BUILDING PERMIT APPLICATION FOR BUILDING AND

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BUILDING PERMIT APPLICATION FORBUILDING AND PLUMBINGChief Building Official:Randy Lovie, CBCOExt. 8511Office Contact:Jackie MasonExt. 8510Applications for Building, Plumbing, Septic and Waterlines can beobtained and submitted at any one of the following locations:Forest7883 Amtelecom Parkway519 243-1400 or 1-866-943-1400Grand Bend4 Ontario St.519 243-1400 or 1-866-943-1400Northville9575 Port Franks Rd.519 243-1400 or 1-866-943-1400NOTE:If your application is for a plumbing permit, septic permit or theinstallation of a waterline only, please contact the County ofLambton at 519 845-0801 or 1-866-324-6912 with any questions or tobook inspections for the above.

THE MUNICIPALITY OF LAMBTON SHORESA HOMEOWNER'S GUIDE TO BUILDING PERMITSWelcome to the Municipality of Lambton Shores Building Department. Thefollowing information is provided to assist you with the building permit applicationprocess.PLEASE NOTE - Information provided in the application, other than personalinformation, is subject to the Municipal Freedom of Information and theProtection of Privacy Act requirements.WHAT IS A BUILDING PERMIT?A building permit is a formal approval to construct, add to, move or remove abuilding on your property.The Ontario Building Code Act requires that a building permit be obtained for theconstruction of a new structure, or an addition or alteration of any structure whichresults in a building area of more than 1 O m2 (108 square feet).Please note that it is illegal to construct or demolish a structure without firstobtaining a building permit. Anyone found guilty of building without a permit orhas not followed an order issued by a Building Official can be fined under theOntario Building Code Act.WHY DO I REQUIRE A PERMIT?Building Inspections protect the interests of both the individual and thecommunity as a whole. The Building Department ensures that all construction inthe municipality meets the Building Code's minimum standards for fire andstructural safety standards. The review by a qualified individual also ensures theplans comply with the regulations of the local municipal zoning by-laws as well asall other applicable laws and regulations.Please note: If the contractor or designer obtains the building permit on yourbehalf, it is still the building/property owner who is ultimately responsible forcomplying with all building requirements.WHEN IS A BUILDING PERMIT REQUIRED?Examples of works that require a building permit: Construct a new building Solar panels installed on buildings Renovate, repair or add to a building Demolish or remove all or a portion of a building

THE MUNICIPALITY OF LAMBTON SHORESA HOMEOWNER'S GUIDE TO BUILDING PERMITS Install, change or remove most walls Make new openings for, or change the size of windows and doors Add a skylight Build a garage Build a balcony or deck (over 2 feet off the ground) Excavate a basement or construct a foundation Install or modify heating, plumbing, air conditioning ductwork Reconstruct a chimney, add a wood burning fireplace Duct workExamples of works that do not require a building permit are: Replace existing, same-size doors and windows Install siding on small residential buildings Build a roofless deck less than two feet in height Build a utility shed less than i O m2 (i 08 square feet) Re-shingle a roof, providing there is no structural work Install eaves trough, providing that drainage is on your own property Replace or increase insulation, dry-wall or plaster Damp-proof basements Paint or decorate Install kitchen or bathroom cupboards without plumbing Erect a fence (fence will need to comply with Municipal regulations) Replace existing forced air furnace (that does not include any duct work) Minor electrical workNote: Although a building permit may not be required, you must still comply withthe requirements of the Zoning By-law, and other application laws andregulations.WHERE CAN I OBTAIN A BUILDING PERMIT APPLICATION?Building permit applications can be obtained at any one of our three MunicipalOffices located in Forest, Grand Bend and Northville.

THE MUNICIPALITY OF LAMBTON SHORESA HOMEOWNER'S GUIDE TO BUILDING PERMITSWHAT DOES THE PERMIT APPLICATION CONSIST OF?As of July 1, 2005, building permit applications submitted to municipalities mustuse the provincially mandated building permit application form. In addition to the"Application for a Permit to Construct or Demolish", there are Schedules for"Designer Information", "Sewage System Installer information", and "PlumbingInformation". Assistance with these forms can be obtained from the BuildingInspector. As an application can not be considered until it is "complete" there is acheck list provided o assist the applicant when completing the documentation.WHAT SHOULD I DO BEFORE I APPLY?It is very important to first inquire at your Municipal Office as to whether or not theconstruction you are proposing complies with the Municipal Zoning By-law. If itdoes not, you must then decide if you wish to proceed with the variance oramendment process - estimated time for an application to be processed,including required notice and appeal periods - 8-1 O weeks. Details of thisprocess can be obtained at the Forest Municipal Office.In order for your building permit to be processed in a timely manner, it isimportant to ensure that all requirements of outside agencies have been metBEFORE you submit your application. These requirements could include a septictank permit, approval of the Ministry of Transportation, or if your property is withina regulated area, a permit from the Conservation Authority. These permits mustbe obtained and submitted with the building permit application.WHAT OTHER INFORMATION MAY BE REQUIRED?HVAC (Heating, Venting and Air Conditioning) CALCULATION - Whenbuilding a new house, or if the planned renovations involve updating the heatingor air conditioning systems, the homeowner is required to submit an HVACcalculation completed by a qualified HVAC technician.PLANS - the Inspector requires 2 sets of building plans (floor plans, elevationsand cross sections, roof trusses, and heating as appropriate) for both largeprojects and smaller projects such as a garage or similar accessory buildings.SEPTIC TANK INSPECTIONS - For those properties serviced with private septicsystems, a septic review will be required if the proposed addition exceeds 15% ofthe existing area. In addition, a septic review will also be required if a planningapproval is necessary prior to proceeding (ie. minor variance, consent, zoneamendment). Inspection fee: 75.00 (payable to the County of Lambton)

THE MUNICIPALITY OF LAMBTON SHORESA HOMEOWNER'S GUIDE TO BUILDING PERMITSIS A PERMIT REQUIRED TO DEMOLISH A BUILDING?If an existing structure is being removed, you will require a demolition permit. Ifyou are rebuilding on the site, the demolition permit can be issued in conjunctionwith the building permit. If the building to be demolished is served with municipalwater and/or wastewater, the operating authority of these systems (OMI) mustcomplete the capping and all inspections. This inspection/permit fee is 150.00 inaddition to the demolition permit fee, if applicable.HOW LONG DOES IT TAKE TO GET A BUILDING PERMIT?When an application is submitted, the Building Inspector has 1 0 business days toreview the submission. If all the required information is provided, (including theseptic tank permit, if applicable) the building permit will be issue within the 1 Odayreview period. If during the review, the application is deemed incomplete, theapplicant will be notified as soon as possible of the documentation needed.Once the required documentation is received, the inspector has 10 businessdays to issue the permit.Providing all required information is submitted with the application, a permit willbe issued in the following times:Septic Tank permitHouses, Townhouses, etc.*Accessories structures serving the aboveSmall Commercial BuildingsFarm Buildings - under 600 m2Tents under Section 3-13 of the OBCSigns under 3-14 of the OBC10 business days10 business days10 business days15 business days15 business days10 business days10 business days* Time starts AFTER the septic permit has been issuedOTHERS:Large Buildings under Part 3Farm Buildings over 600 m220 business days20 business daysWHAT ARE THE APPLICABLE FEES?A building fee schedule is included with the building permit application form.Additional fees may be required and are listed below:

THE MUNICIPALITY OF LAMBTON SHORESA HOMEOWNER'S GUIDE TO BUILDING PERMITSBuilding Inspection Security Deposit (By-law 46 of 2007) - This fee isrequired to be paid at the time the building permit is issued. For majorconstruction the deposit is 750.00 and for minor projects, the deposit is 250.00. This bond will be refunded to the property owner once a final inspectionhas been completed by the Building Inspector.Development Charges (By-law 43 of 2008, as amended) - Developmentcharges are designed to have growth pay for new or improved infrastructurerequired to service the growth. Fees have been established for urban services water and wastewater services, plus municipal wide services. A complete copyof the Development Charges By-law and report can be obtained at any one ofour three offices. The municipal office can also advise you of the amountapplicable to your application.Plumbing permit fees - determined by the number of fixtures being installed asindicated on the drawings submitted.911 Sign & Post - 33.90 (if required)¾" Water Meter - 500.00 - *Price for larger sized meters can be obtained fromthe Community Services Department - 243-1400 or 1-866-943-1400Meter Pit - Price for meter pits can be obtained from the Community ServicesDepartment - 243-1400 or 1-866-943-1400ARETHEREFURTHERAPPLICATION IS ISSUED?REQUIREMENTSONCETHELOCATING UNDERGROUND UTILITIES:Homeowners needing to locate underground utilities can call Ontario One Call1-800-400-2255 or www.on1call.com. Please note Ontario One Call will locatewater, sewers, gas, telephone etc at no charge within 5 business days. Pleasenote, locates are good for 30 days only.WHEN DO I CALL FOR INSPECTIONS?During construction, several mandatory inspections are required to ensure thatall work is done in compliance with the approved plans and the Ontario BuildingCode. Inspections do not happen automatically - it is your responsibility toensure that either you or your contractor contacts the Municipality toarrange for an inspection. The required inspections are listed on the permit,and include ( but are not limited to) footings, foundation pre-backfill, framing,insulation-air and vapour barrier, completion of air barrier system, fireseparations, plumbing, HVAC, final interior and exterior.

THE MUNICIPALITY OF LAMBTON SHORESA HOMEOWNER'S GUIDE TO BUILDING PERMITSPlease note, the inspector must be able to see the part of the work to beinspected. Failure to have inspections performed may result in having touncover and expose work for inspection.Inspections must be booked at least 48 hrs in advance.MISCELLANEOUS:Foundation Survey - New House A foundation survey is required, and must besubmitted prior to final inspection. This is to ensure that the foundation is locatedin compliance with the zoning requirements.Site Plans for Additions or Accessory building - A site plan is to be submittedwith building permit applications for additions and accessory buildings. Thedrawing is to drawn to scale, and identify buildings and other features in relationto the property boundaries. Other pertinent information that will need to beprovided is the location of any easements or right of ways, and a calculation ofthe lot coverage. The property owner is also required to sign a form indicatingthat he/she has been advised of the required yard setbacks and that he/shetakes full responsibility for ensuring that the structure adheres to the setbacks.Grading Certificate - Before the final inspection, a grading compliance letter willneed to be submitted if required in the subdivision agreement.Home Insurance - during renovations, you may want to consider "homerenovation" insurance for the duration of the construction as such coverage isoften not part of a standard homeowner's policy.Restrictive Covenants - In addition to municipal requirements, development incertain subdivisions is subject to "restrictive covenants".Restrictive covenants are part of an agreement between the developers and theland purchaser. Property Owners are encouraged to review their deed and/orcontact the resident association in the area to determine any additional buildingrequirements.Asbestos testing - Homeowners should be aware of the potential requirementto have their homes tested for the presence of asbestos dependent upon thevintage of their home. If asbestos is present, it must be removed beforeconstruction commences. www.labour.qov.on.ca/english/hs/reg asbestos.htmlDID YOU KNOW.that on the Building Permit application form, a toilet isreferred to as a "water closet"? and R.W .L. stands for rain water leader.

THE MUNICIPALITY OF LAMBTON SHORESA HOMEOWNER'S GUIDE TO BUILDING PERMITSADDITIONAL PERMITS THAT MAY BE REQUIRED ARE:Plumbing and Septic:County of Lambton789 Broadway StreetWyoming, Ontario NON ITOPhone: 845-0801Electrical:Hydro One1-888-664-93761-866-324-6912Conservation Authority Flood and Fill Regulations:Area: Port Franks, Thedford, Arkona, Grand BendAusable Bayfield Conservation AuthorityContact: Andrew Bicknell or Geoff Cade71108 Morrison LineR.R. #3Exeter, Ontario NOM IS5www.abca.on.cae-mail: abicknell@abca.on.caPhone: 235-2610 1-888-286-2610Area: Forest, lpperwashSt. Clair Region Conservation AuthorityContact: Dallas Cundick205 Mill Pond Gres.Strathroy, Ontario N7G 3P9e-mail: dcundick@scrca.on.caPhone: (519) 245-371OMTO (if your property is in the vicinity of Highway 21):659 London RoadLondon, ONN6E 1 L3Related links: ww.mnr.gov.on.cawww.mmah.gov.on.ca(519) 873-4100www.mto.gov.on.caUtility locationsNew Home Registration (formerlyOntario New Home Warranty Program)MOS calculations & site regulationsSpecies at risk

Municipality Of Lambton ShoresFee Consolidation - Municipal FeesAs of January 19, 2018Consolidation for Convenience only, Please consult applicable by-law for full detailsTypeDescriptionCost Additional InformationCostTaxes (HST13%)By-law #if applicableN/A(BL 31-2012)Building FeesResidentialAny additional inspections above what isincluded in feeResidential dwellings, including mobile homes& park models - Main FloorAdditional living space – i.e.: second storey,basements(includes 5 inspections)Attached Garage in conjunction with apermit for a new residence(Includes 5 inspections)Residential – Additions(Includes 10 inspections)Minor alterations (no structural change –Value Under 2,500)Minor alterations (structural change – Valuebetween 900 and 2,500)80.00 per inspections 9.00 per square metreN/A(BL 31-2012) 4.50 per square metreN/A(BL 31-2012) 2.50 per square metreN/A(BL 31-2012) 9.00 per square metreN/A(BL 31-2012)N/A(BL 31-2012)no permit requiredno fee 25.00N/A(BL 40-2013) 200.00N/A(BL 40-2013) plus 9.00 per thousand dollar value over200.00 10,000*N/A(BL 40-2013)9.00 per square metreN/A(BL 31-2012)9.00 per square metreno permit requiredN/AN/A(BL 31-2012)(BL 31-2012)N/A(BL 40-2013)N/A(BL 95-2012)AlterationsAlterations – value between 2,500. – 10,000(includes 5 inspections)Alterations – value over 10,000(includes10 Inspections)Commercial, Institutional and IndustrialCommercial – Buildings and Additions Including patios and decks(includes 10 inspections)Institutional (Includes 10 inspections)Industrial – Manufacturing no feeAgriculturalFarm Structures – excluding dwellings 3.50per square metre, a minimum chargeof 300.00Green Houses, Manure Tanks & Feed Storage Bunkers (Without Roof)Structures from 0 - 600 square metres 650.00Structures from 600 -1500square 900.00metresStructures from 1500 square metres and up 1,150.00N/A(BL 95-2012)N/A(BL 95-2012)Fully Engineered Agricultural BuildingsBuildings from 0 - 600 square metresBuildings from 600- 1500 square metresBuildings from 1500 square metres and upDecks and Accessory StructuresDecks and porches – over 2 feet high(under18.58 square metres)Decks and porches – over 2 feet high (over18.58 square metres)Decks and porches with a roofAccessory Buildings - Pre-built between 10square metres and 15 square metresAccessory Buildings - under 10 sq. metersAccessory Buildings – between 10-67 sq.meters & Pre-built over 15 square metresAccessory Buildings– over 67 sq. metersSwimming PoolUpdated 16/08/2018 1,000.001,500.002,000.00N/AN/AN/A(BL 95-2012)(BL 95-2012)(BL 95-2012) 100.00N/A(BL 40-2013) 200.00N/A(BL 40-2013)N/A(BL 31-2012)9.00 per square metre 50.00no permit requiredno feeN/A(BL 40-2013)N/A(BL 31-2012) 250.00N/A(BL 40-2013) 5.00 per square metre150.00N/AN/A(BL 31-2012)(BL 40-2013)Municipal Fees 2017 - Building1 of 2

With Pool ShedDemolitionDemolitionAdditional Demolition fee if property servicedwith municipal water and/or sewerDepositsEngineered buildings or architect inspectedbuildings – Deposit to ensure submission offinal engineer’s/architects report (refundablewhen required reports submitted)Road Bond -When applicable (Refundableupon final building inspection)Building Inspection Security DepositBuilding Inspection & Grading CertificateSecurity Deposit 250.00N/A(BL 40-2013) 200.00N/A(BL 31-2012) 200.00N/A(BL 31-2012) 3,000.00N/A(BL 95-2012)N/A(BL 31-2012) - 250.00Small ProjectN/A(BL 31-2012) 750.00Large ProjectN/A(BL 31-2012)(Required on all permits – refundable upon final building inspection) – NOTE – the deposit is forfeited if the building permit lapses and will beused to compensate the municipality for additional inspections over the allowed number.Miscellaneous StructuresFireplace and wood burning appliances(when not in conjunction with a residentialdwelling permit)Wind TurbineMet (meteorological) TowersCommunications TowerTemporary Buildings under agreement w/mun 300.00N/A(BL 31-2012) plus 9.00 per thousand dollar value350.00of base / foundation350.00575.00N/AN/AN/A(BL 31-2012)(BL 31-2012)(BL 31-2012) 300.00N/A(BL 31-2012)MiscellaneousWater service inspection – existing dwellingEncroachment permitHourly rates N/AN/AN/A(BL 31-2012)(BL 31-2012)(BL 31-2012)Administrative Fee – Phased permits 100.00350.0080.00 per hourin addition to the calculated permit350.00feeN/A(BL 31-2012)N/A(BL 31-2012)N/AN/A(BL 31-2012)(BL 31-2012)N/A(BL 31-2012)N/A(BL 31-2012)N/A(BL 31-2012)N/A(BL 31-2012)Conditional Permit – Foundation only –(Agreement with municipality required)Transfer of PermitWithdraw of applicationApplication to use alternate solutions inobjective based 2006 codeChange of Use Permit Other structures designated as buildings in the code(includes 10 Inspections)5.00 per square metre150.0075.00plus 80.00 per hour of reviewDeposit 1,500400.00 plus 80.00 per required inspection350.00350.00 plus 9.00 per 1000PenaltiesBuilding without a permit 300.00plus 100% of the amount calculatedpermit feeWhen required, the value is determined by multiplying the number of square meters of the structure by 1,395.00square foot)Updated 16/08/2018Municipal Fees 2017 - Building( 130.00 per2 of 2

Application for a Permit to Construct or DemolishThis fom, is authorized under subsection 8(1.1) of the Bui/ding Code Act, 1992For use by Principal AuthorityApplication number:Permit number (if different):Date received:Roll number:Application submitted to:(Name of muni ipality, upper tier municipality, board of health or conservatlon authority)A. Project informationUnit numberBuilding number, street namePlan number/other descriptionPostal codeMunicipalityArea of work (m")Project value est. B. Purpose of applicationDNew constructionProposed use of buildingDAddition to anexisting buildingDLot/con.Alteration/repairCurrent use of buildingDDemolition ConditionalPermitDescription of proposed workC. ApplicantLast nameApplicant is: ,!Owner orFirst nameI !Authorized agent of ownerCorporation or partnershipUnit numberStreet addressMunicipalityPostal codeTelephone numberFaxD. Owner (if different from applicant)Last nameFirst nameProvinceE-mailCell numberCorporation or partnershipUnit numberStreet addressMunicipalityPostal codeTelephone numberFaxApplication for a Permit to Construct or Demollsh - Effective January 1, 2014Lot/con.ProvinceLot/con.E-mailCell numberPage 1 of 4

E.Builder (optional)Last nameFirst nameIStreet addressMunicipalityPostal codeTelephone numberFaxICorporation or partnership (if applicable)Unit numberProvinceE-mailILot/con.Cell numberF. Tarion Warranty Corporation (Ontario New Home Warranty Program)Is proposed construction for a new home as defined in the Ontario New Home WarrantiesPlan Acn If no, go to section G.ii. Is registration required under the Ontario New Home Warranties Plan Acni. IYes!Yes INo!Noiii. If yes to (ii) provide registration number(s):G. Required Schedulesi) Attach Schedule 1 for each individual who reviews and takes responsibility for design activities.ii) Attach Schedule 2 where application is to construct on-site, install or repair a sewage system.H. Completeness and compliance with applicable lawi) This application meets all the requirements of clauses 1.3.1.3 (5) (a) to (d) of Division C of theBuilding Code (the application is made in the correct form and by the owner or authorized agent, allapplicable fields have been completed on the application and required schedules, and all requiredschedules are submitted).Payment has been made of all fees that are required, under the applicable by-law, resolution orregulation made under clause 7(1)(c) of the Building Code Act, 1992, to be paid when theapplication is made.ii) This application is accompanied by the plans and specifications prescribed by the applicable by-law,resolution or regulation made under clause 7(1)(b) of the Building Code Act, 1992.iii) This application is accompanied by the information and documents prescribed by the applicable bylaw, resolution or regulation made under clause 7(1)(b) of the Building Code Act, 1992 which enablethe chief building official to determine whether the proposed building, construction or demolition willcontravene any applicable law.iv) The proposed building, construction or demolition will not contravene any applicable law.I. Declaration of applicantI2.l jNo YesI JYes YesQesNoNol jNo Nodeclare that:(print name)1.I JYesThe information contained in this application, attached schedules, attached plans and specifications, and other attacheddocumentation is true to the best of my knowledge.If the owner is a corporation or partnership, I have the authority to bind the corporation or partnership.DateSignature of applicantPersonal information contained In this fonr1 and schedules ls collected under the authority of subsection 8(1.1) of the Building Code Act, 1992, and will beused in the administration and enforcement of the Building Code Act, 1992. Questions about the collection of personal Information may be addressed to: a)the Chief Building Official of the municipality or upper-tier municipality to which this applicatlon is being made, or, b) the inspector having the powers andduties of a chief building official in relatton to sewage systems or plumbing for an upper-tter municipality, board of health or conservation authority to whomthis application is made, or, c) Director, Building and Development Branch, Ministry of Munlcipal Affairs and Housing 777 Bay St., 2nd Floor. Toronto, M5G2E5 (416) 585-6666.Application for a Permit to Construct or Demolish - Effective January 1, 2014Page 2 of4

Schedule 1: Designer InformationUse one form for each individual who reviews and takes res onsibilitv for desian activities with resnect to the aro;ect.A. Project InformationBuilding number, street namePostal codeMunicipalityIUnit no.Plan number/ other descriptionILoVcon.B. Individual who reviews and takes responsibility for design activitiesINameStreet addressUnit no.Postal code I ProvinceMunicipalityTelephone numberFirmE-maillloVcon.Cell numberFax numberC. Design activities undertaken by Individual Identified in Section B. [Building Code Table 3.5.2.1. ofDivision C]!.!HouseLJBuilding Structural Plumbing - Hause on-sitePlumbing - All BuildingsSewage SystemsUHVAC - HouseD Building ServicesD Small BuildingsD Large BuildingsR Detection, Lighting and PowerFire ProtectionFi Complex BuildingsDescription of designer's workD. Declaration of DesignerIdeclare that (choose one as appropriate):(print name)I review and take responsibility for the design work on behalf of a firm registered under subsection 3.2.4.of DivisionC, of the Building Code. I am qualified, and the firm is registered, in the appropriate classes/categories.Individual BCIN:Firm BCIN:I review and take responsibility for the design and am qualified in the appropriate category as an "other designer"under subsection 3.2.5.of Division C, of the Building Code.Individual BCIN:Basis for exemption from registration:The design work is exempt from the registration and qualification requirements of the Building Code.Basis for exemption from registration and qualification:I certify that:1. The information contained in this schedule is true to the best of my knowledge.2. I have submitted this application with the knowledge and consent of the firm.DateSignature of DesignerNOTE:1.For the purposes of this form, "individual" means the "person" referred to in Clause 3,2.4.7(1) (c).of Division C, Article 3.2.5.1. ofDivision C, and all other persons who are exempt from qualification under Subsections 3.2.4. and 3.2.5. of Division C.2.Schedule 1 is not required to be completed by a holder of a license, temporary license, or a certificate of practice, Issued by the Ontar ioAssociation of Architects. Schedule 1 is also not required to be completed by a holder of a license to practise, a limited license to practise,or a certificate of authorization, issued by the Association of Professional Engineers of Ontario.Application for a Permit to Construct or Demolish - Effective January 1 1 2014Page 3 of4

Schedule 2: Sewage System Installer InformationA. Project InformationBuilding number, street nameMunicipalityUnit numberPostal codeI Plan number/ other descriptionT LoUcon.B. Sewage system installerIs the installer of the sewage system engaged in the business of constructing on-site, installing, repairing, servicing, cleaning oremptying sewage systems, in accordance with Building Code Article 3.3.1.1, Division C?C. DYes (Continue to Section C)No (Continue to Section E)Registered installer information (where answer to B is "Yes") Installer unknown at time ofapplication (Continue to Section E)NameBCINStreet addressUnit numberMunicipalityPostal codeTelephone numberFaxI ProvinceD.Qualified supervisor information (where answer to section Bis "Yes")E.Declaration of Applicant:Name of qualified supervisor(s)ICell numberBuilding Code Identification Number (BCIN)declare that:(print name)ORE-mailI LoUcon.I am the applicant for the permit to construct the sewage system. If the installer is unknown at time of application, I shallsubmit a new Schedule 2 prior to construction when the installer is known;I am the holder of the permit to construct the sewage system, and am submitting a new Schedule 2, now that the installer isknown.I certify that:1.The information contained in this schedule is true to the best of my knowledge.2.If the owner is a corporation or partnership, I have the authority to bind the corporation or partnership.DateSignature of applicantApplication for a Permit to Construct or Demolish- Effective January 1, 2014Page 4 of 4

SCHEDULE 'A'Plumbing InformationOwner Name:Address of Proposed Work:Plumber:Municipality:Please list the number of fixtures per floor on the following chart.FLOORBasement12(new or relocated)3Total Number4ToiletBath tubWash basinKitchen sinkLaundry tubsFloor drainShowersUrinalClothes washerDish washer - domesticOther sinksDrinkina fountainHot water heaterSewaae PumpGrease lnterceotorTOTALNo. of Dwelling UnitsR.W.L.Water LinesSoil Vent StacksSanitary LateralOil InterceptorCatch BasinStorm LateralBackflow PreventerLawn Sprinkler SystemSignatureDate

A building permit is a formal to construct, add to, move or remove a building on property. The Ontario Building Code Act requires that a building permit be obtained for the construction of a new structure, or an addition or alteration of any structure which results in a

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c. For a Revision to an existing permit or shop drawings, select "Application for Revision/shop drawing". d. For Permit Extensions, select "Permit Extension". e. For a Re-issueof an expired permit, select "Permit Reissuance". f. For a Change of Contractor to a permit, select "Change of Contractor".