Transcription of Medina County Building Department
1 Main: (330) 722-9220 Fax: (330) 764-8204 RandlesBuilding Officialcrandles Medina County Building DepartmentPermit Center791 W. Smith , Ohio 44256 PROJECT & LOCATION Name: Address: City: Zip: Township Village City:DESCRIPTION New Addition Alteration Change of Occupancy Other TYPE(S) OF PLAN APPROVAL(S) Building /Structural Mechanical Electrical Exhaust Hood Sprinkler System Suppression System Fire Alarm Hood Suppression OtherTYPE OF CONSTRUCTION I-A I-B II-A II-B III-A III-B IV V-A V-BOBC GROUP CLASSIFICATION A-1 A-2 A-3 A-4 A-5 B E F1 F2 H-1 H-2 H-3 H-4 H-5 I-1 I-2 I-3 I-4 M R-1 R-2 R-3 R-4 S-1 S-2 UAPPLICANT Name: Ph.
2 #: ( ) - - Fax#: ( ) - - E-mail: CONTRACTOR Name: Address: City: Zip: Ph.#: ( ) - - Fax#: ( ) - - E-mail: PROPERTY OWNER Name: Address: City: Zip: Ph.#: ( ) - - Fax#: ( ) - - E-mail: DESIGN PROFESSIONAL IN CHARGE Name: Ohio Registration #: Address: City: Zip: Ph.#: ( ) - - Fax#: ( ) - - E-mail: Commercial Application # _____Project Est. Cost: $ Area of Construction(Project Square Footage) Applicable Floor(s) Basement: First Floor: Second Floor: Third Floor: Other: SQ. FT. TOTAL:Number of Exterior Lighting Poles**OFFICE USE ONLY** Date Paid: _____/_____/_____ Cash Check # _____ Amount : $_____ Receipt # _____Checks payable to.
3 Medina County TreasurerCOMMERCIAL PLAN REVIEW FEE SCHEDULE AN APPLICATION AND PLAN REVIEW FEE ARE REQUIRED WITH ALLCOMMERCIAL PLANS SUBMITTED FOR ofConstruction(square footage)All UseGroupsBase Fee+StateFee+TechnologyFee= Total0 499$ $ $ - 1,999$ $ $ ,000 - 3,999$ $ $ ,000 - 5,999$ $ $ ,000 - 7,999$ $ $ ,000 - 9,999$ $ $ ,000 19,999$ $ $ ,000 39,999$ $ $ ,000 59,999$ $ $ ,000 79,999$ $ $ ,000 99,999$ $ $ 100,000$ $ $ ACTUAL COST OF PLAN REVIEW EXCEEDS SCHEDULE FEE LISTED ABOVE, THEPLAN REVIEW FEE WILL BE ADJUSTED TO REFLECT ACTUAL COST.
