APPLICATION FOR UCC BUILDING PERMIT
APPLICATION FOR UCC BUILDING PERMITSite InformationPolitical SubdivisionandCountynames are Name (name of company, mall, institution, university, etc.): BUILDING and/or Tenant NameStreet NumberandNameCityStateZip CodePolitical SubdivisionCountyApplication TypeAccessibility OnlyReviewAdditionAlteration or RenovationNew BuildingNew Structure/FacilityPartial OccupancyPhased ApprovalPlan Revision/Deferred SubmissionUncertified (Existing) BuildingUse/OccupancyClassification:Chec k box toleft of applicable allthat Adult CareR-3R-4S-1S-2USingle Family Dwelling/Townhouse (must be state-owned)Mandatory DocumentsCheck each block below indicating that all of the following will be submitted with this APPLICATION :Four (4) site plans Three (3) assembledand boundsets of construction drawingsOne (1) completed copy of the UCC-2 UCC PLAN REVIEW CHECKLIST One (1) set of specifications (only ifAddition, Alteration, New BUILDING /Structure/Facility) Special Requirements & DocumentationDoes this construction involve modular units built in a factory?
Tax Parcel ID: TOTAL FEES OWED $ Make check or money order payable to Commonwealth of Pennsylvania. Applicant’s Certification: Note: THE BUILDING PERMIT AND THE CERTIFICATE OF OCCUPANCY FOR THIS BUILDING OR
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