Residential Building Permit Application - SCMCCI

1 230 of 1972, as amendedSouth Central Michigan Construction Code Inspection, :Mandatory to obtain permit1309 Cleaver Rd Suite A - Caro MI 48723 Penalty: Permit can not be issuedPh: 989/672-3750 or Toll Free: 1-888-863-2904 Fx: 989/672-3814 Date: Residential Building Permit ApplicationPermit:*Inspection Scheduling: 1-888-863-2904*Amount:Office Hours 8:00am to 4:00pmMethod of Payment:Monday thru FridayReceipt #:1. CONSTRUCTION LOCATIONP roject NameAddress:City/VillageTownshipCountyZi p CodeBetweenAndProperty Code#2. PROPERTY OWNER OR LESSEE:NameAddress:CityState, Zip CodeTelephoneWork PhoneFax3. CONTRACTOR INFORMATION Name of ContractorAddressCityState, Zip CodeTelephoneWork PhoneFaxLicense #Expiration DateFederal ID #Workers Comp #MESC Employer #4.

2 ARCHITECT OR ENGINEER INFORMATION (when applicable)NameAddressCityState, Zip CodeTelephoneWork PhoneFax5. _____I AM SUBMITTING 3 SETS OF PROJECT PLANS ALONG WITH A SITE PLAN FOR PLANREVIEW ONLY AT THIS TIME. I REALIZE FURTHER DOCUMENTATION MAY BE PLEASE CHECK THE FOLLOWING REQUIRED DOCUMENTS THAT ARE BEING SUBMITTEDWITH THIS Application (when applicable)_____Zoning Approval_____3 sets of Prints(plans)_____Soil Erosion Permit_____Well Permit_____Driveway Permit_____DEQ Permit_____Sewer Permit_____Site Plan_____Wetlands Permit7. THE PROJECT WILL CONSIST OF: (separate permits are required for each roof structure)_____Stick Built Home_____Addition _____with attached garage_____Alteration/Remodel_____State of Michigan Approved Manufactured home_____Garage Serial numbers (Side One)_____ _____detached _____attached/existing bldg (Side Two)_____Pole Building _____ with attached garage_____Storage Bldg/utility bldg/accessory bldg_____Hud Approved Mobile/Doublewide, (year _____)

3 _____Pool Title serial numbers _____ _____below ground _____above ground HUD Certificate numbers_____Fire Job _____with attached garage_____ Demolition, most recent use_____Deck/Porch _____with roof structure _____without roof structurepg 18. PLEASE ANSWER THE FOLLOWING QUESTIONS:Footing type:_____ pole _____ full footingWall type:_____ poured walls_____ piers_____crawl space_____ block walls_____ slab_____ trench _____ wood constructionThe principle type of frame will be:_____wood_____post_____masonry_____st ructural steel_____otherThe principle type of heating fuel:_____natural gas_____propane gas_____fuel oil_____electric_____otherThe type of water supply is:_____private_____public systemThe type of sewage disposal is:_____private_____public systemThe number of bedrooms involved:_____# of bathrooms _____#1/2 bathrooms _____Will project have Air Conditioning:_____ yes _____noWill this project have a fireplace.

4 _____ yes _____noif yes, what kind:_____masonry_____zero-clearance____ _gas burningWill this project have a finished basement?:_____ yes _____no9. STRUCTURAL ELEMENTSThis project will use:_____truss' spaced _____" on center (provide manufacturers engineering)_____rafters _____" x _____" spaced _____" on center_____ truss carriers ( pole barns) _____" x _____" _____ outside/_____ insideExterior walls:_____ 2"x4" spaced _____" on centerSupport Columns:_____wood _____x_____ 2"x6" spaced _____" on center spaced_____" on centerFloor Joints:_____ 2"x6" spaced _____" on center_____steel _____ 2"x8" spaced _____" on center _____diameter_____ 2"x10" spaced _____" on center _____other_____ 2"x12" spaced _____" on center _____" on center_____ TJI's (provide manuf"s engineering)10.

5 DIMENSIONS OF PROJECTB asement, unfinished_____x_____= SPACE basement, finished_____x_____= slab _____crawl space_____x_____= floor_____x_____= level or loft area_____x_____= _____attached _____detached_____x_____= building_____x_____= building_____x_____= , with a roof structure_____x_____= without a roof structure_____x_____= , with a roof structure_____x_____= without a roof structure_____x_____= (requires electric Permit /poss. mechanical) _____x_____= job_____x_____= _____x_____= FROM GRADE LEVELFT.(to highest point of Building )TOTAL SQ. FT. OF PROJECTTOTAL LIVING AREAYOUR ESTIMATED COST OF THIS PROJECT (required)$pg 2(Should include Building , mechanical, electrical, and plumbing)11.

6 IF YOU ARE Building ON OR NEAR A WATERWAY, PLEASE COMPLETE THE FOLLOWING:My project is approximately _____ feet from a lake, river, stream or county drain. My soil erosion Permit numberis _____. The bottom of the lowest horizontal structural member of this project will be approximately _____ft. above summer lake project is in a flood hazard area; my DEQ Permit number is _____. The 100 year floodplain elevation or riseat this location is _____. Determined by my project is in a flood plain hazard area, I understand that certain Building restrictions will apply. Before constructionbeings, I must have a registered surveyor create an on site bench mark, upon completion andbefore occupancy of this project I must submit a certificate of as-built elevation from a registeredland **THIS Application WILL NOT BE ACCEPTED IF THIS SECTION IS NOT FILLED OUT COMPLETELY**12.

7 APPLICANT IS RESPONSIBLE FOR THE PAYMENT OF ALL FEES AND CHARGES APPLICABLE TO THIS Application AND MUST PROVIDE THE FOLLOWING INFORMATION:I here by certify that the owner of record authorizes the proposed work and that I have been authorized by the ownerto make this Application as his/her authorized agent and I agree to confirm to all applicable laws of the State ofMichigan. All information submitted on this Application is accurate to the best of my 23A OF THE STATE CONSTRUCTION CODE ACT OF 1972, ACT NO. 230 OF THE PUBLIC ACTS OF 1972, BEINGSECTION OF THE MICHIGAN COMPLIED LAWS, PROHIBITS A PERSON FROM CONSPIRING TO CIRCUMVENTTHE LICENSING REQUIREMENTS OF THIS STATE RELATING TO PERSONS WHO ARE TO PERFORM WORK ON A Residential Building OR A Residential STRUCTURE.

8 VIOLATORS OF SECTION 23A ARE SUBJECT TO CIVIL Applicant Name (not company)Drivers License #AddressCityState, ZipSIGNATURE OF APPLICANT:Phone #LOCAL GOVERNMENTAL AGENCY TO COMPLETE THIS SECTIONREVIEWS TO BE PERFORMED:_____ Building_____Electrical_____ Mechanical_____ PlumbingENVIROMENTAL CONTROL APPROVALSR equired?Approved/ByDateNumberA - Zoning_____ Yes _____No/B - Septic System_____ Yes _____No/C - Water Supply_____ Yes _____No/D - Driveway _____ Yes _____No/E - Soil Erosion_____ Yes _____No/F - Flood Zone_____ Yes _____No/G - Variance Granted_____ Yes _____No/H - Other_____ Yes _____No/VALIDATION - FOR DEPARTMENT USE ONLY_____ Use Group_____ Type of constr_____Square Feet_____ No.

9 Of Insp.$_____ Fee enclosedBuilding Official's Signature:DateZoning Official's Signature (where applicable)Comments:pg 311/13/2007 SCMCCI1309 S Cleaver Rd, Caro MI 48723PH: 989-672-3750 FX: 989-672-3814_____APPLICATION FOR PLANS EXAMINATIONTWO SETS OF PLANS MUST BE SUBMITTED FOR REVIEW. ALL SEALED PRINTS MUST CONTAIN A PROPER COVERPAGE WITH USE GROUP, CONSTRUCTION TYPE, SQUARE FOOTAGES, OCCUPANT LOAD AND ALL OF THEARCHITECTS/ENGINEERS INFORMATION ON IT. ALL PRINTS MUST BE PROPERLY DIMENSIONED AND ALL ROOMSPACES MUST BE IDENTIFIED FOR THEIR INTENDED NOT IN COMPLIANCE WITH THESE REQUIREMENTS, WILL NOT BE CONSIDERED AS READY FOR THEPLAN REVIEW PROCESS. THE TEN (10) WORKING DAY PERIOD FOR COMPLETEING THE PLAN REVIEW WILL NOTBEGIN UNTIL PLANS COMPLY WITH ALL Hours: Mon.

10 & Fri. 8:00 am to 4:00 pm_____ Permit NO: DATE AMOUNT: _____RECEIPT NO: CHECK NO: NAME OF PROJECT JOB ADDRESSCITYSTATEZIP ( ) APPLICANT NAME(PLEASE PRINT)