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APPLICATION FOR UCC BUILDING PERMIT
Check that applies
EXPEDITE REVIEW. ADDITIONAL FEE SUBMITTED.
ACT 24 EXEMPTION
Site Information
Political Subdivision and County names are required.
Facility Name (name of company, mall, institution, university, etc.):
Building and/or Tenant Name
Street Number and Name
City
Political Subdivision:
County
Application Type
Application Type
Accessibility Only Review
Addition
Alteration or Renovation
New Building
New Structure/Facility
Partial Occupancy
Phased Approval
Plan Revision/Deferred Submission
Uncertified (Existing) Building
Use/Occupancy Classification:
Check box to left of applicable group. Check all that apply.
Use/Occupancy Classification
A-1
A-2
A-3
A-4
A-5
B
E
F-1
F-2
H-1
H-2
H-3
H-4
H-5
I-1
I-2
I-3
I-4
M
R-1
R-2
R-3 Adult Care
R-3
R-4
S-1
S-2
U
Single Family Dwelling/Townhouse (must be state-owned)
Mandatory Documents
Check each block below indicating that all of the following will be submitted with this application:
Mandatory Documents
Four (4) site plans
Three (3) assembled and bound sets of construction drawings
One (1) completed copy of the UCC-2 UCC PLAN REVIEW CHECKLIST
One (1) set of specifications (only if Addition, Alteration, New Building/Structure/Facility)
Special Requirements & Documentation
Does this construction involve modular units built in a factory?
Yes
No
If “Yes,” submit 1 copy of the letter described in Section J., 6., on the “Plan Review and Inspection Requirements” page on the UCC website.
Is this construction regulated by the Health Care Facilities Act?
Yes
No
If “Yes,” submit 1 copy of the approval letter issued by the PA Department of Health.
Is this construction exempt from energy code requirements?
Yes
No
If “Yes,” submit 1 copy of a letter indicating that the building or structure will use neither electricity nor fossil fuels, and thus is exempt per ASHRAE 90.1, §2.2(B). If “No,” submit 1 copy of the compliance documentation described in Section H., 7., on the “Plan Review and Inspection Requirements” page on the UCC website.
Is project in flood hazard area?
Yes
No
If “Yes,” submit 1 copy of one of the flood hazard certifications mandated in section 1612.5 of the International Building Code.
Are International Building Code (Chapter 17) special inspections or structural observations required?
Yes
No
If “Yes,” submit 1 copy of the UCC-6 SPECIAL INSPECTIONS OBSERVATIONS STATEMENT.
Will an alternative construction method or material be used on this project?
Yes
No
If “Yes,” submit a signed statement indicating that the proposed method or material meets the requirements of 34 PA Code §403.44.
Is this application for “phased approval”?
Yes
No
If “Yes,” submit the statement described in Section D., 4., on the “Plan Review and Inspection Requirements” page on the UCC website.
Project Data
Number of stories above grade
Does it have a basement?
Yes
No
Total floor area (sq. ft.)
Floor area new construction (sq. ft.)
Floor area of addition (sq. ft.)
Floor area renovated (sq. ft.)
Estimated cost of construction $
(Required -- even if project is state-owned and exempt from permit fees.)
Type(s) of construction per Chapter 6 of the International Building Code (check all that apply):
IA
IB
IIA
IIB
IIIA
IIIB
IV
VA
VB
Fire Supression:
Full
Partial
None
If application applies to an existing certified building, provide any prior file #, DI #, permit #, etc. associated with this project:
File #
Permit #
DI #
Other (MA #/Fee #)
Building Code Data
Triennial ICC code version used for Building code compliance:
2015
2018
If Alterations to existing certified building: (select applicable document used)
IBC Chapter 34
International Existing Building Code (IEBC)
Accessibility Code Data
Triennial ICC code version for Accessibility code compliance/IBC Chapter 11
2018
2021
Design Professional In Responsible Charge
Seal must be in space to right of name & address
Name
Address
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Email
Phone
Fax
Owner Information
Owner Name
Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Phone
Deferred Submissions
If you intend to defer any of the plan submission below, please, check the appropriate box(es). See Section Q on the “Plan Review and Inspection” page on the UCC website for information about submitting these drawings at a later date.
Fire Alarm System
Wood Roof Trusses (Certified)
Sprinkler System
Fees:
List total sq. ft. of floor area:
List estimated construction cost:
If new building or addition: Pay $388.81 standard fee
Plus, pay $.78 multiplied by total sq. ft. of floor area
If new structure or facility (other than building): Pay $1168.85
If alteration or renovation of existing building: Pay $388.81 standard fee
Plus, pay $78.73 per each $1000 of est. construction cost
If accessibility only review: Pay $781.25
If phased approval: Pay $300.00
If revision of approved plans or partial occupancy request: Pay $605.62
IF EXPEDITED REVIEW: Pay $1211.25 plus applicable fees above
Total FEES
Applicant’s Certification:
Note:
THE BUILDING PERMIT AND THE CERTIFICATE OF OCCUPANCY FOR THIS BUILDING OR STRUCTURE WILL BE ISSUED TO AND IN THE NAME OF THE PERSON LISTED BELOW.
As the owner or the authorized agent of the project for which this application is filed, I certify that:
1. The estimated construction cost and all other information provided as part of this application for a building permit is correct.
2. 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 the Department of Labor & Industry.
3. 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.
4. Any changes to the approved documents will be filed with the Department of Labor & Industry.
5. If the licensed architect or engineer in responsible charge of this construction should change, written notice of the change will be provided to the Department of Labor & Industry.
6. 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.
7. 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 Name
Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Email
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