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Is
5.10
5.11
5.12
5.13
5.14
6.1
6.2
6.3
6.4
6.5
building is not yet completed, as provided in Division C, Subsection 1.3.3 of the OBC
.
Completion
Certi?cate
A completion certi?cate
a certi?cate that. as a result of a ?nal inspection. is issued
to indicate the satisfactory
completion of a construction project (building, foundation
or demolition). Where applicable. the completion certi?cate may also permit the
occupancy
of the building
Sign Permit
A sign permit is a type of building permit to install a sign within the City in accordance
with the C tys Sign By-law6-2006 as amended
and the Act.
Tent Permit
A tent permit is a type of building permit to erect a fabric covered structure.
A tent
permit is required in order to verify compliance with the City's Zoning By-law and the
Ontario Building Code.
Hoarding
Permit
A hoarding permit is a type of building permit to erect hoarding or a covered way on a
public street or laneway. or other City property with respect to a construction andlor
demolition project as required by the Occupational Health and Safety Act (Ontario).
Enquiry Response
An enquiry response is a written response by an authorized person on behalf of the
City to enquiries made regarding the use and development of a property and/or the
existence or status of any work orders with respect to the property.
PART 6
PLANS AND SPECIFICATIONS
Plans and Speci?cations submitted for permit purposes shall contain infonnation
that the Chief Building Official?nds suf?cient to enable the Chief Building Of?cial to
determine whether or not the proposed work.change of use or transfer of permit will
conform to the Building Code Act.the Ontario Building Code, such City By-Laws as
may be applicable, and/or any other applicable law.
Plans shall be drawn to scale on paper and shall be legible and be acceptable
to the
Chief Building Official. Every permit application shall, unless otherwise speci?ed by
the Chief Building Official, be accompanied
by two (2) complete sets of plans and
speci?cations
as described in this By-law.
Plans for Industrial, Institutional, Commercial and large Residential projects shall be
submitted with one (1) additional electronic copy of the plans in pdf fonnat or other
electronic media approved by the Chief Building Of?cial.
A site plan or plans shall be prepared by a quali?ed person. A site plan or plans shall
show:
.1
lot size and the dimensions of property lines;
.2
existing and proposed ground levels (elevations) and grades (slope), pattern of
proposed drainage and swales;
stonn water management
measures
as may be required;
existing rights-of-way, easements
and municipal services;
existing and proposed entrances
to the lot;
proposed erosion and sediment control measures during construction;
existing and proposed elevations of underside of footings. ?nished basement slab,
top of foundation wall and ?nished ?rst ?oor level; and
the location and dimensions of all existing and proposed buildings and structures
and measurements
of their respective setbacks to property boundaries.
on
kibabilisin
For purposes of permits for new work, the permit holder shall:
.1
provide to the Chief Building Official upon completion of the buildings foundation,
a survey by an Ontario Land Surveyor to con?nn compliance with the Ontario
Building Code.the City's Zoning By-law and the grading plan approved for the
development.
-()
BY-LAW
- 2016
Page 11 of 1
2
PART11
REVOCATION OF PERMITS
11.1
Prior to revoking a permit under subsection B.(10) of the Act, the Chief Building
11.2
12.1
12.2
12.3
12.4
12.5
13.1
13.2
Of?cial may serve a notice by personal service or registered mail at the last known
address of the permit holder, and, following a 30 day period from the date of service,
the Chief Building Of?cial may revoke the permit ifgrounds to revoke stillexist,
without any further notice
Apermit holder may within 30 days from the date of service
of a notice under this
Part request
in writing that the Chief Building Officialdefer the revocation.stating
reasons why the permit should not be revoked. The Chief Building Officialhaving
regard to then curren provisions of the Act, Ontario Building Code or any other
applicable law may con?nn the revocation or allow the permit to continue in effect and
attach any conditions thereto. Such permission
shall be given
in writing.
PART12
NOTICE REQUIREMENTS FOR INSPECTIONS
In accordance
with Sect on 10 2 1 of the Act a bui ding permit holder shall notify the
Chief Buiding Of?cial, or a Registered Code Agency where one is appointed, of each
stage of construction for which a mandatory inspection
is required under Division C,
Sentence 1.3.5.1. 2) of the Ontario Building Code.
In accordance with Section 11 of the Act.a demolition permit holder shall provide
notice to the Chief Building Officialafter each sewer service has been excavated and
sealed at the property line prior to back?lling, after the water service has been
excavated
and sealed at the main prior to back?lling. and again at the completion of
demolition work to ensure that the site has been back?lled and graded with clean ?ll
material to the satisfaction of the Chief Building Official.
A notice pursuant to this Part of the By-law is not in effect until notice is received by
the Chief BuildingOf?cial, his designate or a Registered Code Agency where one is
appointed.
Upon receipt of notice the Chief BuildingOf?cial, his designate or a Registered Code
Agency, where one is appointed, shall undertake a site inspection of the building
withintwo (2) business days for a notice to which Section 12.1 of this Part applies;
within ten (10) business days for a notice to which Section 12.2 of this Part applies;
and withinfive (5) business days for a sewage system permit.
For the purposes of Part 12 of this By-law, notice shall be given to the Chief Building
O?icial
using one or more of the following:
.1 Written notice by email at
;
.2 Verbal or written notice in person at the Customer Service desk or the Planning
and Building Services Department counter;
.3
Verbally by phone or voice mail to:
(519)
4
Other means as approved by the Chief Building Official.
:0!'
PART13
SCHEDULES
Schedules A and B shall form
art of this by-law.
.1
Schedule A
Permit Fee Calculation
.2
Schedule B
Permit Fee Rates
Schedule C is provided for information only and does not form part of this By-law.
The Chief Building Official may make changes to Schedule C forms from time to time
as may be necessary
without amendment to this by--law.
insgection@stthomas
ca
631-1680 ext 4500
Original signed by "Heather Jackson"
Original signed by "Maria Konefal"
Permit type
Flat lee
Commercial KitchenHood (new or alteration)
200.00
Change oi Use
150.00
Transfer of perrnil ownership
100.00
Construct or alter driveway approach
I
100.00
Additionalinspection
I
100.00
Partial occupancy certi?cate
150.00
Altemalive Solution review
300.00
Liquor License clearance letter
100.00
Enquiry response
letter
90.00 + HST
Femrlf type
Single detached residential and residential accessory
buildings
Flat In
'200.00plus security deposit
Any Part 9 building (except single detached and accessory)
'500.00plus security deposit
Any Part 3 building
'75D.O0
plus security deposit
Any demolitioninvolving implosion
'1.5oo.oo
plus security deposit
SCHEDULE
B
PERMIT FEE RATES
E. DEMOLITION
The appropnate security deposit shall be detemiined by the Chief BuildingOflicialbased on the nature and
size
of the proposed demolition.
F. SIGNS,TENTS & MOVING
Parmlt type
Flat fee
I
Pedestal I Ground I Pylon sign
250 00
|
Retractable
Canopy or rigid sign overhanging public
10 00 |
roads in DowntownArea
'
Other permanent
signs not listed above
100 on I
Tent
100 00
Moving building
oversized load
100 00
' NOTE: The DowntownArea is as depicted on Schedule C of the Sign By--law6-2006,
as amended. This permit fee applies onlyto canopies
or signs approved by
and erected forthe DowntownDevelopment Board.
G. MISCELLANEOUS
H. OTHER PERMITSNOT LISTED ABOVE
Permit Fee = $9.75 times the value of construction
(rounded up to (he nexl even than and) divided by
1.000
minimum
IS $150.00
By law
2016
x"l,.'-'7j",."'Ix
[vii
i'
By-law
» 2016 Schedule C
Form 1
Application
for a Permit to Construct
or Demolish
'
'
'
d nder subsection 8(1 1)oi the Building Code Act, 1992
ST. THOMAS
For use by Principal Authority
Application num
r.
Permit num
r (ifdifferent):
Date received:
Roll numben
Application submitted to:
St.
(Name of municipality. upper-tier municipality, board at health or conservation authority)
A.
Project information
Building number. street name
Unitnumber
Lotlcon.
Pasta code
Plan numberlother description
Municipality
st. Thomas
Project value est. $
Area of work (m')
B. Purpose
of application
D
New constmction
U
Addition to an
E
Aiterationlrepair
El
Demolition
D
Conditional
existing building
Permit
Proposed
use of building
Current use of building
Description of proposed work
C. Applicant
Applicant is:
Owner
or
D Authorized agent of owner
Last name
First name
Corporation or partnership
Street address
Unitnumber
Lotloon.
Municipality
Postal code
Province
Cell number
i
)
Telephone number
Email
Fax
(
)
(
)
D.
Owner (if different from applicant)
Last name
First name
Corporation or partnership
Street address
Unitnumber
Lotlcon.
Municipality
Postal code
Province
Cell number
Telephone number
Email
Ii=ax
)
(
)
(
)
Application tor a Pennit to Construct or Demolish
Efiedive January
1 2014
IS
O
4' $4
Thxslonn IS authorize
__1_:
nu
rnu-um-um-ruu.«m«
60
(print n
e)
' fo
ation con a' e
I
is application. at a
e
s
les. attached plans and speci?cations, and other attached
cu
e taio
is me to the best of my knowledge.
2.
it
0
er isacorporation
or partnership.|ha
e
e
u
only to bind the corporation or partnership.
Date
Signature oi applicant.
Personal informationcontained in this form and schedules is collected under the authority of subsection 8(1 1) of the Building Code Act, 1992, and willbe
used in the administration and enforcement of the Building Code Act, 1992 Questions about the collection at'personal inionnation may be addressed to
a) the Chief Building Official of the municipality or upper-tier municipality to which this application is being made
or b) the inspector
having the powers
and duties of a chiei building oi?cial in relation to sewage systems or plumbing ior an upper-tier municipality board of health or oonservatinn authority to
whom this application is made
or 1:) Director Building and Development
Brandi
Ministry of Municipal Affairs and Housing 777 Bay st
2nd Floor
Toronto MSG 2E5 (416) 585-6666
Application for a Permit to Construct or Demolish
Effective January
1 2014
By-law
- 2016 Schedule C
Form 1/2
E.
Bullder (optional)
ast name
irst name
Corporation or partnership (if applicable)
Street address
Unit number
Lollcon.
Municipality
Postal code
Province
Cell number
(
)
Telephone number
Emai
Fax
(
)
(
)
F.
Tarion Warranty Corporation (Ontario New Home Warranty Program)
is proposed construction for a new home as de?ned in the Ontario New Home Warranties
E]
Yes
D
N
o
Plan Act? Ifno, go to section G.
ii
is registration required under the OntarioNew Home Warranties Plan Act'?
I]
Yes
D
N
o
iii Ifyes to (ii) provide registration number(s)
G. Required Schedules
i) Attach Schedule 1 for each individualwho 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
law
') This application meets all the requirements of clauses
1.3 1.3 (5) (a) to (d) of DivisionC of the
E]
Yes
D
N
o
Building Code (the application is made in the correct tom and by the owner or authorized agent,
all
applicable ?elds have been completed on the application and required schedules
and all required
schedules are submitted)
Payment has been made of all fees that are required, under the applicable by-law resolution or
Y
regulation made under clause 7(1)(c) of the Building Code Act, 1992, to be paid when the
El
es
application is made.
ii) This application is accompanied
by the plans and speci?cations prescribed by the applicable by-law,
D Yes
resolution or regulation made under clause 7(1 )(b) of the Building Code Act, 1992.
in)This application is accompanied by the inlorrnalion and documents
prescribed by the applicable by-
D
Yes
law, resolution or regulation made under clause 7(1)(b) of the Building Code Act, 1992 which enable
the chief building official to detennine whether the proposed building, construction
or demolition will
contravene any applicable law
v) The proposed building. construction or demolition wi
not contravene
any applicable law.
D
yes
N
o
N
o
No
El
EIEJEJ
No
I. Declaration of applicant
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Project
It
ress of Project
Munici
WHEREAS the Building Code Act prohibits
the construction
or demolition ot a building
It a permit authorizing
the constructi
n
r demolition
has not been issued. and
WHEREAS the
Building
Code
requires
that the
construction
or demolition
ot the project
indicated
have
general
r view undertake
by
architects andlor protessional
engineers
that are licensed to practice
in Ontario, and
WHEREASgeneral
review shatl not commence until it pennit
is issued.
NOW THEREFOREthe Owner who intends to construct or
or have the project indicated c
or dern
con?rms that
1 The undersigned architect s armorprptessional
engliee
s have been retained to undertake genera
review mine
or demo?tton ot the
protect indicated to detennlne
r cons
'
or dernolibon orthe protect indicated is in general
contonnity with the plans and other dociments
that tom
the basis for the
'
at a permit. with general
review undertaken
in accordance with the performance
standards of
e Ontario
Association ot Architects (OAA andlor Protessioria Erigneers Ontario PEO ,
2. Allgeneral review
reports bythe architect s andlor
l
s will be torwarded prornptty to the Chret Buildng Ofticial
3 Should any retained architect or
rotesstonat engiieer
cease to provide general review tor any reason or
c
e Ctr t
Building Otlicralwill be noti?ed
'
immediately
and another architect or p
essiona
engi eer
retained so that
ew con hues
without interruption;
4 Construction or e
at the
'
indicated will only be undertaken
it architectts andlor profession
en
5 are
undertake
general
review
and a permit
'
'
the construction or dernolitiori has been issued, and
5 Theari:hrtect(s
andlorprot
'
'
stlistedbelowwilbenotifiedinwntirigotlhestartdaeot
'
or
ottheproiect
indicated and that no r:
'
or
WIIIcommence betore the start date given inthe noti?cation.
The undersl
d hereh
certi?es
that he or she has read and
rees to the above.
Owner's Company
arne
Frst and Last Name
Signature
Date
Owners Address
F
Erna
00
pan
na
e
title I".
'
o the vain
'
prote
a engineers
First and Las Name
A
Email.
The undersigned
architect s a
pint
eriglieerts
declare that they are It
to practice
in
and have been retained to
undertake geneml
review
of the parts ot construction or demolition at the project indicated to determine whethe the 1:
ion or
5 I
general
conlormily with the plans and other docirnents that tonn the basis tor the issuance
of a perm l, with general
review
completed
accordance
withthe
ertonnance standards ot the OM andlor PEO
U ARCHITECTURAL
D STRUCTURAL
U MECHANICAL
D ELECTRICAL
U SITE SERVICES
U OTHER:
Company Na e
First and Last Name
rgnature
Date
Address
Telephone
Fax.
Erna
D ARCHITECTURAL
D STRUCTURAL
CIMECHANICAL
U ELECTRICAL
CISITE SERVICES
D OTHER:
Company Name
First and Last Name
5
nature
Da e
Address
Te
F
Erna
U AR HITECTURAL
U STRUCTURAL
D MECHANICAL
D ELECTRICAL
U SITE SERVICES
D OTHER'
mpany Name
First arid Last Name
ignature
Date
AOGTESS
TE
E
Fax.
E
2|
DARCHITECTURAL D STRUCTURAL
U ME HANICAL
U ELE TRICAL
[1 SITE SERVICES
UOTHER
mpany Na e
First and Last Name
3
atirre
Da e
Address
Tetep
e
Fax
By-law
2016 S: e ue
Form
OWNER
COMMITMENT
T0 NA VE GENERAL REVIEW
UNDERTAKEN
Engmeas Architectsand
D?icbls
slzndudlonn
by AA,PE and
It of al ardmects and
ssso
n
Telephone.
'L
By-law
2016 Schedule C
Form 3
H 9'
ST ?'10MA5
Schedule
1: Designer
Information
Use one form for each individualwho reviews and takes responsibility for design activities with respect to the project.
A.
Project Information
Building number.street name
Unitno.
Lot/con.
Municipality
st. Thomas
Postal code
Plan numberl other description
B.
individual who reviews and takes responsibility
for design activities
Name
Finn
Street address
Unit no.
Lotlcon.
Municipality
Postal code
Province
Cell number
Qielephone
nurnber
Ema'i
i=(ax
i1Ui"l;:Jei
'
C.
Design activities
undertaken by individualidenti?ed in Section B
[Building Code Table 3.5.2.1. of DivisionC]
House
HVAC
-- House
Building Stmcturai
Smal Buildings
Building Services
Plumbing
-- House
Large Buildings
Detection.Lighting and Power
Plumbing
-- AllBuildings
Complex Buildings
Fire Protection
On-site Sewage Systems
Description of designefs
work
D.
Declaration of Designer
I
declare that (choose one as appropriate):
(print name)
Ireview and take responsibility for the design work on behalf of a ?n11registered under subsection 3.2 4.of Division
C. of the Building Code
I am quali?ed, and the ?rrn is registered,
in the appropriate classes/categories.
IndividualBCIN:
Finn BCIN:
I review and take responsibility for the design and am quali?ed in the appropriate
category as an "other designer'
under subsection
3.2 5 of DivisionC, of the Building Code.
Individual BCIN.
Basis for exemption from registration-
E]
The design work is exempt from the registration
and quali?cation requirements
of the Building Code
Basis for exemption from registration
and quali?cation
I certify that.
1
The iniorrnationcontained
in this schedule is tme to the best of my knowledge
2
Ihave submitted this application withthe knowledge and consent of the Finn
Date"
Signature oi Designer
NOTE
1
For the purposes oi this iorrn 'individual' means the person reierred to In Clause 3 2 4 7(t ) (c) of Division C, Article3 2 5 1 oi
DivisionC and all other persons who are exempt from quali?cation 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 certi?cate oi piac?ce
Issued by the Onlano
Association oiArctiitects
Schedule 1 is also not required to be completed by a holder oi a license to practise
a limitedlicense to practise
or a certi?cate of authorization issued by the Association oi Professional Engineers of Ontario
3
Personal infonriationcontained in this iorrn is collectedunder the authonty oi subsection B(1 1 of the Building Code Act, 1992 and willbe
used in the administrationand enforcement of tiie BuildingCode Act, 1992
.""'!
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71'
uu.nIIn
By-law la
- 2016 Schedule C
Form 4
:9 'M
ST. THOM \S
Schedule
2: Sewage
System
Installer Information
A.
Project Information
Building number, street name
| Unitnumber
Lollcon.
. .
.
Pl
. .
Municipality
St. Th 0 ma5
Postal code
I
an numberl other description
3.
Sewage
system
installer
Is the installerof the sewage system engaged in the business of constructing on-site, installing, repairing, servicing, cleaning or
emptying sewage
systems.
in accordance
with Building Code Article3.3.1.1, Division C?
D
Yes (Continue to Section C)
E]
No (Continue to Section E)
D
Installer unknown at time of
application (Continue to Section E)
0.
Registered
installer Information (where answer
to B is "Yes")
Name
BCIN
Street address
Unitnumber
I
Lol/con.
Municipality
Postal code
Province
Cell number
;l'elephi)3ne
number
Email
E=ax
))
D.
Quali?ed supervisor
information
(where answer
to section
B is "Yes")
Name of quali?ed supervisor(s)
Building Code identi?cation Number (BCIN)
E.
Declaration
of Applicant:
I
declare that:
(print name)
I am the applicant for the permit to construct
the sewage
system
Ifthe installer is unknown at time of application, I shall
submit a new Schedule 2 pnor to construction when the Installer is known
E
D
Iam the holder of the permit to construct the sewage
system
and am submitting a new Schedule 2, now that the installer
is known
I certify that.
1.
The information contained
in this schedule is true to the best of my knowledge.
2.
Ifthe owner is a corporation or partnership, l have the authority to bind the corporation or partnership.
Date
Signature of applicant
Personal informationcontained in this lonn is collected under the authonty of subsection B(1 1)of the Building Code Act, 1992 and
willbe used in the administration and enioroementof the Building Code Act, 1992
.
-1-"
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1
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hdlc
H1
By law
2016 Sc e u e
ST. THOMAS ENERGY SERVICES
INC.
UTILITYAND EASEMENT CLEARANCE APPROVAL
RESIDENTIA
OM ER IA
INDUSTRIAL
CONSTRUCTION
A SITEPLANWITH DETAILSAND MEASUREMENTSOF THEPROPOSED
STRUCTUREMUST ACCOMPANYTHISAPPLICATION
SIGNATURE
A
NO PART OF THE BUILDINGOR STRUCTURE SHALL
ENCROACH OR OVERHANG ONTO EASEMENT
Application for Approval must be made to St. Thomas Energy Services located at
135 Edward Street
Phone No. 519-631-5550 ext 235
Fax No. 519-631-2243
Operations Dept
D
The work location and details 0 t e o
descnbed above are CLEAR of any underground
electrical cables.
D
The work location IS not clear of underground electrical cables and a locate has been provided.
This locate expires
in thirty days
CAUTION: This locate is based on information given at the time. Any changes
to the location
or nature
of work will require a new locate.
Pennit Denied:
D
De
Pemlil Approved: 3
Conditions on Approval
Address of construction:
Work being done'
Area of work.
I:
FRONT
Owner'
Name
I]
REAR
Cl suns
Address.
Phone'
Dale work to begin-
OFFICE USE ONLY
REVIEWEDBY
COMMENTS
Engineering Dept
j
,.j- »-..
.,_,1'_-
yl
[§02osshdIc
B--aw
-
1
ceue
Form6
Building Services Department
City HallAnnex
P.O. Box 520, 545 Talbot Street
City of St. Thomas
St. Thomas, ON
N5P 3V7
UTILITY CLEARANCE FORM
*
Telephone:
519-631-1680
DEMOLITION PERMIT
F"
5'°""3"2'3°
website:
www.5tthomas.ca
Prior to application and issuance of a permit for the demolition of buildings in the City of St. Thomas.this
form must be completed and ?led in support of the demolition application.
APPLICANTTO COMPLETETHE FOLLOWINGINFORMATION:
Property Location:
Date ol Application:
Type of Building:
is this a corner
lot?:
Yes
No
OWNER
CONTRACTOR
Name:
Name:
Address.
Address
City'
City'
Postal
Postal
Phone
Phone
Email
Emal
Applicant to obtain clearance from the following listed of?ces for the demolition of the buiIding(s)
described above:
AGENCY
APPROVAL
SIGNATURE
APPROVAL
DATE
Fire Department
Na"
305-311 Wellington Street
St. Thomas. ON N5R 2T2
T' 519-631-1660 ext 4184
F. 519-631-2015
Name:
BellCanada
T 519-633-6140
F. 519-633-1188
Union Gas Ltd
"'"'°
109 Commissioners Road W
London. ON
NBA-1P1
T 519-667-4100
F 519-667-41 70
St. Thomas Energy Inc.
"'"'°
135 Edward Street
5| Thomas. ON
NSP 4A8
T 519-531-5550
F 519-531-2243
Publicworks
"""°-
1ODBurwellRoad
St Thomas ON N5P 3R8
T 519-631-0368 ext 10
F 519-631-5542
Rogers Cable
T 519-660-7527
F 519--G72--0199
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By-law l6o-2016 Schedule C
:9 9'
Form 7
Application
for a Temporary
Tent Permit
For use by Principal Authority
Penriit number:
Date Issued:
ST. Tl-lO\[
\S
Date received:
Rollnumber'
A.
Project information
Building number, street name
Unitnumber
Lotlcon.
Municipality
st. Thomas
Postal code
Plan number/other description
Project value est $
No. oi tents.
B. Purpose of application
Event
Alcoholserved
Sides open
Food sewed
Sides enclosed
Chairs and tables
Site plan provided
Date of tent installation"
Date of tent removal:
C. Applicant
Applicant is:
Owner or
_
Authorized agent of owner
Last name
First name
Corporation or partnership
Street address
Unit number
Lotloon.
Municipality
Postal code
Province
Cell number
(
)
Telephone
number
Email
Fax
(
)
(
)
D.
Declaration of applicant
I
declare that:
(print name)
1.
The information contained in this application, attached schedules,
attached
plans and speci?cations.
and other attached
documentation is true to the best of my knowledge.
2.
Ifthe owner is a corporation or partnership. I have the authority to bind the corporation or partnership.
Date:
Signature oi applicant:
ADDITIONAL INFORMATION REQUIRED for TENT PERMITS
Site Plan:
A site plan shall include the property lines and all buildings and structures
located on the
property.
All proposed
tents shall be located on the plan with setback dimensions to
property lines, structures
and other tents.
The site plan should include the location of all
parking spaces.
any proposed privies and any temporary fencing for any assembly area.
Floor Plan:
Covering:
If a tent is to utilize sides or be provided with table and chairs, a floor plan shall be
provided showing aisles and exits.
A certi?cate of ?ame
resistance
of the tent covering
material,
as provided by the tent
supplier. in conformance with CAN/ULC-S109, "Flame Tests of Flame-Resistant Fabrics
and Films", or NFPA 701 "Fire Tests for Flame-Resistant
Textiles and Films" shall be
provided.
Personal infonnatlon contained in this formis collected under the authority of subsection 8(1 1) of the Building Code Act, 1992, and
willbe used in the administration and enforcement of the Building Code Act, 1992
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By-law
- 2016 Schedule C
Form 8
Application
for Transfer
of Permit Ownership
Q* q'
For use by Principal Authority
Pemiit number:
ST THOMAS
Date received
Ro number
A.
Project
information
Building number, street name
Unit number
Lot/con.
Municipality
Postal code
Plan numberlother
description
St. Thomas
B. Applicant
Applicant is:
E] Owner or
|:|
Authorized agent of owner
Last name
First name
Corporation or partnership
Street address
Unitnumber
Lotlcon.
Municipality
Postal code
Province
Cell number
(
)
Telephone number
Email
Fax
(
)
(
l
D.
Declaration
of Applicant
I
declare that:
(print name)
1.
The information contained in this application is true to the best of my knowledge.
2.
ifthe owner is a corporation or partnership, i have the authority to bind the corporation or partnership.
Date
Signature of applicant
C. Permit Owner
Last name
First name
Corporation or partnership
Street address
Unit number
Lot/con.
Municipality
Postal code
Province
Telephone
(
)
D. Declaration
of Permit Owner
I
declare
that:
(print name)
1.
I agree to the transfer of ownership of the above mentioned permit.
2.
The information contained in this application is true to the best of my knowledge.
3.
ifthe permit owner is a corporation or partnership, I have the authority to bind the corporation or partnership.
Date'
Signature of applicant:
Personal inionnation contained in this ionn is collected under the authority oi subsection B(1 1)oi the Building Code Act, 1992 and
willbe used in the administration and enforcement oi the Building Code Act, 1992
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By-law
2016 Schedule C
Form 9
:9 9'
ONTARIOBUILDINGCODEANDSUPPLEMENTARYSTANDARDSB-10
DETAILEDFORMS
PROJECTINFORMATION
Pl'O]ECI'
Locat on
BuildingPermit Application No
Date
ArchitecturalDesigner
Mechanical Designer
in
tion'
in
I
tlon
City
Date(YY/MM/DD)
Date(YV/MM/DD)
Signature
Date(YV MM/DD)
'lFM as DE IGNERSAIIEINVDLVEDFROVIDEADDITIDNALCDPIDFTHI FORM
TN5 CIIECXL
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UMENT N VANDI
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IREMENTSDECRBEDINTHE ONTARD
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HEY PF
1OBC SB-10 COMPLIANCESUMMARY
[
Energy Efficiency Design'
are are
ureneryycompranceapaon
t
meett
erequ
rem nt
CSB
0Diws:on2
Pleasesele tthe
nf nnan e
ptwn
Iected
rthis project. Theenergye/ficiency
Ilbutidingsmu
bedesigned
t
Compliance Path
Forms to
Complete
(A 1
by not lessthan 25% the energy ef? iency ev
5 attain
by onformlrg to the CCBF.'Mod l
[IVE
FORM A
National E
rgy
for Buiidl
(MNECB)
Note that this compliancepath requires that the prupa ed building is drawn to consume at ieast25!6 less energy
than the MNECBrgerencebuildingwhen modelled acconilng tn the procedures outlined in Part 8 atthe MNECB.
(A
e by not less than 5%!
energy efflcl no; levels attai
by conforming to the AN I/ASHRAE/IESNA?YES
FORMA
90 1
2010 'Energy Standardfor Bulidi
Except Law-RI
Residential Building
"
Nate that this carnpllancepath requires that the prapased building is shown to
nsurne at least 576less enemy
than the ASHRAE90.1 2010 referencebuilding when modelled according to the procedures
outlined in Chapter
11 o[A5l-IRAE90.1-2010.
Note that this path cannot be usedfora building with electric space heating. Referto Q
10.
(B)Achl v th
rgy IIICI
ylev I attal
dby
nfurmln tothe ASHRAE
1
1
'En rgyitandard for
?YES
FORMS
Building Ex ept
w R se ilesi entlai Buildings' an
Div slon
of is
Thiscompliance path Includesbothprucriptive and performancepath aptlans.
Please praceed to Farm 8
(C Achiev the n rgy
liiclency level attained by
nf rrnin to th
NE 8
11 National E
rgy Code oi Canada
EYES
NE 8 For
m;
I raulldl
andDlvl I n
IB1
Thiscarnpllance path includes both prescriptiveand perfarvnancepathoptions
Please proceedto NECBRmns
L
O D
GAND
EQUIREMENTOFTHEONTARI
E
C
S
ASSU
SPONS
BUILDW
OD
[ .
R
E5
5
SBASEDO
T E
IS
E
5
TO
U EACCU
0
EV
E
EQU
S EST
5
O EG.332/
12
GU
S
S ESU
$1161)
Nae
Numbering
Isbasql
on Sledulon of ASHRAE90.1 2010
ST THO\I
\S
)Exceed
2)Exce d
Code
MS
90
20 0,
DT
TNJT
NSCTO
foe
4
B. Compliance
Option
[indicate the building code compliance option being employed
I? this house design]
I]
SB-12 Prescriptive(circIeone): A B C
D E F G
H I J
K L M
or
ClTable 2.1.1.10. (Additions)
Elprescriptive trade-offs used (Specify 2.1 1.2. or 2 1.1.3. sentences
being employed):
El SB-12 Performance'
[SB-12 - 2.1.2]
El Energy Stai®'
[SB-12
- 2.1.31
El EnerGuide 80®
"
C. Project Design Conditions
' Attach energy perionnance
calculations using an approved software
' Attach Builder Option Package
[BOP] tom-i
' House must be evaluated
by NRCan advisor and meet a iating of B0
Climatic Zone (SB-1):
Heating Equipment EfficiencLSpace Heating Fuel source
a Zone 1 §< 5000 degree days)
D 2 90% AFUE
Cl Gas
Propane
Solid Fuel
in Zone 2 (2 5000 degree days)
El 2 78% < 90% AFUE
in Oil
Eiectnc
Earth Energy
Ratio of Windows. Skylights & Glass (W. S & G) to Wall Area
Other Building Conditions
Area oiwalls
=
rn'
W S 8'G
=
ICF Basement
Walkout Basement
LoglPost&Beam
Area nl W. S 5 G -
in
ICF Above Grade
Slab-on-ground
D. Building Speci?cations
[provide values and ratings of the energy eiiiciency components proposed.
or attach Energy Star BOP fonnl
Building
Component
RSI I R values
Building component
Efficiency
Ratings
Thermal Insulation
Windows 8. Doors
Provide U-Value inw/m'.i<,or ER rating
Ceiling withAttic Space
Windows/Sliding
Glass Doors
Ceiling without Attic Space
Skylights/GlazedRoofs
Exposed Floor
Mechanicais
Walls Above Grade
HeatingEquip.(Ai=uEor condensing
type)
Basement Walls
HRV Ef?ciency (sRE% at 0°C)
Slab (all >600mm below grade)
DHW Heater (EF)
Slab (edge only 5600mm below grade)
DWHR(CSAB55.1 Efliciency)
Slab (all 5600mm below grade. or heated)
E. Performance
Design Veri?cation
[complete applicable sections it SB-12 Perlonriance. Energy siar or EnerGui'i1e80options used]
SB-12 Performance:
The annual energy consumption using Subsection 2.1.1. SB-12 Package
The annual energy consumption of this house as designed is
The software used to simulate the annual energy use of the building is:
The buildingis being designed using an air leakage of
is
Gj (1 G.=1000Mj)
Gi
air changes per hour @50Pa.
Energy Star. Submit the BOP fonn with EnergyAdviser's certi?cation on completion
Energy Star and EnerGuide80:
EvaluatnrlAdvisor/Rater Name:
EvaluatorlAdvIsorIRater Licence it'
F.
House Designer
[name &BCIN.if applicable. o person providing inionnaiion herein to substantiate that design meets the building code]
Name
BCIN
Signature
roim authorized by OHM, OIOA, LMCBO Nevis-d uoumbu
21 2013
??1?I
name
'Munmupauy
Poslal cone
Keg
Han
mlnner
I olner assmpnon
Form 10
Energy
Ef?ciency
Design
Summary
(Building Code Pan 9, Residential)
5
0I'l'11IS used b a desln
r o
emonslrate
that the ene -
e
clenc
desln
o a house comlies
wilhthe buildin
code
Foruse
-
Pnnu|Au
.
A. Project Information
§
?]