UCC-15 APPLICATION FOR UCC ALTERATIONS - LEVEL 1 PERMIT

APPLICATION FOR UCC ALTERATIONS - LEVEL 1 PERMIT

Application for UCC Alterations

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

Address(Required)

Street Number and Name County City State / Province / Region ZIP / Postal Code

Political Subdivision

Contact Name

Phone

Previous L&I File No.

Project

Describe the alterations in sufficient detail to confirm that the work meets the Level-1 scoping requirements found in the IEBC and on the Plan Review and Inspection Requirements page on the UCC web site. Carry over this description to an additional sheet of paper, if necessary, and attach the sheet to this application.

Applicant & Owner Information

Applicant Name(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Owner Name

Address

Street Address City State / Province / Region ZIP / Postal Code

Phone

Fee Requirements

List estimated construction cost:

Email(Required)

File

Drop files here or

Accepted file types: jpg, jpeg, png, gif, pdf, Max. file size: 1 GB.