BOROUGH OF SWARTHMORE APPLICATION FOR BUILDING PERMIT 121 Park Ave, Swarthmore, PA (p) / (f)
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1 BOROUGH OF SWARTHMORE APPLICATION FOR BUILDING PERMIT 121 Park Ave, Swarthmore, PA (p) / (f) Swarthmore2@comcast.net PERMIT # SECTION 1. PROPERTY AND OWNERSHIP INFORMATION Owner: Address: Telephone: (home) (work) Property Location (if different from above): Ownership (Please circle one): Private (Individual, Corporation, Nonprofit, etc.) / Public (Federal, State, or Local Government) SECTION 2. DESCRIPTION OF PROPOSED IMPROVEMENT Type of Improvement Principal Type Proposed Use For Demolition most recent use Of Frame 1. New Building Masonry Residential Non-Residential 2. Addition One Family Church, other Religious Sect 3. Alteration Wood Two or More Family Service Station, Repair Garage 4. Repair, Replacement # of units Office, Bank, Professional 5. Demolition Structural Hotel, motel dormitory School, Library, other Educational 6. Foundation Only Steel # of units Mercantile, Stores 7. Fence Garage Public Utility 8. Shed, Garage Reinforced Carport Hospital, Institutional 9. Interior Alteration Concrete Tanks, Towers 10. Roofing Other 11. Solar Panels Other 12. Driveway/Sidewalk International Energy Code 13. Other Compliance ResCheck ComCheck If New Construction (New building, addition or shed/garage) General description: Proposed use: Area (sq.ft.) to be disturbed: Number of trees to be removed, if any: The following must be sealed and submitted in duplicate with the application: Site plan to scale showing the size and location of existing and proposed structures and other impervious surfaces on the site, distances from lot lines, established and proposed finished grades, and major topographic features including slopes in excess of 15%, areas of significant vegetation, permanent or intermittent streams, floodplains, and wetlands. Building construction plans sealed by a registered architect or engineer in sufficient detail to determine compliance with applicable Borough codes. *Note: Any new, additional or replacement of impervious cover over 499 sq.ft. requires a stormwater management plan application in addition to the building permit.
2 Alteration, Repair/Replacement, *Demolition or Foundation Only General description: Former use: Proposed Use: Area (sq.ft.) to be disturbed: Number of trees to be removed, if any: The following must be submitted in duplicate with the application: Building construction plans in sufficient detail to determine compliance with applicable Borough codes. For Demolition/Foundation: You must notify PA One Call before digging (811). * Homeowners are advised to record via photographs and plans, if available, the exact location and size of any building to be demolished. Roofing General description: Application is for: Roof Repair New Roof/Total Reroof Existing roof/siding material New roof/siding material Number of roofing layers when permitted work is complete Driveway/Sidewalk/Curbing General description: Application is for: To Construct To Replace Area (sq.ft.) to be disturbed: Number of trees to be removed, if any: The following must be submitted with the application: Site plan to scale showing the size and location of existing and proposed impervious surfaces on the site, distances from lot lines, established and proposed finished grades, and major topographic features including permanent and intermittent streams, floodplains and wetlands. Construction documents in sufficient detail to determine compliance with applicable Borough codes. *Note: Any new, additional or replacement of impervious cover over 499 sq.ft requires a stormwater management plan application in addition to the building permit. Solar Panels / Other (** See additional paperwork) General description:
3 Fence General description: Application is for: To Construct To Replace Height of fence: Fencing Material: The following must be submitted with the application: Site plan to scale showing the location of the fence, verification of placement of finished side, and all proposed gates and openings. Certified survey OR photographic proof of boundary marker installed by a surveyor OR photographic proof of boundary markers approved in writing by any neighbor whose property adjoins the proposed fence. Copy of written notice of intention to install a fence sent to adjoining property owners. SECTION 3. ARCHITECT AND CONTRACTOR INFORMATION Architect Name: Architect Address: Telephone /Cell Number(s): / Fax Number: / Contractor Name: Contractor Address: Telephone /Cell Number (s): / Fax Number: / SECTION 4. PERMIT INFORMATION Date of application: Contractor s Insurance Company: Contractor s PA License Number: Cost of permitted work: Applicant s Signature (Application can be signed by architect, contractor, or property owner) **The right is reserved to revoke this permit if it appears that the information and/or signature/name have been obtained by fraud or misrepresentation, or if the Zoning Ordinance is violated.
4 ***FOR OFFICE USE ONLY*** Folio #: Page and Parcel #: Date Certificate of Insurance Received: Contractor s License #: Fee: Date Paid: Receipt #: Building Permit #: Fee: Date Paid: Receipt #: Zoning Officer Signature # Date Building Inspector Signature # Date Building Code Official Signature # Date Accessibility Inspector Signature # Date Fire Inspector Signature # Date Date Use and Occupancy Certificate mailed to Delaware County ZONING INFORMATION Zoning District Lot Size Existing Lot Coverage sq. ft. % Proposed Lot Coverage sq. ft. % Existing Front Yard Setback Proposed Front Yard Setback (New Construction) Existing Rear Yard Setback Proposed Rear Yard Setback (New Construction) Existing Side Yard Setbacks Proposed Side Yard Setbacks (New Construction) Existing Pervious Coverage sq. ft. % Proposed Pervious Coverage sq. ft. % Additional Zoning Information (including applicable variances, special exception and conditional use permits): Previous ZHB history? yes no Decision attached BUILDING INSPECTOR/ZONING INSPECTOR NOTES:
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