CORPORATION OF THE CITY OF PEMBROKE BUILDING DEPARTMENT

Similar documents
The Corporation of the Township of Malahide

BUILDING DEPARTMEN T

BUILDING PERMIT GUIDELINES - RESIDENTIAL

TOWN OF AMHERSTBURG BUILDING DEPARTMENT 271 Sandwich Street S. Amherstburg ON N9V 2A5 Ph Fax

TOWNSHIP OF DRUMMOND/NORTH ELMSLEY. Deck/Porch Guide & Permit

Township Of Blandford-Blenheim Permit Guide

Trailer Park Decks and Add on Rooms

Sewage System Permit Instructions

DECKS INCLUDED: LIST OF REQUIREMENTS DECK DESIGN MATRIX APPLICATION FORM SAMPLE DRAWINGS

New Door and Window Openings - Building Permit Application Requirements

Two complete sets of plans that are legible and drawn to conventional scale are required to be submitted with the Building Permit Application Form.

Permit Application Checklist Pursuant to Section G of an application to Construct or Demolish

For use by Principal Authority. A. Project information Building number, street name Unit number Lot/con. Street address Unit number Lot/con.

Porch Enclosure - Building Permit Application Requirements

Zoning- check the zoning on the property you are planning to build on, this can be done at the municipal office.

SEWAGE SYSTEM PERMIT GUIDELINES

APPLICATION FOR BUILDING PERMIT CHECKLIST

Procedure for Uncovered Deck Dock, or Shoreline Storage Building:- Shed, Boathouse, Dryland Boathouse or Boatport

The Homeowner s Building Application Checklist for Constructing a Residential Addition

SEWAGE SYSTEM PERMIT APPLICATION INSTRUCTIONS FOR COMPLETION

Township of Georgian Bluffs

Procedure for an Application for an Garage, Gazebo, Sauna, Pump House, Shed

Application for a Sewage System Permit

REQUIRED SEPTIC DRAWINGS

ACCESS RISERS & EFFLUENT FILTER

Application for a Sewage System Permit

Infrastructure and Development Department Building Division

For use by Principal Authority. A. Project information Building number, street name Unit number Lot/con.

INCLUDED: LIST OF REQUIREMENTS

SEWAGE SYSTEM PERMIT APPLICATION INSTRUCTIONS FOR COMPLETION

Procedure to Obtain a Sewage System Building Permit

Septic Permit Application

Application for a Permit to Construct or Demolish This form is authorized under subsection 8(1.1) of the Building Code Act,1992

Woodstoves, Fireplaces, Chimneys & Outdoor Solid Fuel Combustion Appliances

Building Permit Requirements Production Residential Homes

Application for a Permit to Construct or Demolish This form is authorized under subsection 8(1.1) of the Building Code Act,1992

BUILDING DIVISION SEPTIC SYSTEM APPLICATION / INFORMATION PACKAGE. Septic System Info. 8 Schellburg Avenue 22 Albert Street, P.O.

Small Business Permit Service

BUILDING PERMIT APPLICATION GUIDE FOR HOMEOWNERS

The Homeowner s Building Application Checklist for Constructing a Residential Sundeck

Building Permit Requirements Septic System

Application for a Permit to Construct or Demolish This form is authorized under subsection 8(1.1) of the Building Code Act,1992

BUILDING PERMIT INFORMATION GUIDE FOR THE HOMEOWNER

Instructions to Building Permit Applicants

Application for a Permit to Construct or Demolish This form is authorized under subsection 8(1.1) of the Building Code Act,1992

Septic Permit Application

DEVELOPMENT REVIEW FORM: Demolish Construct Alter/Repair

BUILDING PERMIT APPLICATION GUIDE FOR INDUSTRIAL COMMERCIAL & INSTITUTIONAL PROJECTS

Application for a Permit to Construct or Demolish This form is authorized under subsection 8(1.1) of the Building Code Act,1992

Application for a Permit to Construct or Demolish This form is authorized under section 8(1.1) of the Building Code Act

Township of Otonabee-South Monaghan

Building number, street name Unit no. Postal code

THE CORPORATION OF THE TOWNSHIP OF HAMILTON HOME BUILDER S GUIDE PART I MUNICIPAL BUILDING REQUIREMENTS

ACCESSORY BUILDING. Building Permit Requirements: (must be completed before submitting application)

Procedures for an Application For Septic Permit

THE CORPORATION OF THE TOWNSHIP OF HAMILTON HOME BUILDER S GUIDE PART I MUNICIPAL BUILDING REQUIREMENTS

A homeowners/applicants guide to understanding and making application for a building permit.

Deck Design Guide. 67 Sharp Road, Brighton, Ontario P.O. Box 189 K0K 1H0 Tel: Fax: Web:

Application for a Permit to Construct or Demolish This form is authorized under subsection 8(1.1) of the Building Code Act.

Building Permit Requirements New Industrial, Commercial or Institutional Projects or High-Rise Residential Buildings

Town of Kingsville. Building Department

HOW TO OBTAIN A BUILDING PERMIT

District of Ucluelet Building Permit Guide

TOWN OF BRADFORD WEST GWILLIMBURY DECK PACKAGE

STANDARD RESIDENTIAL DECK DETAILS

Fees and Permit requirements are regulated by the Township s Building By-law

Building a Wood Deck, Gazebo, or Pergola

Application for a Permit to Construct or Demolish This form is authorized under subsection 8(1.1) of the Building Code Act.

CITY OF HAGERSTOWN PLANNING & CODE ADMINISTRATION DEPARTMENT. Submittal Requirements

BUILDING DEPARTMENT GUIDE TO RESIDENTIAL BUILDING PERMITS

DECK CONSTRUCTION REQUIREMENTS

RESIDENTIAL BUILDING PERMIT GUIDE FOR MULTI-FAMILY DWELLINGS

Town of Kingsville. Building Department

Application for a Permit to Construct or Demolish This form is authorized under subsection 8(1.1) of the Building Code Act.

HATFIELD TOWNSHIP DECK/PATIO PERMIT PROCEDURES

14240 W. 151 st Street, Homer Glen, IL Phone Fax Deck Building Guide

Municipality of Neebing

A guide to: ACCESSORY BUILDINGS. Brought to you by: City of Port Colborne - Building Division

MUNICIPALITY OF MIDDLESEX CENTRE BY-LAW NUMBER

Application for a Permit to Construct or Demolish - SEPTIC

COMMERCIAL OR RESIDENTIAL NEW BUILDINGS, REMODELS AND ADDITIONS

General Requirements Yes N/A 1. Is the designer qualified for the proposed work?

Building Permit Requirements Custom Built Homes

******************************************************************************

Township of Georgian Bluffs. Building Permit Information

MINIMUM PLAN INFORMATION REQUIRED FOR A BUILDING PERMIT

Plans created at home centers are acceptable for plan review. These computer designs do not allow homeowners to duplicate conditions at their home.

BUILDING PERMIT APPLICATION PACKAGE

DOCK CONSTRUCTION GUIDE

THE CORPORATION OF THE TOWNSHIP OF HAMILTON HOME BUILDER'S GUIDE PART I MUNICIPAL BUILDING REQUIREMENTS

DECK GUIDE PERMIT FEES

Scale Drawing This drawing will need to show the full lot and location of the proposed

TOWN OF ROTTERDAM RESIDENTIAL BUILDING PERMIT APPLICATION Ext. 395 Needed to Obtain Permit:

Zoning- check the zoning on the property you are planning to build on, this can be done at the municipal office.

Residential Deck Safety, Construction and Repair. Juneau Permit Center, 4 th Floor Marine View Center,(907) February 2016

DECK PLANS. BUILDING DEPARTMENT

City of St. Peters Residential Deck Guide

Residential Building Permits

Detached garages/ Sheds/ Gazebo s

PERMIT APPLICATION CHECKLIST Municipal Address, Phone & Fax NONRESIDENTIAL

Transcription:

CORPORATION OF THE CITY OF PEMBROKE BUILDING DEPARTMENT 1 PEMBROKE STREET EAST PEMBROKE ON K8A 3J5 PHONE 613-735-6821 x1304 FAX 613-735-3660 www.pembroke.ca DECK GUIDELINES All decks require a building permit. This includes decks under 108 ft 2 that are attached or floating and serve a building on the property. Decks serving pools also require a permit. Decks that do NOT require a permit are decks that are less than 24 above grade to walking surface, less than 108 ft 2 in size, do not have a roof, are not serving a structure on the lot (e.g. a free-standing 10 x 10 deck in a rear yard), and are greater than 4 ft. or 1.2 m from all other structures. 1. Decks cannot be attached to a house unless proper footings are in place to a depth of at least 4 and have a minimum footing size of 24 x 24 x 8 or incorporate a 24 Bigfoot and have a minimum of an 8 Sonotube. Footing depth can be reduced if on free-draining soils or rock (as defined by the Ontario Building Code (OBC)). All Sonotubes must have concrete extending minimum 6 above grade. Dek Blocks must be installed on patio stone or similar in order to maintain stability. Decks not attached to the house and less than 24 to the underside of the deck joists can be floating and installed on Dek Blocks on grade. Decks between 24 and 36 can also be installed in this manner but require minimum 6 x 6 posts and the following bracing: a) 2 x 4 bottom skirt bracing linking all bottoms of the posts above Dek Block attached with minimum 1-3/8 x 3 lag on each end; b) 2 x 4 cross bracing on the face and back of each post in a diagonal installation with minimum 2-3/8 carriage bolts at each connection point. Decks requiring different footings (floating vs. in-ground) may be attached to each other as long as the area is not high traffic during winter months and/or has frost-susceptible soil that could cause differential movement. The CBO will review each case separately and advise the owner if there are any issues. 2. Beams that are not sandwich style beams must have full bearings underneath (For example, a 2-2 x 10 lintel beam 3 wide must be on a minimum of a 4 x 4 post 3.5 wide, and a 3-2 x 8 lintel beam 4.5 wide must be on a minimum of a 6 x 6 post that is 5.5 wide.) Two-ply lintels can be installed on top of a 4 x 4 as a post (only if underside of joist does not exceed 24 from grade) but must be locked into place with 2 x 4 outside gusset braces in all situations with adequate nailing (minimum 2 rows of 4-3.5 spiral nails on each side). 3. 4 x 4 support posts for a beam will only be allowed on a deck that is no higher than 24 to the underside of the joists. Anything above that height requires minimum 6 x 6 beam posts. City of Pembroke Deck Guidelines Package February 2017

4. Sandwich beams/lintel beams (2 ply) (see example sheet) will be allowed based on the following span table: Span (achieved by adding ½ of the span of the joists on each side of a beam); cantilever joists on the other side of beam need to be considered 2 x 6 lintel beam or sandwich beam (clear span of beam between supports) 2 x 8 lintel beam or sandwich beam (clear span of beam between supports) 2 x 10 lintel beam or sandwich beam (clear span of beam between supports) 8 ft. 5 9 7 1 8 7 10 0 10 ft. 5 2 6 4 7 9 8 11 12 ft. 4 9 5 9 7 0 8 2 2 x 12 lintel beam or sandwich beam (clear span of beam between supports) 5. Decks that have walking surfaces over 2 ft. from grade will require 2 x 8 minimum floor joists to allow for conventional wood framed guards. If engineered top mount railing systems (approved with documentation) are installed, 2 x 6 joists will be considered in place of the 2 x 8 minimum joist size. Please note that all deck joist spans shall adhere to the minimum spans as per Table A-1-9.23.4.2 (1) of the 2012 OBC. 6. Deck guards (railings) are to be a minimum of 36 high on all decks that are over 2 from grade and less than or equal to 5 11 from grade. All decks higher than 5 11 from grade will require a minimum 42 high railing. These requirements apply to stair guards as well. 7. Guards shall not be climbable in any manner and shall have no horizontal member that is higher than 5.5 from the top of the walking surface to a minimum height of 36 above the walking surface. 8. Handrails that are not incorporated into a guard shall be between 2 7 and 3 2 above the front nosing of the steps it serves. Guards that are also handrails must be fully graspable along the full length of the guard and be no larger than 3.5 in width. 9. Concrete Sonotubes shall be no further out of the ground than 3 times the diameter of the Sonotube (e.g. 10 Sonotube cannot be further than 30 above grade). 10. All standard wood framed guards shall adhere to SB-7 of the 2012 OBC. 11. Maximum overhang (cantilever) of any deck joist over a beam shall be no greater than the following: 2 x 6 deck joists: max cantilever of 12 2 x 8 deck joists: max cantilever of 16 2 x 10 and 2 x 12 deck joists: max cantilever of 24 City of Pembroke Deck Guidelines Package February 2017

12. Maximum overhang (cantilever) of a beam supporting deck joists is 8 for all built up beams, sandwich beams and lintel beams. 13. Ledger boards fastened to the house shall have a minimum 1-1/2 lag screw every 2 ft. 14. Joist hangers shall have approved joist hanger nails, ensuring that they are engineered products. Fasteners should not be mixed and matched. 15. Decks constructed with traditional nailing framing methods (no engineered hangers) shall have all nailing patterns adhere to Table 9.23.3.4 of the 2012 OBC. 16. Minimum separation between pickets in a deck is no more than 4. 17. Decks with roofs shall have proper blocking installed between the joists to carry all loads from above down to the ground and shall be situated above the supporting members (beam and Sonotubes) and shall not be offset from the column supporting the loads from above. 18. Other than safety-required OBC items, all structural requirements can be altered with consultation and reviewed by an Ontario registered Structural Professional Engineer. A stamped signed letter is to be provided by the P.Eng in these situations. 19. 2-3 deck screws are not permitted in any structural item on a deck (beams, hangers, etc.). 20. All built up beams have to be fastened with lag bolts or bolts (exterior grade). Built up beams must be nailed as per OBC. 21. All steps must adhere to the OBC for rise, run, tread depth, and nosing. Support for steps on Sonotubes or in some cases patio stones. 22. All exterior wood must be pressure treated, or cedar with approved exterior treatment. All hardware must be exterior grade. An application for a Deck Building Permit requires the following: 1. Building Permit Application completely filled out with estimated cost of construction and area of deck given on the application; 2. Deck sketch: one side view with heights to underside of joist and walking surface, beam details, post details, fastener details, railing details, foundation details and depth, Sonotube sizes, deck block sizes, grade location, deck board sizes, etc.; 3. Deck sketch: plan view from above with all beam locations, deck size, floor joist and beam cantilever, if any; 4. Deck sketch: ledger board attachment and size if applicable; and 5. Site Plan; 6. Grading Plan (see attached for examples). City of Pembroke Deck Guidelines Package February 2017

City of Pembroke Deck Guidelines Package February 2017

6. CORPORATION OF THE CITY OF PEMBROKE BUILDING DEPARTMENT 1 PEMBROKE STREET EAST PEMBROKE ON K8A 3J5 PHONE 613-735-6821 x1304 FAX 613-735-3660 www.pembroke.ca SITE PLAN AND GRADING PLAN INFORMATION NOTE: Site Plan and Grading Plan details must be included with a building permit application. Site Plans must show: 1. Drawn to scale, and scale clearly indicated 2. Dimensions of lot, buildings, structures, decks, accessory buildings (height of proposed buildings) 3. When possible, use copy of survey, registered plan, as base diagram 4. North arrow, road allowances, easements, right-of-ways, utilities, and services 5. Dimensions of laneways, curbs, parking lots, lighting, guards, billboards, etc. 6. Fences (detailing type, location, neighbouring land uses, and location of neighbours structures where within 10 ft. of lot lines). 7. Any pools, decks, circulating pumps, and landscape features such as trees, retaining walls, etc. 8. All site plans required for Site Plan Agreement, subdivisions, and public use muse be of professional standards (see no. 11). 9. New development and major re-development may require additional storm water management plans and calculations. 10. Depending on the situation, the City retains the right to reject or request additional details and quality of submissions. 11. Drawings must have appropriate seals, Professional Engineer, BCIN, or equivalents. Grading Plans must show: 1. BM bench mark for property (Geodetic Benchmark preferred) 2. Existing elevations and contours (arrows showing surface flows) 3. Floor elevation basement 4. Top of foundation elevation E.g. 93.5 m Proposed 5. Elevation at exits (doors) 92.0 m Existing 6. Finish grade around house 7. Garage floor slab elevation 8. Septic tank and bed elevation (estimate), where applicable 9. Sump hole (location and outlet), where applicable 10. Swales, ditches or water courses (outlet details), slopes, cross-sectional details 11. Landscape details 12. Arrows showing slope and direction of water flow(s) 13. Eaves troughs and where they outlet 14. Driveway slopes and spot elevation 15. Road elevation, catch basin locations and elevations 16. Services provided: sanitary, storm, distribution 17. Provide details of subdivision agreement or any other development agreement applicable City of Pembroke Deck Guidelines Package February 2017

CORPORATION OF THE CITY OF PEMBROKE BUILDING DEPARTMENT 1 PEMBROKE STREET EAST PEMBROKE ON K8A 3J5 PHONE 613-735-6821 x1304 FAX 613-735-3660 www.pembroke.ca SITE PLAN CHECKLIST This checklist provides homeowners a summary of the Building Permit submission requirements for constructing a residential building. Construction of a building, including pre-fabricated buildings, occupying an area greater than 10 square metres (108 square feet) requires a Building Permit. The Ontario Building Code outlines the minimum requirements for various elements, such as framing and foundation, and can be viewed on the Ontario Ministry of Municipal Affairs and Housing website at http://www.obc.mah.gov.on.ca/site4.aspx. The City of Pembroke s Planner can advise on zoning regulations impacting your building design, such as setbacks to lot lines, building height and lot coverage. The Planner s phone number is 613-735-6821 x1301. Required Drawings Two complete sets of plans that are legible and drawn to conventional scale must be submitted with the Building Permit Application Form. Site Plan Drawing to include: Lot lines including dimensions Location of proposed accessory buildings dimensioned to other buildings and lot lines Indicate any changes to grading (grading approval may be required) Lot area, main building area, and all other accessory buildings areas Municipal address Foundation Plan Drawing to include: Footings and foundation walls Floor construction Floor Plan Drawing to include: Wall location and thickness Window and door locations including sizes and lintels Roof construction including beams, rafters, joists or trusses, sizes and direction Elevations Drawing to include: The general appearance of the accessory building from all four sides Indicate windows and doors Indicate exterior wall finish (e.g. siding)

Cross Section Drawing to include: Foundation construction and depth Floor construction Wall construction including stud height Roof construction including roof pitch Height from grade to roof peak Site Plan Checklist Additional Information A truss layout as supplied from manufacturer may be required, depending on the complexity of preengineered roof trusses. The joist layout as supplied from the manufacturer is required when pre-engineered joists are used. Building Permit Application Submit a Building Permit Application to the City of Pembroke s Building Department at 1 Pembroke Street East. To expedite the Building Permit s issue, ensure all applicable information is submitted. Required Inspections At key stages of building construction, your work must be inspected to ensure that the applicable stage of construction complies with the Ontario Building Code. The permit plans and specifications must be on site and made available to the Building Official at the time of inspection. To ensure the availability of a Building Official, you should book inspections 48 hours in advance. Failure to have the appropriate inspection performed may result in your having to uncover and expose the work for inspection, other Orders may be issued, etc. The City of Pembroke s phone number is identified on the building permit. It is your responsibility to call for inspections. For a list of required inspections that may apply based on the proposed building, please refer to the following table. Inspection Lateral Excavation Plumbing Underground Foundation Plumbing Rough-In Framing and Mechanical Rough-In Insulation/Vapour Barrier Plumbing Final Occupancy Final Inspection Description Prior to backfill of sanitary and storm sewers and water service. Required prior to placement of concrete footings. Required prior to covering underground plumbing. (Test required) Required prior to backfill of foundation. Required at completion of plumbing rough-in, which includes drains, waste, vent and water piping system. (Test Required) Required at completion of structural framing, is satisfactory as required by the Ontario Building Code. Required at completion of insulation, air barrier and vapour barrier installation. Required at completion of plumbing system, fixtures and appliances. (Test required) A person may occupy a dwelling that has not been fully completed provided an Occupancy Permit has been issued by the Building Official. To be eligible there must be no outstanding Building Code Orders and certain building components and systems must be complete and inspected under Articles 1.3.3.1 and 1.3.3.2. Required at completion of the building.

CORPORATION OF THE CITY OF PEMBROKE BUILDING DEPARTMENT 1 PEMBROKE STREET EAST PEMBROKE ON K8A 3J5 PHONE 613-735-6821 x1304 FAX 613-735-3660 www.pembroke.ca mschultz@pembroke.ca DECK CHECKLIST This check sheet will help you design and plan your project, assist you in providing the Building Department with proper and compliant detail drawings, and point out frequently overlooked details. GENERAL: Deck Size: x Max height above ground: *Railings? Y N *Attached to house/structure Y N *If yes, a detailed railing plan required *Railing required if over 24 from ground * If yes, flashing required * Deck foundation to be considered frost action FOOTINGS: Type: Depth: W Bigfoot/Flared bottom Y N BEAM: # of Ply: Lumber size: Max Span between piers: Deck design to not incorporate beam: Y N JOIST: *Lumber size: x Wood Type: *Joists to be 2x8 minimum as per OBC SB-7 Spacing: o/c Max Span: PLANKING: Lumber Size: Wood Type: STAIRS: Y N IF Yes # of risers/steps: Handrail: Y N Spacing of Stringers: Joist Hangers or Mechanical Fasteners to be used: Y N (All joist hangers and other metal fastener plates require joist hanger nails/approved fastener as per manufacturer) RAILINGS: Size of Post: x Spacing of Posts: Wood Type: Size of Pickets/Spindles: Railing Height: Spacing: o/c Max 4 inch spacing re all openings in guards ALL FASTENERS IN CONTACT WITH PRESSURE TREATED WOOD ARE REQUIRED TO BE ACQ APPROVED/COMPATIBLE

CORPORATION OF THE CITY OF PEMBROKE BUILDING DEPARTMENT 1 PEMBROKE STREET EAST PEMBROKE ON K8A 3J5 PHONE 613-735-6821 x1304 FAX 613-735-3660 www.pembroke.ca LETTER OF AUTHORIZATION PLEASE PRINT CLEARLY I, authorize to apply for and (PROPERTY OWNER) obtain a building permit to: (PERMIT APPLICANT) Construct Install Alter Renovate Demolish Describe work below: at the following location (civic address or legal description): Date Signature

Application for a Permit to Construct or Demolish This form is authorized under subsection 8(1.1) of the Building Code Act,1992 For use by Principal Authority Application number: Permit number (if different): Date received: Roll number: Application submitted to: (Name of municipality, upper-tier municipality, board of health or conservation authority) A. Project information Building number, street name Unit number Lot/con. Municipality Postal code Plan number/other description Project value est. $ Area of work (m 2 ) B. Purpose of application New construction Proposed use of building Addition to an existing building Alteration/repair Current use of building Demolition Conditional Permit Description of proposed work C. Applicant Applicant is: Owner or Authorized agent of owner Last name First name Corporation or partnership Street address Unit number Lot/con. Municipality Postal code Province E-mail Telephone number Fax Cell number D. Owner (if different from applicant) Last name First name Corporation or partnership Street address Unit number Lot/con. Municipality Postal code Province E-mail Telephone number Fax Cell number Application for a Permit to Construct or Demolish Effective January 1, 2014 Page 1 of 4

E. Builder (optional) Last name First name Corporation or partnership (if applicable) Street address Unit number Lot/con. Municipality Postal code Province E-mail Telephone number Fax Cell number 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. Yes No ii. Is registration required under the Ontario New Home Warranties Plan Act? Yes No 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, 1992, to be paid when the Yes Yes No No application is made. 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. Yes No iii) This application is accompanied by the information and documents prescribed by the applicable bylaw, resolution or regulation made under clause 7(1)(b) of the Building Code Act, 1992 which enable Yes No the chief building official to determine whether the proposed building, construction or demolition will contravene any applicable law. iv) The proposed building, construction or demolition will not contravene any applicable law. Yes No I. Declaration of applicant I (print 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. Application for a Permit to Construct or Demolish Effective January 1, 2014 Page 2 of 4

Schedule 1: Designer Information Use one form for each individual who reviews and takes responsibility for design activities with respect to the project. A. Project Information Building number, street name Unit no. Lot/con. Municipality Postal code Plan number/ other description B. Individual who reviews and takes responsibility for design activities Name Firm Street address Unit no. Lot/con. Municipality Postal code Province E-mail Telephone number ( ) Fax number ( ) Cell number ( ) C. Design activities undertaken by individual identified in Section B. [Building Code Table 3.5.2.1. of Division C] House Small Buildings Large Buildings Complex Buildings Description of designer s work HVAC House Building Services Detection, Lighting and Power Fire Protection Building Structural Plumbing House Plumbing All Buildings On-site Sewage Systems D. Declaration of Designer I declare that (choose one as appropriate): (print name) I review and take responsibility for the design work on behalf of a firm registered under subsection 3.2.4.of Division C, of the Building Code. I am qualified, and the firm is registered, in the appropriate classes/categories. Individual BCIN: Firm BCIN: I review and take responsibility for the design and am qualified in the appropriate category as an other designer under subsection 3.2.5.of Division C, of the Building Code. Individual BCIN: Basis for exemption from registration: The design work is exempt from the registration and qualification requirements of the Building Code. Basis for exemption from registration and qualification: I certify that: 1. The information contained in this schedule is true to the best of my knowledge. 2. I have submitted this application with the knowledge and consent of the firm. Date Signature of Designer NOTE: 1. For the purposes of this form, individual means the person referred to in Clause 3.2.4.7(1) d).of Division C, Article 3.2.5.1. of Division C, and all other persons who are exempt from qualification under Subsections 3.2.4. and 3.2.5. of Division C. 2. Schedule 1 is not required to be completed by a holder of a license, temporary license, or a certificate of practice, issued by the OntarioAssociation of Architects. Schedule 1 is also not required to be completed by a holder of a license to practise, a limited license to practise, or a certificate of authorization, issued by the Association of Professional Engineers of Ontario.

Permit Number: Street Address: Roll Number: CITY OF PEMBROKE BUILDING PERMIT APPLICATION ADDITIONAL INFORMATION REQUIRED INTERNAL USE ONLY LEGAL DESCRIPTION OF PROPERTY: ZONE: PROPERTY IS LOCATED ON THE SIDE BETWEEN & (north, south, east, west) (street) (street) LOT SIZE: x (frontage) (depth) SIZE OF PROPOSED CONSTRUCTION HEIGHT OF PROPOSED CONSTRUCTION AREA OF PROPOSED CONSTRUCTION FRONT YARD SETBACK REAR YARD SETBACK SIDE YARD SETBACK SIDE YARD SETBACK (width) x (length) (ft 2 ) INTERNAL USE ONLY FEE PERMIT ADMIN WATER METER 9-1-1 TOTAL (Development Charge) APPLICANT CHECKLIST Completed application signed and dated by owner/applicant; Completed additional information; Site plan showing setbacks from property lines and existing buildings (not required for interior construction); and 2 complete sets of drawings (floor plan, cross sections, electrical, mechanical).