CODE COMPLIANCE INSPECTORS 655-9254
351 South Main Street
Pittston, PA 18640 DATE_____________________
SAM MARRANCA (Cell Phone) 301-8631 PERMIT#
BUILDING PERMIT APPLICATION
BOROUGH OF WEST WYOMING-LUZERNE COUNTY
TO SCHEDULE AN INSPECTION, CALL THE PHONE NUMBER LISTED ABOVE
ZONING APPROVAL IS USUALLY REQUESTED PRIOR TO SUBMITTING APPLICATION FOR A BUILDING PERMIT. ANY QUESTIONS REGARDING ZONING APPROVAL SHOULD BE DIRECTED TO THE BOROUGH ZONING OFFICER.
TYPE OF PERMIT (CHECK ALL THAT APPLY)
BUILDING ( ) PLUMBING ( ) ELECTRICAL ( ) HEATING ( ) OTHER ( )
PROPERTY’S OWNER INFORMATION:
NAME __________________________________________________________________
ADDRESS_______________________________________________________________
CITY______________________________________STATE__________________ ZIP_______________
PHONE NUMBER________________________________________
CONTRACTOR’s INFORMATION:
NAME__________________________________________________
ADDRESS_______________________________________________
CITY_________________________________________STATE________________ZIP_________________
PHONE NUMBER__________________________
PRESENT USE OF PROPERTY: (CHECK ALL THAT APPLY)
SINGLE FAMILY RESIDENTIAL ( ) MULTI-FAMILY RESIDENTIAL ( )
COMMERCIAL ( ) INDUSTRIAL ( ) INSTITUTIONAL ( ) OTHER ( )
SCOPE OF WORK-MUST ATTACH A COPY OF SIGNED CONTRACT, ESTIMATE AND ONE (1) SET OF PLANS AND SPECIFICATIONS (IF APPLICABLE)
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
PERMIT FEE (BASED ON COST OF WORK)
Dumpster Fee $25.00
All Other inspections $140.00
Total Cost __________________ FEE____________________CHECK #_______________________
OTHER________________________
MAKE CHECKS PAYABLE TO “BOROUGH OF WEST WYOMING”
FOR NEW construction and/OR STRUCTURAL ALTERATIONS ATTACH THE FOLLOWING (Next Page)
(1) COPY OF PLANS AND SPECIFICATIONS
(2) PROOF OF COST OF PROJECT, CONTRACT WITH CONTRACTOR
A. SIGNED CONSTTRUCTION CONTRACT
B. IF WORK IS PERFORMED BY OWNER – RECEIPT FOR MATERIALS
PRIOR TO ISSUING A BUILDING PERMIT, ZONING APPROVAL BY THE MUNICIPALITY IS REQUIRED FOR NEW CONSTRUCTION. STRUCTURAL ALTERATIONS AND ADDITIONS INCLUDING DECKS, PATIOS, SUNROOMS, FENCES AND SWIMMING POOLS.
FOR ANY WORK REQUIRING ZONING APPROVAL, YOU MUST ATTACH THE FOLLOWING WHEN APPLYING FOR A PERMIT: COPY OF YOUR MUNICIPAL ZONING APPROVAL AND COPY OF YOUR MUNICIPAL ZONING APPROVAL FOR SEWAGE.
CERTIFICATION: I hereby certify that I am the property owner, equitable or authorized agent of the owner for the property and project listed in this application. I further certify that all work will be performed in accordance with the UCC building code, the attached plans and specifications (if applicable) the Pa Building Energy Conservation Act (Act 22 of 1980) and all other applicable laws and regulations. I further agree that the building described I this permit at reasonable hours to inspect the premises and enforce the provisions of the Code and this permit.
APPLICANT’s
FEE_________________ DATE________________ SIGNATURE_________________________________
BUILDING CODE PERMIT
The undersigned Building Code official hereby verifies that the building construction described above and within attached building plans and specifications does to the best of my knowledge comply with the requirements of the UCC Building Code as adopted and amended locally. The owner(s) and contractor are hereby advised that compliance with all UCC Building Code standards is required and incomplete or inconclusive building plan details shall not be grounds for example from specific UCC standards.
Review and inspections of the construction process is required to assure Code Compliance.
THE FOLLOWING IS A LIST OF ITEMS REQUIRING A MANDATORY INSPECTION
-ELECTRICAL SERIVCE – upgrade existing service/new service
-RENNOVATIONS/CHANGE OF STRUCTURE – requires inspection
-FOOTINGS – After excavation and any forming PRIOR to concrete pour
-FOUNDATION – After construction, prior to backfill, complete with foundation, drains, damp proofing and embedded anchor bolts and BEFORE any framing including all sill plates.
-FRAMING – After construction PRIOR to insulation and interior wall covering.
-PLUMBING, ELCECTRICAL, etc. shall be”roughed in” and will b inspected
-FINAL- After structural completion with all fixtures complete and functional.
CERTIFICATE OF OCCUPANCY – The undersigned Building Code Official hereby verifies that the building construction described above has been completed in accordance with the UCC Building Code, and has complied with other applicable local regulations necessary to facilitate occupancy. Accordingly, this Certificate of Occupancy Approval is hereby granted.
BCO SIGNATURE________________________________________DATE____________________________
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