone
 
Fire Alarm Design Professional
 
Fire Alarm Design Professional Phone
 
Fire Alarm Contractor
 
Fire Alarm Contractor Phone
 
Plumbing Design Professional
 
Plumbing Design Professional Phone
 
Plumbing Contractor
 
Plumbing Contractor Phone
 
Signage Design Professional
 
Signage Design Professional Phone
 
Signage Contractor
 
Signage Contractor Phone
 
Excavation/Utilities Design Professional
 
Excavation/Utilities Design Professional Phone
 
Excavation/Utilities Design Contractor
 
Excavation/Utilities Design Contractor Phone
 
Landscaping Design Professional
 
Landscaping Design Professional Phone
 
Landscaping Contractor
 
Landscaping Contractor Phone
 
Masonry Design Professional
 
Masonry Design Professional Phone
 
Masonry Design Contractor
 
Masonry Design Contractor Phone
 
Asphalt Design Professional
 
Asphalt Design Professional Phone
 
Asphalt Design Contractor
 
Asphalt Design Contractor Phone
 
Concrete Design Professional
 
Concrete Design Professional Phone
 
Concrete Contractor
 
Concrete Contractor Phone
 

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Notes:

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