Application for PA Uniform Construction Code Permit

BOROUGH OF SCHWENKSVILLE

300 Main St., Schwenksville, PA 19473
APPLICATION FOR PA UCC CONSTRUCTION PERMIT
Municipality*
Development or Subdivision (if applicable)
Lot (if applicable)
Section (if applicable)
Proposed Work Site Address*
Tax Parcel ID*
Tax Parcel ID Lookup Tool
Is the Property within the Floodplain?*
What is the market value of the property?
Applicant Name*
Applicant's Email*
example@example.com
Applicant's Mailing Address*

Mailing Address

Street Address Line 2

CityState

Zip
Applicant's Home Phone*
Format: (000) 000-0000.
Applicant's Mobile Phone
Format: (000) 000-0000.
Applicant's Fax
Property Owner (if different than applicant)
Property Owner's Email
example@example.com
Property Owner's Mailing Address

Mailing Address

Street Address Line 2

CityState

Zip
Property Owner's Home Phone
Format: (000) 000-0000.
Property Owner's Mobile Phone
Format: (000) 000-0000.
Property Owner's Fax
Contractor
PA License
Insurance
Person in Charge of Work
Person in Charge Email
example@example.com
Contractor's Address

Mailing Address

Street Address Line 2

CityState

Zip
Contractor's Business Phone
Format: (000) 000-0000.
Contractor's Mobile Phone
Format: (000) 000-0000.
Contractor's Fax
Design Professional in Responsible Charge
PA License
Design Professional in Charge of Work
Design Professional's Email
example@example.com
Design Professional's Mailing Address

Mailing Address

Street Address Line 2

CityState

Zip
Design Professional's Business Phone
Format: (000) 000-0000.
Design Professional's Mobile Phone
Format: (000) 000-0000.
Design Professional's Fax
ResidentialNon-ResidentialOne-FamilyTwo-FamilyManufactured
AdditionAlterationsDeckElectricalElectrical ServiceFire SuppressionMechanicalNew BuildingPlumbingSwimming PoolRoofOther
YesNo
Existing Use*
Proposed Use*
Copy of signed construction contract

Cancelof
New Construction Square Footage
Number of Stories Above Grade
YesNo
Total Cost of Construction *
YesNo
Cost of Mechanical Work *
Number of Appliances*
YesNo
Cost of Electrical Work *
Number of Electrical Devices*
YesNo
Cost of Plumbing Work *
Number of Plumbing Fixtures*
ResidentialNon-ResidentialNew ServiceUpgrade ExistingOther
Work Permit No.
Meter No.
Phase
Voltage
Amps
UndergroundOverhead
Description of work*
THIS SECTION APPLIES TO ALL PERMIT APPLICATIONS
You must upload a Certificate of Insurance unless the homeowner is completing the project

If the Certificate of Insurance does not included Workers Compensation Insurance Coverage and liability, then you must complete the Workers Compensation Insurance Exemption Form. This form must be printed, signed and either delivered to the Borough or uploaded below.

All applications will be considered incomplete without this information.
Certificates of Insurance must name "Schwenksville Borough, Agents & Employees" as an Additional Insured
Work is being completed by homeownerWork is being completed by contractor
I will email the required documents to info@schwenksville-pa.org will upload the required documents to this applicationI will upload the required documents to this application
Upload Certificate of Insurance here:

Cancelof
*(3) SETS OF DETAILED CONSTRUCTION PLANS MUST BE SUBMITTED WITH ALL APPLICATIONS.* ALL COMMERCIAL CONSTRUCTION PLANS MUST BE PREPARED, SIGNED & SEALED BY A LICENSED DESIGN PROFESSIONAL FAILURE TO FILL OUT THE PERMIT APPLICATION COMPLETELY MAY RESULT IN DELAYS OR REJECTION OF APPLICATION
Upload Electronic Copy of Plans here:*

Cancelof
As the owner or the authorized agent of the project for which this application is filed, I certify that:

1. The inspector is hereby granted access to observe the work in this application upon coordination with the owner or his agents.

2. The estimated construction cost and all other information provided as part of this application for a building permit is correct.

3. The building or structure described in this application will not be occupied until all known code violations are corrected and a Certificate of Occupancy has been received from Building Code Official.

4. This project will be constructed in accordance with the approved drawings and specifications (including any required non-design changes) and the Uniform Construction Code standards as specified in 34 PA Code Chapters 401-405.

5. Any changes to the approved documents will be filed with the Building Code Official.

6. If the licensed architect or engineer in responsible charge of this construction should change, written notice of the change will be provided to the Building Code Official.

7. When required, up to 20% of the total cost of any work performed on an area of primary function in an existing building will be expended to provide an accessible route to the area of primary function or other approved accessibility improvements.

8. No error or omission in either the drawings and specifications or application, whether approved or not, shall permit or relieve me from constructing the work in any manner other than provided for in 34 PA Code Chapters 401-405.
Applicant Signature*
Date*

MonthDayYear
Date
Date Received

MonthDayYear
Date
Project Number
Plan Review Fee
Permit & Inspection Fee
Borough Administrative Fee
State Permit Fee
Total Permit Fee
Use Group
Code Edition
Construction Type
YesNo
Zoning Permit Number
NPDES Permit Number
Sewage Permit Number
Water/Well Permit
Permit Number
Approval Date

MonthDayYear
Date
UCC Approved by:
YesNo
Zoning Approval Date

MonthDayYear
Date
Zoning Officer Signature
Should be Empty:

BOROUGH OF SCHWENKSVILLE

APPLICATION FOR PA UCC CONSTRUCTION PERMIT