RESIDENTIAL APPLICATION FORM

SUBMIT ONE APPLICATION FORM FOR EACH BUILDING

OR STRUCTURE. PLEASE PRINT OR TYPE

MONTGOMERY COUNTY

BUILDING REGULATIONS DIVISION

451 W. Third St. P.O. Box 972 Dayton, OH 45422 937-

225-4622

• www.mcohio.org/build • Fax 937-225-6327

1. DESCRIPTION OF WORK TO BE COVERED WITH APPLICATION

•

If this permit application is connected to an existing building

permit, what is that permit number? BLD

•

(For Building Permits only) What is the estimated market value

of completed project $

2. SCOPE OF PROJECT

•

Check box that best describes the scope of this application:

New Complete Building Repairs Only

New Building Addition Damage Assessment

Alteration of Full Building or Dwelling Unit

Alteration of Partial Building or Dwelling Unit

•

Size of work being built and/or altered, rounded to the nearest

100 sq. ft.

Include all areas under roof, including garages, covered

porches, basements, whether finished or unfinished. __Sq. Ft.

•

Is the project in a FEMA regulated Floodplain? Yes No

•

Is the project in the WPAFB Airport Zoning District? Yes No

•

Type of sewer system: Public Private

•

This project is designed to be: Heated Unheated

•

Were any of the spaces that are proposed to be heated

previously unheated spaces? Yes No

•

The heat source for this project is:

Natural Gas Electric LP Gas

Geothermal Unheated Other

3. TYPE OF PERMIT(S) YOU ARE REQUESTING

(Check all that apply to this application) UP-FRONT FEE

B.2 Building Work Only $200

(For general construction of new, additions, alterations, remodeling, repairs, etc.)

$250

$150

$200

$125

$100

$150

$125

B.3 Both Building and Mechanical work

M.1 Mechanical Work Only

B.10 Footing/Foundation Phase Only

B.11 Demolition of Entire Building

B.14 Floodplain Compliance Only

M.5 Furnace/AC/Water Heater Replacement

(Same size and location only)

M.8 Gas Piping

(Submit gas

piping worksheet)

SUB-TOTAL UP-FRONT FEE DUE $

4. ADDITIONAL FEES TO BE ADDED TO BALANCE DUE:

B.15 or M.9 Additional Inspection(s) Requested:

How Many? x $75 = $

Multi-family dwellings require separate Certificates of Occupancy for each unit. The first one is

included in the base fee.

A.1 Number of Additional CO’s Needed ___x $100 = $

A.4 Emergency Inspection or Evaluation $100

TOTAL UP-FRONT FEE DUE $

5. PROJECT Project Name

Address

City & Zip

Lot Number Subdivision

Actual Jurisdiction (Township, Village, or City)

Parcel ID

6. BUILDING OWNER Phone

Company Name

Contact Person

Address

City, State, Zip

7. APPLICANT INFORMATION Phone

Company Name

Contact Person

Address

City, State, Zip

8. DESIGNER INFORMATION Phone

Company Name

Contact Person

Address

City, State, Zip

9. CONTRACTOR INFORMATION Phone

Company Name

Contact Person

Address

City, State, Zip

10. I HEREBY CERTIFY that I am the: Property Owner Agent for

the Owner, and all information contained in this application is true,

accurate, and completed to the best of my knowledge. All official

correspondence in connection with this application should be sent

to my attention at the address shown above. I also understand that

UP-FRONT FEES ARE NON-REFUNDABLE AND NON-TRANSFERABLE.

Applicant Signature

Printed Name Date

OFFICE USE ONLY

Received by via: Main Office Mail Fax Electronic

Total Fee Due $

Amount Paid Up-Front $ FOP

Penalty Fee Due $

Balance Due $ FOP

Plans approved by

Date approved Code Ed.

Does this get a Certificate of Occupancy? Yes No

Applicant Notified Permit Ready by Date

MASTER PERMIT NO.

PERMIT NO. DATE RECEIVED

Residential Application

Revised 04/10/2019

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APPLICATION INFORMATION AND INSTRUCTIONS

See www.mcohio.org/build for more project success information Effective July 1, 2017

Documents submitted for plan review shall be drawn to

an architect’s or engineer’s scale and be sufficiently

clear, comprehensive, detailed and legible so it can be

determined if the proposed work will conform to all

applicable provisions of the Residential Code of Ohio. All

documents must bear the name, address and phone

number of the party responsible for their preparation.

Documents must be collated and bound into sets. Two sets

of all drawings must be submitted for review.

1. Site Plans must include:

Dimensions of the lot. Size and location of all proposed

and existing structures with dimensions from the

building face to the property lines. All easements and

setbacks. For properties that extend into flood hazard

areas, shown existing and proposed topographic lines,

and FEMA floodplain boundaries.

2. Foundation Plan must include:

Foundation materials. (concrete, block, etc.) Any

reinforcing steel or mesh. All dimensions. Interior pier

and thickened slab location and sizes. Beam sizes and

spans. A continuous footing under the concrete slab at

the garage doors. Window locations in foundation

walls. Any access door locations and sizes. The

direction, size, spacing and species of joists or trusses

above or a joist layout plan. Footings shown as dashed

lines, foundation walls shown as solid lines. For

additions, include enough of the existing to show how

the addition connects to the existing.

3. Floor Plans of each level must include:

Label all room uses, such as Kitchen, Clothes Closet,

Storage, etc. Note that “Bonus Room” or “Loft” are not

acceptable description of room uses. Include all room

dimensions and overall building dimensions; door and

window sizes and locations including emergency

egress windows in all bedrooms; location of safety

glazing; furnace, water heater, plumbing fixture, and

washer and dryer locations.

Show all beam and column sizes; and the direction,

size, spacing and species of joists and rafters, or a

joist layout plan. For pre-engineered floor and roof

framing systems, provide floor framing systems plans

and details, and roof framing plans showing the

spacing and span of the joists and trusses, along with

separate professionally sealed truss engineering

drawings. Submit all deck and porch structural

information. For additions, include enough of the

existing building to show how the addition connects to

the existing, including room usage in existing structure

and existing structure being attached to.

Note: Truss drawing may be submitted after the

building permit is issued, but they must be submitted

for approval, and the approved drawings must be on

the job site at the time of the framing inspection

4. All Exterior Elevations or Views:

Indicate type and extent of exterior finishes. Show all

doors and windows; indicate proposed finish grade;

and show all porches, steps and decks. For additions,

include enough of the existing building to show how

the addition connects to the existing.

5. Wall Sections must include:

Show all foundation materials, sizes and reinforcement;

foundation waterproofing; all floor materials, wall

materials, roof materials, connection details, and all

insulation being installed, including type, thickness and

R-value. Dimension the height of insulation on

foundation wall if less than full height of wall.

6. Energy Analysis must include:

Submit REScheck analysis or other approved

alternative compliance method. Include all

component areas, calculations showing compliance,

and match R-values and U-factors of the various

sections. (See Permit Success Checklist on our

website for more details)

IMPORTANT NOTICES

1. A separate application is required for each individual

dwelling unit, building or structure.

2. Footing /Foundation permit issuance constitutes

partial plan approval for construction of the footing

and foundation only. Construction may proceed only

to the point for which approval has been given, at the

permit holders risk and without assurance that

approval for the entire structure will be given.

3. It is unlawful to begin the construction of a new

structure, alteration or addition to an existing

structure, and /or changing the use of an existing

structure before receiving approved plans from this

department, and zoning approval from the local

zoning jurisdiction. WORK BEGUN BEFORE

PERMIT ISSUANCE WILL RESULT IN A

PENALTY OF A DOUBLE PERMIT FEE.

4. All approved documents from permit issuance or

subsequent modifications, must be available at the

project jobsite for any scheduled inspection.

5. Up Front Fees are not refundable, except in the case

of Montgomery County clerical error, in which case

all fees will be refunded. If you are unsure about your

application, ask questions before you submit it. If a

permit can’t be approved due to code compliance

issues, or if you change your mind or don’t get the

job to do the work, no refund of the Up Front fees

will be authorized.

As necessary, separate applications are required for

permits issued from:

• For private septic systems – Submit proof of Health

Department approval with building permit application);

and for other plumbing permits – Public Health – Dayton

& Montgomery County (937-225-4421)

• Zoning Approval (Proof of approval required at time of

building permit application.) Contact list available at our

offices or at www.mcohio.org /build

Residential Application

Revised 04/10/2019

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