· 2016-10-24 · application for certificate ucc-f280 t.c.o. control card ucc-f290 ongoing...
TRANSCRIPT
Ape
ndix
B -
UC
C S
tand
ard
Form
s, L
ogs
& R
epor
ts
For
m N
umbe
r
D
escr
iptio
n
UC
C-F
100
(pgs
1, 2
& 3
)C
onst
ruct
ion
Perm
it A
pplic
atio
nU
CC
-F10
1-C
UPW
Con
sent
to U
nder
take
Pro
pose
d W
ork
UC
C-F
101-
HEC
C
Hom
e El
evat
ion
Con
tract
or C
ertif
icat
ion
UC
C-F
101-
LEA
D
Cer
tific
atio
n of
Hom
eow
ner L
ead
Aba
tem
ent i
n O
wne
r-oc
cupi
ed S
FDU
CC
-F11
0B
uild
ing
Subc
ode
Tech
nica
l Sec
tion
UC
C-F
110S
TATE
Bui
ldin
g Su
bcod
e Te
chni
cal S
ectio
n, S
tate
ver
.U
CC
-F12
0El
ectri
cal S
ubco
de T
echn
ical
Sec
tion
UC
C-F
120S
TATE
Elec
trica
l Sub
code
Tec
hnic
al S
ectio
n, S
tate
ver
.U
CC
-F13
0Pl
umbi
ng S
ubco
de T
echn
ical
Sec
tion
UC
C-F
130S
TATE
Plum
bing
Sub
code
Tec
hnic
al S
ectio
n, S
tate
ver
.U
CC
-F14
0Fi
re P
rote
ctio
n Su
bcod
e Te
chni
cal S
ectio
nU
CC
-F14
0STA
TEFi
re P
rote
ctio
n Su
bcod
e Te
chni
cal S
ectio
n, S
tate
ver
.U
CC
-F14
5M
echa
nica
l Ins
pect
ors T
echn
ical
Sec
tion
UC
C-F
145S
TATE
Mec
hani
cal I
nspe
ctor
s Tec
hnic
al S
ectio
n, S
tate
ver
.U
CC
-F15
0El
evat
or S
ubco
de T
echn
ical
Sec
tion
UC
C-F
150S
TATE
Elev
ator
Sub
code
Tec
hnic
al S
ectio
n, S
tate
ver
.U
CC
-F15
5El
evat
or S
ubco
de –
Mul
tiple
Dev
ices
UC
C-F
160
App
licat
ion
for a
Var
iatio
nU
CC
-F17
0 (p
gs 1
& 2
)C
onst
ruct
ion
Perm
it, R
equi
red
Insp
ectio
nsU
CC
-F18
0 (p
gs 1
& 2
)C
onst
ruct
ion
Perm
it N
otic
eU
CC
-F19
0Pe
rmit
Upd
ate
UC
C-F
200
Insp
ectio
n N
otic
eU
CC
-F21
1N
otic
e of
Vio
latio
n an
d O
rder
to T
erm
inat
eU
CC
-F21
1STA
TEN
otic
e of
Vio
latio
n an
d O
rder
to T
erm
inat
e, S
tate
ver
.U
CC
-F21
2N
otic
e an
d O
rder
of P
enal
tyU
CC
-F21
2STA
TEN
otic
e an
d O
rder
of P
enal
ty, S
tate
ver
.U
CC
-F21
3N
otic
e of
Vio
latio
n an
d O
rder
to T
erm
inat
e (P
ost-C
of O
–R
esid
entia
l)U
CC
-F21
3STA
TEN
otic
e of
Vio
latio
n an
d O
rder
to T
erm
inat
e (P
ost-C
of O
–R
esid
entia
l), S
tate
ver
.U
CC
-F21
4N
otic
e an
d O
rder
of P
enal
ty (P
ost-C
of O
–R
esid
entia
l)U
CC
-F21
4STA
TEN
otic
e of
Ord
er o
f Pen
alty
(Pos
t-C o
f O –
Res
iden
tial),
Sta
te v
er.
UC
C-F
221
Insp
ectio
n St
icke
r App
rova
l for
Bui
ldin
gU
CC
-F22
2In
spec
tion
Stic
ker A
ppro
val f
or E
lect
ricU
CC
-F22
3In
spec
tion
Stic
ker A
ppro
val f
or P
lum
bing
UC
C-F
224
Insp
ectio
n St
icke
r App
rova
l for
Fire
Pro
tect
ion
UC
C-F
225
Insp
ectio
n St
icke
r App
rova
l for
Ele
vato
rU
CC
-F22
6
I
nspe
ctio
n St
icke
r App
orva
l for
Mec
hani
cal I
nspe
ctio
n
UC
C-F
230
Insp
ectio
n St
icke
r App
rova
l –N
OT
App
rove
d
UC
C-F
241
Not
ice
of U
nsaf
e St
ruct
ure
U
CC
-F24
1STA
TEN
otic
e of
Uns
afe
Stru
ctur
e, S
tate
ver
.
UC
C-F
242
Not
ice
of Im
min
ent H
azar
d
UC
C-F
245
Uns
afe
Stru
ctur
e N
otic
e
UC
C-F
245S
TATE
Uns
afe
Stru
ctur
e N
otic
e, S
tate
ver
.
UC
C-F
250
Stop
Con
stru
ctio
n O
rder
U
CC
-F25
0STA
TESt
op C
onst
ruct
ion
Ord
er, S
tate
ver
.
UC
C-F
255
Stop
Con
stru
ctio
n N
otic
e
UC
C-F
260
Cer
tific
ate
U
CC
-F27
0A
pplic
atio
n fo
r Cer
tific
ate
U
CC
-F28
0T.
C.O
. Con
trol C
ard
U
CC
-F29
0O
ngoi
ng In
spec
tions
Con
trol C
ard
U
CC
-F30
0O
ngoi
ng In
spec
tions
Sch
edul
e
UC
C-F
310
Ele
vato
r Ins
pect
ion
U
CC
-F32
0El
evat
or N
otic
e
UC
C-F
325
Not
ice
of E
leva
tor D
evic
e Se
aled
Out
of O
pera
tion
U
CC
-F32
6A
ccid
ent/I
ncid
ent R
epor
t
UC
C-F
350
Cut
-In
Car
d
UC
C-F
360
Den
ial o
f Per
mit
U
CC
-F37
0C
him
ney
Cer
tific
atio
n fo
r Rep
lace
men
t of F
uel F
ired
Equi
pmen
t
UC
C-F
375
Tick
ler/X
-Ref
Car
d
UC
C-F
380
Hyd
raul
ic S
yste
m D
ata
Plat
e
UC
C-F
390
Fram
ing
Che
cklis
t
UC
C-F
391
DA
CT
Util
izin
g M
FVN
Ver
ifica
tion
U
CC
-F39
2
A
ir B
arrie
r and
Insu
latio
n C
heck
list
R
evis
ed: 10
-201
6 89
Ape
ndix
B -
UC
C S
tand
ard
Form
s, L
ogs
& R
epor
ts
Log
/Rep
ort N
umbe
r
D
escr
iptio
n
UC
C-L
700
Per
mit
Fee
Log
UC
C-L
710
Insp
ectio
n Lo
gU
CC
-L72
0C
ertif
icat
e Lo
gU
CC
-L73
0O
ngoi
ng In
spec
tion
Log
UC
C-R
800
Insp
ecto
r’s R
epor
tU
CC
-R81
1M
unic
ipal
Mon
thly
Act
ivity
Rep
ort -
Cer
tific
ates
UC
C-R
812
Mun
icip
al M
onth
ly A
ctiv
ity R
epor
t -Pe
rmits
UC
C-R
840
Stat
e Pe
rmit
Surc
harg
e Fe
es R
epor
tU
nnum
bere
dA
pplic
atio
n to
the
Con
stru
ctio
n B
d. o
f App
eals
Unn
umbe
red
Dec
isio
n of
the
Con
stru
ctio
n B
d. o
f App
eals
90
12345678901234567890123456789012123456789012345678901234567890121234123456789012345678901234567890121234567890123456789012345678901212341234567890123456789012345678901212345678901234567890123456789012123412345678901234567890123456789012123456789012345678901234567890121234123456789012345678901234567890121234567890123456789012345678901212341234567890123456789012345678901212345678901234567890123456789012123412345678901234567890123456789012123456789012345678901234567890121234123456789012345678901234567890121234567890123456789012345678901212341234567890123456789012345678901212345678901234567890123456789012123412345678901234567890123456789012123456789012345678901234567890121234123456789012345678901234567890121234567890123456789012345678901212341234567890123456789012345678901212345678901234567890123456789012123412345678901234567890123456789012123456789012345678901234567890121234123456789012345678901234567890121234567890123456789012345678901212341234567890123456789012345678901212345678901234567890123456789012123412345678901234567890123456789012123456789012345678901234567890121234123456789012345678901234567890121234567890123456789012345678901212341234567890123456789012345678901212345678901234567890123456789012123412345678901234567890123456789012123456789012345678901234567890121234
12345123451234512345123451234512345123451234512345123451234512345123451234512345123451234512345123451234512345123451234512345
123451234512345123451234512345123451234512345123451234512345123451234512345123451234512345123451234512345123451234512345
123451234512345123451234512345123451234512345123451234512345123451234512345123451234512345123451234512345123451234512345
123451234512345123451234512345123451234512345123451234512345123451234512345123451234512345123451234512345123451234512345
123412341234123412341234123412341234123412341234123412341234123412341234123412341234123412341234
123412341234123412341234123412341234123412341234123412341234123412341234123412341234123412341234
123451234512345123451234512345123451234512345123451234512345123451234512345123451234512345123451234512345123451234512345
123412341234123412341234123412341234123412341234123412341234123412341234123412341234123412341234
123123123123123123123123123123123123123123123123123123123123123123123123123123123123
12121212121212121212121212121212121212121212121212121212
123123123123123123123123123123123123123123123123123123123123123123123123123123123123
12121212121212121212121212121212121212121212121212121212
12121212121212121212121212121212121212121212121212121212
123123123123123123123123123123123123123123123123123123123123123123123123123123123123
123123123123123123123123123123123123123123123123123123123123123123123123123123123123
12121212121212121212121212121212121212121212121212121212
BLOCK _____________ LOT ______________ QUALIFICATION CODE _______________ ADDRESS (SITE) _________________________________ PERMIT NO. ______________________
CONSTRUCTION PERMITAPPLICATION
Applicant Completes: Sections I, II, III (optional), IV, VI, and VII
U.C.C. F100-1 (rev. 8/08)
I. IDENTIFICATION
V. FEE SUMMARY (for office use only)
$
1. Number of StoriesVI. BUILDING/SITE CHARACTERISTICS (office use only)
3. Area — Largest Floor sq. ft.4. New Building Area sq. ft.5. Volume of New Structure cu. ft.
ft.2. Height of Structure
VII. DESCRIPTION OF BUILDING USE A. RESIDENTIAL (primary use) 1. State Specific Use:
2. Use Group, Proposed:
3. Change in Use Group, Indicate Present: 4. No. of dwelling units: Gained, Sale Gained, Rental Lost, Sale Lost, Rental B. NON-RESIDENTIAL (primary use) 1. State Specific Use: 2. Use Group, Proposed: 3. Change in Use Group, Indicate Present: C. MIXED USE -List secondary use(s): D. Construct. Classification:
1.
2.
3. PrivatePublicOwnership in Fee:
IV. DOES OR WILL YOUR BUILDING CONTAIN ANY OF THE FOLLOWING?
UpdateUpdate
8. Subtotal $
10. Subtotal $11. Cert. of Occupancy12. Other13. TOTAL $
1. Building $2. Electrical3. Plumbing4. Fire Protection
Elevator Devices5.6. Subtotal7. Less 20% for State Plan Review
9. State Permit Surcharge Fee
7. Max. Occupancy Load6. Max. Live Load
IIa.PROPOSED WORK
Building
Electrical
Plumbing
Fire Protection
Elevator
DO YOU WANT:
IIb. SUBCODES(Check all that apply)
1. Partial Releases2. Prototype Processing
III. PLAN REVIEW (optional)
TOTAL COST
PlansRec'd by
DateRec'd
RejectionDate
ApprovalDate
Re-viewer
Resubmission Dates Approval Rejection
Re-viewerEst. Cost
Minor Work New Building Addition Demolition
Repair Alteration Renovation Reconstruction
Asbestos Abat. -Subch. 8 Lead Hazard Abatement Radon Remediation Annual Permit
8. If Industrialized Building: State Approved HUD 9. Total Land Area Disturbed sq. ft.10. Flood Hazard Zone 11. Base Flood Elevation ft. 12. Wetlands yes no
FOR OFFICE USE ONLY (Optional)
Total Units Income-restricted
Proposed Present
6. Responsible Person in Charge once Work has BegunFAX:Tel. ( )( )
5. Architect or Engineer Contact
FAX:( ) ( )Address e-mailTel.
License No. OR, if new home, Builder Reg. No. Exp. Date
Home Improvement Contractor Registration No. or Exemption Reason (if applicable):
Federal Emp. ID No. FAX: ( )
Tel.Principal Contractor:4. ( )Address e-mail
Proposed Work Site at:
Name of Owner in Fee:
Tel. ( ) e-mail
zip codemunicipalitystreetAddress
1. Elevators/Escalators/Lifts/Dumbwaiters/Moving Walks
2. High Pressure Boilers3. Pressure Vessels
4. Refrigeration Systems5. Cross-Connections/Backflow Preventers6. Hazardous Uses/Places of Assembly7. Sprinklers/Standpipes
8. Smoke Control Systems in Open Wells9. Underground Storage Tanks
10. Swimming Pools, Spas and Hot Tubs11. LPGas Tanks
12. Fire Alarm
91
CE
RT
IFIC
AT
ION
IN L
IEU
OF
OA
TH
I.O
WN
ER
SE
CT
ION
(to
be
com
plet
ed if
the
appl
ican
t is
the
owne
r in
fee)
I her
eby
cert
ify th
at I
am th
e ow
ner
in fe
e of
the
prop
erty
list
ed o
n P
age
1.
Mar
k th
e fo
llow
ing
appl
icab
le b
oxes
:
A.
()
I fu
rthe
r ce
rtify
tha
t a
new
hom
e (p
rivat
e re
side
nce)
will
be
cons
truc
ted
on t
his
prop
erty
for
my
own
use
and
occu
-pa
ncy.
Thi
s dw
ellin
g is
to
be o
ccup
ied
by m
ysel
f an
d is
not
to
be u
sed
for
any
purp
ose
othe
r th
an s
ingl
e fa
mily
resi
dent
ial u
se. I
atte
st th
at a
ll co
nstr
uctio
n, p
lum
bing
, or
elec
tric
al w
ork
will
be
done
, in
who
le o
r in
par
t, by
me
or b
ysu
bcon
trac
tors
und
er m
y su
perv
isio
n, i
n ac
cord
ance
with
all
appl
icab
le l
aws;
and
, I
furt
her
ackn
owle
dge
that
sai
dne
w h
ome
is n
ot c
over
ed u
nder
the
New
Hom
e W
arra
nty
and
Bui
lder
s R
egis
trat
ion
Act
(N
.J.S
.A. 4
6:3B
-1 e
t seq
.) a
ndth
at s
uch
fact
sha
ll be
dis
clos
ed to
any
per
son
purc
hasi
ng th
is p
rope
rty
with
in te
n ye
ars
of th
e da
te o
f iss
uanc
e of
ace
rtifi
cate
of
occu
panc
y.
I U
ND
ER
STA
ND
TH
AT
IN
MA
RK
ING
BO
X A
, I
AC
KN
OW
LED
GE
TH
AT
I A
M A
SS
UM
ING
RE
SP
ON
SIB
ILIT
Y F
OR
TH
E W
OR
K D
ON
E O
N S
AID
PR
OP
ER
TY,
TH
E C
ON
DIT
ION
OF
TH
E P
RO
PE
RT
Y P
RIO
R T
O, D
UR
ING
, AN
D A
FT
ER
AN
Y W
OR
K P
ER
FO
RM
ED
, AN
D F
OR
TH
E P
ER
FO
RM
AN
CE
OF
TH
E S
UB
CO
NT
RA
CT
OR
S I
HIR
E, E
MP
LOY,
OR
OT
HE
RW
ISE
CO
NT
RA
CT
OR
WIT
H W
HO
M I
MA
KE
AG
RE
EM
EN
TS
TO
PE
RF
OR
M W
OR
K.
I AM
VO
LUN
TAR
ILY
AN
D K
NO
WIN
GLY
AS
SU
MIN
G T
HIS
RE
SP
ON
SIB
ILIT
Y.
B.
()
I fur
ther
cer
tify
the
follo
win
g as
req
uire
d by
the
New
Jer
sey
Uni
form
Con
stru
ctio
n C
ode,
N.J
.A.C
. 5:2
3-2.
15(f
)1.ix
:
I per
sona
lly p
repa
red
the
plan
s su
bmitt
ed fo
r: 1
) th
e ne
w h
ome
refe
rred
to in
A.;
or, 2
) an
add
ition
, alte
ratio
n, r
enov
a-tio
n, o
r re
pair
to a
n ex
istin
g si
ngle
fam
ily r
esid
ence
ow
ned
and
occu
pied
by
mys
elf a
nd lo
cate
d on
the
prop
erty
list
edon
Pag
e 1;
or,
3) a
new
str
uctu
re t
hat
will
be
phys
ical
ly s
epar
ate
from
, bu
t th
at w
ill b
e de
emed
par
t of
, an
exi
stin
gsi
ngle
fam
ily r
esid
ence
that
is o
wne
d an
d oc
cupi
ed b
y m
ysel
f and
loca
ted
on th
e pr
oper
ty li
sted
on
Pag
e 1.
C.
()
I fur
ther
cer
tify
that
I w
ill p
erfo
rm o
r su
perv
ise
the
follo
win
g w
ork:
C.1
.(
)B
uild
ing
C.2
.(
)F
ire P
rote
ctio
n
I fur
ther
cer
tify
that
I w
ill p
erfo
rm th
e fo
llow
ing
wor
k:C
.3.
()
Ele
ctric
alC
.4.
()
Plu
mbi
ng
D.
()
I agr
ee to
adv
ise
all c
ontr
acto
rs o
n th
is p
roje
ct th
at th
ey a
re r
equi
red
to b
e re
gist
ered
with
the
New
Jer
sey
Div
isio
n of
Taxa
tion
and
to c
ompl
y w
ith a
ll N
ew J
erse
y ta
x la
ws.
I fu
rthe
r ce
rtify
the
fol
low
ing
as r
equi
red
by t
he U
nifo
rm C
onst
ruct
ion
Cod
e, N
.J.A
.C.
5:23
-2.1
5(a)
5: A
ll re
quire
d S
tate
, co
unty
,an
d lo
cal p
rior
appr
oval
s ha
ve b
een
give
n, in
clud
ing
such
cer
tific
atio
n as
the
con
stru
ctio
n of
ficia
l may
req
uire
.
I und
erst
and
that
if a
ny o
f the
abo
ve s
tate
men
ts a
re w
illfu
lly fa
lse,
I am
sub
ject
to p
unis
hmen
t.
Sig
natu
re__
____
____
____
____
____
____
____
____
____
____
____
____
____
____
___
Dat
e__
____
____
____
____
____
_
II.A
GE
NT
SE
CT
ION
(to
be
com
plet
ed if
the
appl
ican
t is
not t
he o
wne
r in
fee)
I her
eby
cert
ify th
e fo
llow
ing
as r
equi
red
by th
e U
nifo
rm C
onst
ruct
ion
Cod
e, N
.J.A
.C. 5
:23-
2.15
(d):
the
prop
osed
wor
k is
aut
ho-
rized
by
the
owne
r in
fee;
and
I ha
ve b
een
auth
oriz
ed b
y th
e ow
ner
in fe
e to
mak
e th
is a
pplic
atio
n as
his
age
nt.
I fu
rthe
r ce
rtify
the
fol
low
ing
as r
equi
red
by t
he U
nifo
rm C
onst
ruct
ion
Cod
e, N
.J.A
.C.
5:23
-2.1
5(a)
5: A
ll re
quire
d S
tate
, co
unty
,an
d lo
cal p
rior
appr
oval
s ha
ve b
een
give
n, in
clud
ing
such
cer
tific
atio
n as
the
con
stru
ctio
n of
ficia
l may
req
uire
.
I ag
ree
to a
dvis
e al
l con
trac
tors
on
this
pro
ject
tha
t th
ey a
re r
equi
red
to b
e re
gist
ered
with
the
New
Jer
sey
Div
isio
n of
Tax
atio
nan
d to
com
ply
with
all
New
Jer
sey
tax
law
s.
I und
erst
and
that
if a
ny o
f the
abo
ve s
tate
men
ts a
re w
illfu
lly fa
lse,
I am
sub
ject
to p
unis
hmen
t.
()
Che
ck if
con
trac
tor.
Age
nt N
ame
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
_
Add
ress
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
_
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
___
Tele
phon
e
____
____
____
____
____
____
Sig
natu
re__
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
__
III.
()
LEA
D H
AZ
AR
D A
BA
TE
ME
NT:
Incl
ude
Hom
eow
ner
or B
uild
ing
Ow
ner A
ffida
vit a
s pe
r N
.J.A
.C. 5
:17.
IV.
()
HO
ME
ELE
VA
TIO
N: I
nclu
de H
ome
Ele
vatio
n C
ontr
acto
r C
ertif
icat
ion
as p
er N
.J.S
.A. 5
2:27
D-1
23.1
6.U
.C.C
. F
100-
2 (r
ev.
9/20
14)
92
123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567812345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456781234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567812345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456781234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567812345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456781234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567812345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456781234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567812345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456781234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567812345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456781234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678
12345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456781234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567812345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456781234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567812345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456781234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567812345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456781234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567812345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456781234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567812345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456781234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567812345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012123456781234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901212345678
LOCALAPPROVAL
COUNTYAPPROVAL
REGIONALAPPROVAL
STATEAPPROVAL
COMMENTSPrelimin.
InitialPrelimin.
InitialPrelimin.
InitialPrelimin.
InitialFinalDate
FinalDate
FinalDate
FinalDate
OFFICE DATE RECEIVED: ______________________________
VIII. PRIORAPPROVALSCHECKLIST
(office use only)
Zoning Officer
Planning Board
Zoning Board
Sewer Authority
Water Authority
Police Department
Health Department
Soil Conservation
N.J. Department ofCommunity AffairsN.J. Department ofTransportationN.J. Department ofEnvironmental Protection
Utility Dig No.
U.C.C. F100-3 (rev. 12/07)
IX. SUBCODES AND SPECIAL REGULATIONS APPLICABLE (office use only—optional)Name of Code & Edition Name of Code & Edition
Building ___________________________________________ Energy ____________________________________________ Other ______________________________________________Electrical ___________________________________________ Barrier Free ________________________________________ __________________________________________________Plumbing __________________________________________ Flood Hazard _______________________________________ __________________________________________________Fire Protection ______________________________________ As Built Elevation Cert. _______________________________ __________________________________________________Mechanical _________________________________________ Other _____________________________________________ __________________________________________________
X. CERTIFICATES ISSUED (office use only) DATE ISSUED DATE EXPIRED DATE REISSUED DATE EXPIREDTemporary Certificate of Occupancy No. __________ ___________________ ___________________ __________________ ___________________Temporary Certificate of Compliance No. __________ ___________________ ___________________ __________________ ___________________Continued Certificate of Occupancy No. __________ ___________________ ___________________ __________________ ___________________Certificate of Compliance No. __________ ___________________ ___________________ __________________ ___________________Certificate of Occupancy No. __________ ___________________ ___________________Certificate of Approval No. __________ ___________________ ___________________Lead Abatement Clearance Certificate No. __________ ___________________ ___________________ __________________ ___________________
93
OW
NER
AGEN
TU
.C.C
. F10
1-C
UP
W (1
0/20
14)
SIG
NED
:O
WN
ER/A
GEN
T
I, th
e
O
wne
r
A
utho
rized
Age
nt o
f the
Ow
ner,
of th
e ab
ove
prop
erty
her
eby
cons
ent t
o th
e en
try o
nto
the
prop
erty
of t
he B
uild
er/C
ontra
ctor
, and
the
empl
oyee
sor
age
nts
of th
e B
uild
er/C
ontra
ctor
, for
the
purp
ose
of c
orre
ctin
g vi
olat
ions
of t
heN
ew J
erse
y U
nifo
rm C
onst
ruct
ion
Cod
e.
Furth
er, I
con
sent
to th
e w
ork
to b
e do
ne a
s de
scrib
ed in
the
atta
ched
pro
posa
l of
the
build
er, s
ubje
ct to
com
plia
nce
with
the
Uni
form
Con
stru
ctio
n C
ode
as d
eter
-m
ined
by
the
loca
l enf
orce
men
t age
ncy.
IDEN
TIFI
CA
TIO
N
Per
mit
#*
Con
sent
to U
nder
take
P
ropo
sed
Wor
k
Dat
e Is
sued
Build
er
Site
Loc
atio
nB
lock
Lot
Qua
lific
atio
n C
ode
Ow
ner i
n Fe
e
Tel.(
)
Fede
ral E
mpl
oyee
No.
Add
ress
Add
ress
Lice
nse
No.
(
)Te
l.
94
U
.C.C
. F
101-
HEC
C (1
0/20
14)
SIG
NE
D:
HO
ME
ELE
VA
TIO
N C
ON
TR
AC
TO
R
DA
TE
: __
____
____
__
IDE
NT
IFIC
AT
ION
IDE
NT
IFIC
AT
ION
IDE
NT
IFIC
AT
ION
IDE
NT
IFIC
AT
ION
IDE
NT
IFIC
AT
ION
P
erm
it #
*
Hom
e El
evat
ion
Con
trac
tor
Cer
tific
atio
n
Dat
e Is
sued
Hom
e E
leva
tion
Con
tract
or
Site
Loc
atio
nB
lock
Lot
Qua
lific
atio
n C
ode
Ow
ner
in F
ee _
____
____
____
____
____
____
____
____
____
____
__
_
____
____
____
____
____
____
____
____
__
_
____
____
____
____
____
____
____
____
____
____
____
____
____
_
___
____
____
____
____
____
____
____
____
____
____
____
____
____
__
Tel
.(
) _
____
____
____
_F
eder
al E
mpl
oyee
No.
Add
ress
Add
ress
Lice
nse
No.
(
)T
el
95
U
.C.C
. F
101-
LEA
D (1
0/20
14)
SIG
NE
D:
HO
ME
OW
NE
R
DA
TE
: __
____
____
__
IDE
NT
IFIC
AT
ION
IDE
NT
IFIC
AT
ION
IDE
NT
IFIC
AT
ION
IDE
NT
IFIC
AT
ION
IDE
NT
IFIC
AT
ION
Per
mit
#*
D
ate
Issu
ed
Add
ress
___
____
____
____
____
____
____
____
____
____
____
____
___
Site
Loc
atio
nB
lock
Lot
Qua
lific
atio
n C
ode
Ow
ner
in F
ee _
____
____
____
____
____
____
____
____
____
____
__
96
123456789012345678901234567890121234567890123456789012345678901212345678901212345678901234567890123456789012123456789012345678901234567890121234567890121234567890123456789012345678901212345678901234567890123456789012123456789012123456789012345678901234567890121234567890123456789012345678901212345678901212345678901234567890123456789012123456789012345678901234567890121234567890121234567890123456789012345678901212345678901234567890123456789012123456789012123456789012345678901234567890121234567890123456789012345678901212345678901212345678901234567890123456789012123456789012345678901234567890121234567890121234567890123456789012345678901212345678901234567890123456789012123456789012123456789012345678901234567890121234567890123456789012345678901212345678901212345678901234567890123456789012123456789012345678901234567890121234567890121234567890123456789012345678901212345678901234567890123456789012123456789012123456789012345678901234567890121234567890123456789012345678901212345678901212345678901234567890123456789012123456789012345678901234567890121234567890121234567890123456789012345678901212345678901234567890123456789012123456789012123456789012345678901234567890121234567890123456789012345678901212345678901212345678901234567890123456789012123456789012345678901234567890121234567890121234567890123456789012345678901212345678901234567890123456789012123456789012123456789012345678901234567890121234567890123456789012345678901212345678901212345678901234567890123456789012123456789012345678901234567890121234567890121234567890123456789012345678901212345678901234567890123456789012123456789012123456789012345678901234567890121234567890123456789012345678901212345678901212345678901234567890123456789012123456789012345678901234567890121234567890121234567890123456789012345678901212345678901234567890123456789012123456789012123456789012345678901234567890121234567890123456789012345678901212345678901212345678901234567890123456789012123456789012345678901234567890121234567890121234567890123456789012345678901212345678901234567890123456789012123456789012123456789012345678901234567890121234567890123456789012345678901212345678901212345678901234567890123456789012123456789012345678901234567890121234567890121234567890123456789012345678901212345678901234567890123456789012123456789012123456789012345678901234567890121234567890123456789012345678901212345678901212345678901234567890123456789012123456789012345678901234567890121234567890121234567890123456789012345678901212345678901234567890123456789012123456789012123456789012345678901234567890121234567890123456789012345678901212345678901212345678901234567890123456789012123456789012345678901234567890121234567890121234567890123456789012345678901212345678901234567890123456789012123456789012123456789012345678901234567890121234567890123456789012345678901212345678901212345678901234567890123456789012123456789012345678901234567890121234567890121234567890123456789012345678901212345678901234567890123456789012123456789012123456789012345678901234567890121234567890123456789012345678901212345678901212345678901234567890123456789012123456789012345678901234567890121234567890121234567890123456789012345678901212345678901234567890123456789012123456789012
123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456
BUILDING SUBCODETECHNICAL SECTION
[ ] Elec. [ ] Plumb. [ ] Fire [ ] ElevatorJoint Plan Review Required:
INSPECTIONS Dates (Month/Day)JOB SUMMARY (Office Use Only)
A. IDENTIFICATION—APPLICANT: COMPLETE ALL APPLICABLE INFORMATION. WHEN CHANGINGCONTRACTORS, NOTIFY THIS OFFICE. CALL UTILITY DIG NO: 1-800-272-1000.
U.C.C. F110 1 White = Inspector Copy 2 Canary = Office Copy(rev. 11/09) 3 Pink = Office Copy 4 Gold = Applicant Copy
$
D. TECHNICAL SITE DATA
Date ReceivedControl #
Date IssuedPermit #
Type: Failure Failure Approval Initial
Barrier-FreeFinalOtherTCOMechanicalEnergy
InsulationBarrier-FreeTruss Sys./Bracing
FrameSlabFoundationFooting BondingFooting
Finishes -Base LayerFinishes -Final
[ ]
DESCRIPTION OF WORK
TYPE OF WORK:New Building[ ]AdditionRehabilitation[ ]Roofing[ ]
[ ] SidingFence ___________ Height (exceeds 6')[ ]Sign _____________ Sq. Ft.[ ]Pool[ ]
Asbestos Abatement Subchapter 8[ ]
Lead Haz. Abatement NJAC 5:17
Other _______________________[ ]Demolition[ ]
Radon Remediation
$
FEE (Office Use Only)
$
Minimum FeeState Permit Surcharge Fee
TOTAL FEE
$
$
Contractor License No. or Builder Registration No. Exp. Date
Federal Emp. ID No. FAX: ( )Home Improvement Contractor Registration No. or Exemption Reason (if applicable):
[ ]
[ ]
Administrative Surcharge
[ ]
Retaining Wall __________ Sq. Ft.
B. BUILDING CHARACTERISTICS
cu. ft.sq. ft.sq. ft.ft.
Use Group Present Proposed
Volume of New Structure
New Bldg. Area/All FloorsArea — Largest FloorHeight of Structure
Max. Live LoadMax. Occupancy Load
No. of StoriesConstr. Class Present Proposed
Est. Cost of Bldg. Work:
3. Total (1+ 2) $2. Rehabilitation $
$1. New Bldg.
If Industrialized Building:State Approved HUD
Approved by:
[ ] CO [ ] CCO [ ] CA
SUBCODE APPROVAL for CERTIFICATE
SUBCODE APPROVAL for PERMIT
Date:
Approved by:Date:
PLAN REVIEW Date Initial
[ ] Interior[ ] Exterior[ ] Structural/Framework[ ] Footings/Foundations[ ] All[ ] No Plans Required
zip codemunicipalitystreetAddress
e-mailTel. ( )
Owner in Fee:
Block Lot Qualification Code
Work Site Location
Address e-mailContractor: Tel. ( )
C. CERTIFICATION IN LIEU OF OATHI hereby certify that I am the (agent of) owner of record and am authorized to make thisapplication.
Sign here:
Print name here:
97
123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456
123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890
ELECTRICAL SUBCODETECHNICAL SECTION
Date ReceivedControl #
U.C.C. F120 (rev. 11/09) 1 White = Inspector Copy 2 Canary = Office Copy 3 Pink = Office Copy 4 Gold = Applicant Copy
Temp. Cut-in-Card Date IssuedFinal Cut-in-Card Date IssuedAnnual Pool Inspection
Date of Grounding and BondingCertification
A. IDENTIFICATION—APPLICANT: COMPLETE ALL APPLICABLE INFORMATION. WHEN CHANGINGCONTRACTORS, NOTIFY THIS OFFICE. CALL UTILITY DIG NO: 1-800-272-1000.
Federal Emp. ID No. FAX: ( )
Contractor: Tel. ( )
Address e-mail
Exp. DateContractor License No.
Home Improvement Contractor Registration No. or Exemption Reason (if applicable):
FinalServiceOtherTCOConstr. Serv.Temp. Serv.
RoughInitialApprovalFailureFailureType:
Dates (Month/Day)INSPECTIONS
Barrier-FreeTrench
Barrier-Free
Block Lot Qualification CodeWork Site Location
zip codemunicipalitystreetAddress
e-mailTel. ( )
Owner in Fee:
B. ELECTRICAL CHARACTERISTICSUse Group Present Proposed
Pole/Pad Temporary Other[ ][ ][ ] #Building Occupied asEst. Cost of Elec. Work $
Utility Co.
JOB SUMMARY (Office Use Only)
Joint Plan Review Required:
Approved by:Date:
CA[ ]COSUBCODE APPROVAL for CERTIFICATE[ ] [ ] CCO
SUBCODE APPROVAL for PERMITDate:Approved by:
[ ] Bldg. [ ] Plumb. [ ] Fire. [ ] Elev.
PLAN REVIEW
Partial -Underslab Utilities Approved[ ]Approved by:Date:
No Plans Required[ ]
Approved by:Date:Electric Plans Approved[ ]
Date IssuedPermit #
$$
$$
TOTAL FEE
Minimum FeeAdministrative Surcharge
State Permit Surcharge Fee
$
HP Garbage Disposal
HP/KW Space Heater/Air HandlerKW Central A/C Unit
KW DishwasherKW Elec. Dryer/ReceptacleKW Elec. Water HeaterKW Oven/Surface UnitKW Elec. Range/ReceptacleStorable Pool/Spa/Hot TubPool Permit/with UW LightsTOTAL NUMBERS
Alarm Devices/F.A.C. PanelCommunications PointsEmergency & Exit LightsMotors—Fract. HPLight PolesDetectorsSwitchesReceptaclesLighting Fixtures
KW Elec. Sign/Outline LightAMP Motor Control CenterAMP SubpanelsAMP ServiceKW Transformer/GeneratorHP Motors 1/+ HPKW Baseboard Heat
[ ] Licensed Elec. Contractor [ ] Certif'd Landscape Irrigation Cont'r [ ] Exempt Applicant
D. TECHNICAL SITE DATA
C. CERTIFICATION IN LIEU OF OATHI hereby certify that I am the (agent of) owner of record and am authorized to make thisapplication and perform the work listed on this application.
DESCRIPTION OF WORK:
Applicant sign/Contractorsign and seal here:
Print name here:
ITEMSSIZEQTY. FEE (Office Use Only)
98
123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456
12345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890
PLUMBING SUBCODETECHNICAL SECTION
B. PLUMBING CHARACTERISTICS
U.C.C. F130 (rev. 11/09) 1 White = Inspector Copy 2 Canary = Office Copy 3 Pink = Office Copy 4 Gold = Applicant Copy
D. TECHNICAL SITE DATA
Date ReceivedControl #
Date IssuedPermit #
A. IDENTIFICATION—APPLICANT: COMPLETE ALL APPLICABLE INFORMATION. WHEN CHANGINGCONTRACTORS, NOTIFY THIS OFFICE. CALL UTILITY DIG NO: 1-800-272-1000.Block Lot Qualification CodeWork Site Location
zip codemunicipalitystreetAddress
e-mailTel. ( )
Owner in Fee:
Exp. DateContractor License No.
Federal Emp. ID No. FAX: ( )Home Improvement Contractor Registration No. or Exemption Reason (if applicable):
DESCRIPTION OF WORK
Est. Cost of Plumbing Work $Private WellPublic WaterWater Service SizePrivate SepticPublic SewerBuilding Sewer Size
ProposedPresentUse Group
Contractor: Tel. ( )
Address e-mail
SinkFloor DrainShowerLavatoryBath TubUrinal/BidetWater Closet
Backflow PreventerInterceptor/SeparatorSewer Pump
Washing Machine
Hot Water BoilerSteam Boiler
Gas PipingFuel Oil PipingWater HeaterHose Bibb
Drinking FountainDishwasher
LPGas Tank
Greasetrap
Stacks
Sewer ConnectionWater Service Connection
Other
$
TOTAL FEEState Permit Surcharge Fee
Minimum FeeAdministrative Surcharge
FIXTURE/EQUIPMENTQTY. FEE (Office Use Only)
$
$
$$
[ ] Licensed Plumbing Contractor [ ] Exempt Applicant
C. CERTIFICATION IN LIEU OF OATHI hereby certify that I am the (agent of) owner of record and am authorized to make thisapplication and perform the work listed on this application.
Gas PipingGas Equipment
SewerWaterRoughSlab
LPGas Tank
Fixtures
TCOSolarFuel Oil Piping
Final
Print name here:
Applicant sign/Contractorsign and seal here:
Approved by:Date:
Type:
Dates (Month/Day)INSPECTIONS
InitialApprovalFailureFailure
JOB SUMMARY (Office Use Only)PLAN REVIEW
Joint Plan Review Required:
Approved by:Date:
CA[ ]COSUBCODE APPROVAL for CERTIFICATE[ ] [ ] CCO
SUBCODE APPROVAL for PERMITDate:Approved by:
[ ] Bldg. [ ] Elec. [ ] Fire. [ ] Elev.
No Plans Required[ ]
Plumbing Plans Approved[ ]
Partial -Underslab Utilities Approved[ ]Approved by:Date:
99
Flammable/Combustible Tanks
[ ]Alarm Devices (i.e., smoke, heat, pulls,water/flow)Supervisory Devices (i.e., tampers, low/high air)Signaling Devices (i.e., horn/strobes, bells)Other DevicesTOTALSuppression Systems
GPM TypeFire PumpDry Pipe/Alarm ValvesPre-action ValvesSprinkler Heads (Dry and Wet)StandpipesPre-engineered SystemsWet ChemicalDry ChemicalCO2 Suppression
Other Systems
Foam SuppressionFM200 SuppressionOther
Kitchen Hood Exhaust SystemSmoke Control SystemFuel-Fired Appliances [ ] GasFireplace Venting/Metal Chimney
[ ] Solid
Other
System[ ][ ] 110v Interconnected
CO Detectors/110v
1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890
1234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456
FIRE PROTECTION SUBCODETECHNICAL SECTION
C. CERTIFICATION IN LIEU OF OATHI hereby certify that I am the (agent of) owner of record and am authorized to make thisapplication.
Alarm Systems
NUMBER FEE (Office Use Only)
Water Supply SourceMethod of Alarm/Suppression System Supervision _____________________
[ ] Certified Contractor [ ] Exempt Applicant
Date ReceivedControl #
Date IssuedPermit #
A. IDENTIFICATION—APPLICANT: COMPLETE ALL APPLICABLE INFORMATION. WHEN CHANGINGCONTRACTORS, NOTIFY THIS OFFICE. CALL UTILITY DIG NO: 1-800-272-1000.
[ ] Oil
U.C.C. F140 (rev. 02/11) 1 White = Inspector Copy 2 Canary = Office Copy 3 Pink = Office Copy 4 Gold = Applicant Copy
D. TECHNICAL SITE DATA
Block Lot Qualification CodeWork Site Location
zip codemunicipalitystreetAddress
e-mailTel. ( )
Owner in Fee:
Fire Protection Equipment, NJ Div of Fire Safety Permit No.Fire Protection Equipment, NJ Div of Fire Safety Installer No.Fire Alarm Contractor No. Exp. Date
Federal Emp. ID No. FAX: ( )Home Improvement Contractor Registration No. or Exemption Reason (if applicable):
InitialApprovalFailure FailureType:Dates (Month/Day)INSPECTIONS
Other
Fireplace VentingFlam/Combust Tanks
Final
TCOSmoke ControlMechanicalPre-Eng. SystemFire PumpStandpipeSuppression Sys.Alarm System
Total Cost of Fire Protection Work $
Fuel Type:
Location:
Solar[ ]Electric[ ]Other
Oil[ ]Gas[ ]
JOB SUMMARY (Office Use Only)PLAN REVIEW
No Plans Required[ ]
Approved by:Date:
SUBCODE APPROVAL for CERTIFICATECA[ ]CO[ ] [ ] CCO
Joint Plan Review Required:[ ] Bldg. [ ] Elec. [ ] Plumb. [ ] Elev.
SUBCODE APPROVAL for PERMITDate:Approved by:
Approved by:Date:Fire Protection Plans Approved[ ]
Partial -Underslab Utilities Approved[ ]Approved by:Date:
Heating System: Modification to ExistingOR [ ]New[ ][ ] ReplacementOR[ ]ConversionOR
New OR
Location of Main Control Valve:Existing
Fire Suppression/Standpipe System:[ ] [ ]
New OR ExistingFire Alarm System: [ ] [ ]Location of Panel:
Fuel Storage Tank:Fuel Type: [ ] Flammable OR [ ] Combustible
Capacity
B. FIRE PROTECTION CHARACTERISTICSProposedPresentUse Group:ProposedPresentConstr. Class:
Contractor: Tel. ( )
Address e-mail
Applicant/Contractorsign here:
DESCRIPTION OF WORK:
$
Administrative Surcharge $Minimum Fee $
State Permit Surcharge Fee $TOTAL FEE $
Print name here:
100
1234567890123412345678901234123456789012341234567890123412345678901234123456789012341234567890123412345678901234123456789012341234567890123412345678901234123456789012341234567890123412345678901234123456789012341234567890123412345678901234123456789012341234567890123412345678901234123456789012341234567890123412345678901234123456789012341234567890123412345678901234123456789012341234567890123412345678901234123456789012341234567890123412345678901234123456789012341234567890123412345678901234123456789012341234567890123412345678901234
MECHANICAL INSPECTIONTECHNICAL SECTION
A. IDENTIFICATION—APPLICANT: COMPLETE ALL APPLICABLE INFORMATION. WHEN CHANGINGCONTRACTORS, NOTIFY THIS OFFICE. CALL UTILITY DIG NO: 1-800-272-1000.
U.C.C. F145 (rev. 10/16)Internet version
FEE (Office Use Only)
TOTAL FEEState Permit Surcharge Fee
Minimum FeeAdministrative Surcharge
GeneratorFireplaceLPG TankOil TankHot Air FurnaceHot Water BoilerSteam BoilerGas Piping ConnectionsFuel Oil Piping ConnectionsWater Heater
FIXTURE/EQUIPMENTNO.
$$$$
Date ReceivedControl #
Date IssuedPermit #
Applicant: When submitting this form to your Local Construction CodeEnforcement Office, please provide one original plus three photocopies.
B. MECHANICAL CHARACTERISTICS
Estimated Cost of Mechanical Work $
Fuel Type:
[ ] [ ] Hot AirHydronicType:
Use Group R-3 or R-5 Present:
[ ] Other[ ] SolarElectric[ ][ ] Oil[ ] Gas
Heating System work: Modification to ExistingNew ReplacementConversion[ ] [ ]OR[ ]OROR[ ]
1234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890123456789012345678901234567890121234567890123456789012345678901212345678901234567890123456789012345678901212345678901234567890123456789012123456789012345678901234567890123456789012123456789012345678901234567890121234567890
Failure Failure Approval InitialDATESINSPECTIONS
Type:Gas PipingApplianceChimney/VentOil PipingOil TankLPG TankHydronic PipingFireplaceChimney Cert.Other
JOB SUMMARY (Office Use Only)PLAN REVIEW
No Plans Required[ ]
Mechanical Plans Approved[ ]
Approved by:Date:
SUBCODE APPROVAL for PERMIT
Approved by:Date:
SUBCODE APPPROVAL for CERTIFICATECA CCO[ ] [ ]
Date:Approved by:
Joint Plan Review Required:[ ] Bldg. [ ] Elec. [ ] Plumb. [ ] Fire.[ ] Elev.
Contractor License No. Exp. Date
Federal Emp. ID No. FAX: Home Improvement Contractor Registration No. or Exemption Reason
zip codemunicipalitystreetAddress
e-mailTel.
Owner in Fee:
Contractor: Tel.
Address e-mail
Block Lot Qualification Code
Work Site Location
C. CERTIFICATION IN LIEU OF OATHI hereby certify that I am the (agent of) owner of record and am authorized to make thisapplication.
D. TECHNICAL SITE DATA
DESCRIPTION OF WORK
Sign here:
Print name here:
$
101
1234567890123456789012345678901212345678901234567890123456789012123456789012123456789012345678901234567890121234567890123456789012345678901212345678901212345678901234567890123456789012123456789012345678901234567890121234567890121234567890123456789012345678901212345678901234567890123456789012123456789012123456789012345678901234567890121234567890123456789012345678901212345678901212345678901234567890123456789012123456789012345678901234567890121234567890121234567890123456789012345678901212345678901234567890123456789012123456789012123456789012345678901234567890121234567890123456789012345678901212345678901212345678901234567890123456789012123456789012345678901234567890121234567890121234567890123456789012345678901212345678901234567890123456789012123456789012123456789012345678901234567890121234567890123456789012345678901212345678901212345678901234567890123456789012123456789012345678901234567890121234567890121234567890123456789012345678901212345678901234567890123456789012123456789012123456789012345678901234567890121234567890123456789012345678901212345678901212345678901234567890123456789012123456789012345678901234567890121234567890121234567890123456789012345678901212345678901234567890123456789012123456789012123456789012345678901234567890121234567890123456789012345678901212345678901212345678901234567890123456789012123456789012345678901234567890121234567890121234567890123456789012345678901212345678901234567890123456789012123456789012123456789012345678901234567890121234567890123456789012345678901212345678901212345678901234567890123456789012123456789012345678901234567890121234567890121234567890123456789012345678901212345678901234567890123456789012123456789012123456789012345678901234567890121234567890123456789012345678901212345678901212345678901234567890123456789012123456789012345678901234567890121234567890121234567890123456789012345678901212345678901234567890123456789012123456789012
1234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456123456789012345612345678901234561234567890123456
ELEVATOR SUBCODETECHNICAL SECTION
U.C.C. F150 1 White = Inspector Copy 2 Canary = Office Copy(rev. 11/09) 3 Pink = Office Copy 4 Gold = Applicant Copy
D. TECHNICAL SITE DATA
C. CERTIFICATION IN LIEU OF OATHI hereby certify that I am the (agent of) owner of record and am authorized to makethis application.
Date ReceivedControl #
Date IssuedPermit #
A. IDENTIFICATION—APPLICANT: COMPLETE ALL APPLICABLE INFORMATION. WHEN CHANGINGCONTRACTORS, NOTIFY THIS OFFICE. CALL UTILITY DIG NO: 1-800-272-1000.
OtherOtherAlterationsAuxiliary Power GeneratorCounterweight Governor and SafetiesOil Buffers
Stairway Chairlift, Inclined andVertical Wheelchair Lifts and Man Lifts
DumbwaiterEscalator/Moving WalkRoped HydraulicHydraulic
Over 10 Floors1 to 10 Floors
Traction or Winding DrumITEMQTY.
DESCRIPTION OF WORK
Work Site Location
e-mailTel. ( )
Owner in Fee:
Block Lot Qualification Code
zip codemunicipalitystreetAddress
Contractor/Installer: Tel. ( )
Address e-mail
Home Improvement Contractor Registration No. or Exemption Reason (if applicable):
( )Federal Emp. ID No. FAX:
e-mailAddress
Tel ( ______ ) FAX ( ______ )
Maintenance/Service Contractor
No. of Stops No. of OpeningsMachine Room LocationManufacturer Device I.D.Building Use Group Building Registration No.B. ELEVATOR CHARACTERISTICS
Capacity (lbs.)Passenger FreightType of ControlTravel (ft.)
Type of OperationSpeed (f.p.m.)
Estimated Cost of Elevator Work $Yr. of Alt.Yr. of Install. Standard AppliedStandard Applied
[ ] CO [ ] CA
Dates (Month/Day)INSPECTIONSInitialApprovalFailure Failure
FinalTemporary
Type:
SUBCODE APPROVAL for CERTIFICATE
JOB SUMMARY (Office Use Only)PLAN REVIEW
Date:SUBCODE APPROVAL for PERMITDate:
Approved by:Approved by:
Joint Plan Review Required:[ ] Bldg. [ ] Elec. [ ] Plumb. [ ] Fire.
Approved by:Date:[ ] Elevator Layout DrawingsDate: Approved by:
No Plans Required[ ][ ] Building Plans and Elevator Specs.
FEE (Office Use Only)
$
Administrative Surcharge $State Permit Surcharge Fee $
TOTAL FEE $
Sign here:
Print name here:
102
CERTIFICATION IN LIEU OF OATHI hereby certify that I am the (agent of) owner ofrecord and am authorized to make this application.
IDENTIFICATION-APPLICANT: COMPLETE ALL APPLICABLEINFORMATION. WHEN CHANGING CONTRACTORS, NOTIFYTHIS OFFICE. CALL UTILITY DIG NO: 1-800-272-1000
Block Lot
SignatureWork Site Location
TECHNICAL SECTIONELEVATOR SUBCODE
DEVICES CHARACTERISTICS
Traction/Winding Drum
Hydraulic
Roped Hydraulic
Escalator/Moving Walk
Dumbwaiter
Stairway/Chair/Man Lift
Auxilary Power Generator
Counterweight Governor
Oil Buffers
Manufacturer
Machine Room Location
Number of Stops
Number of Openings
Travel (ft.)
Speed (f.p.m.)
Type of Operation
Type of Control
Passenger/Freight
Capacity
Temp. Cert. of Comp.
Cert. of Compliance
Issue DateYear of Installation/Major Alteration
Expire DateNumber
DateID ID ID ID ID ID ID
U.C.C. F155 1 White = Inspector Copy 2 Canary = Office Copy (rev. 5/03) 3 Pink = Office Copy 4 Gold = Applicant Copy
Date
SUPPLEMENT FOR MULTIPLE EQUIPMENT
Qualification Code
Date ReceivedControl #
Date IssuedPermit #
103
IDE
NTI
FIC
ATIO
N
AP
PLI
CA
NT
STA
TEM
EN
T
Ple
ase
stat
e th
e re
quire
men
ts o
f the
sub
code
from
whi
ch a
var
iatio
n is
sou
ght.
(Use
sep
arat
e ap
plic
atio
n fo
rms
for e
ach
varia
tion
requ
est):
DE
TER
MIN
ATIO
NTh
is a
pppl
icat
ion
is to
be
revi
ewed
with
in 2
0 bu
sine
ss d
ays.
Afte
r rev
iew
ing
the
fact
s, w
e [
] DE
NY
[ ]
GR
AN
T th
e ab
ove
varia
tion
requ
est,
in a
ccor
danc
e w
ith N
.J.A
.C. 5
:23-
2.9
thro
ugh
2.13
, for
the
follo
win
g re
ason
s:
How
wou
ld c
ompl
ianc
e w
ith s
aid
prov
isio
ns re
sult
in p
ract
ical
diff
icul
ties?
Exp
lain
the
natu
re a
nd e
xten
t of t
hese
diff
icul
-tie
s:
U.C
.C. F
160
(rev.
5/2
003)
APP
LIC
ATIO
NFO
R A
VAR
IATI
ON
Blo
ckLo
t
Con
tract
or
Lice
nse
#
Addr
ess
Tele
. ( _
__ )
Fede
ral E
mp.
#
Wor
k S
ite L
ocat
ion
Dat
eB
uild
ing
Sub
code
Offi
cial
Plu
mbi
ng S
ubco
de O
ffici
al
Ele
vato
r Sub
code
Offi
cial
Ele
ctric
al S
ubco
de O
ffici
alFi
re S
ubco
de O
ffici
al
Con
stru
ctio
n O
ffici
al
Tele
. ( _
__ )
Addr
ess
FEE
$
Ow
ner i
n Fe
e
(Det
erm
ined
by
Enfo
rcin
g Ag
ency
)
Ple
ase
stat
e an
alte
rnat
ive
to th
e su
bcod
e re
quire
men
t tha
t will
stil
l pro
tect
the
heal
th, s
afet
y an
d w
elfa
re o
f the
occ
upan
ts:
DAT
ESI
GN
EDA
PP
LIC
AN
T
Dat
e R
ecei
ved:
Con
trol #
:D
ate
Issu
ed:
Per
mit
#:D
ate
Rev
ised
:D
ate
Per
mit
Issu
ed:
Qua
lific
atio
n C
ode
*
104
Date Issued
Permit #CONSTRUCTIONPERMIT
PAYMENTS (Office Use Only)Building _________________________Electrical ________________________Plumbing ________________________Fire Protection ___________________Elevator Devices __________________Other ___________________________DCA State Permit Fee______________Cert. of Occupancy ________________Other ___________________________Total ___________________________Check No. _______________________Cash ___________________________Collected by _____________________
(see reverse side)1 WHITE—INSPECTOR 2 CANARY—OFFICE 3 PINK—TAX ASSESSOR 4 GOLD—APPLICANT
[ ] LEAD HAZARD ABATEMENT
Construction Official
Estimated Cost of Work $
DESCRIPTION OF WORK:
Date
Is hereby granted permission to perform the following work:[ ] BUILDING [ ] PLUMBING[ ] ELECTRICAL [ ] FIRE PROTECTION [ ] DEMOLITION[ ] ELEVATOR DEVICES [ ] ASBESTOS ABATEMENT [ ] OTHER
(Subchapter 8 only)
NOTE: If construction does not commence within one (1) year of date of issuance, orif construction ceases for a period of six (6) months, this permit is void.
IDENTIFICATION BlockWork Site Location
Owner in FeeAddress
Address
Tel. ( ______ )
Tel. ( ______ )Lic. No. or Bldrs. Reg. No.
ContractorLot
U.C.C. F170 (rev. 01/04)
Qualification Code
Sample
Sample
Sample
105
REQUIRED INSPECTIONS
U.C.C. F170-2 (rev. 1/04)
Construction work must be inspected in accordance with the State Uniform Construction Code Regulations N.J.A.C. 5:23-2.18. This agency will carry out such periodic inspections during the progress of work as are necessary to insure that workinstalled conforms with the requirements of the Uniform Construction Code.
The owner or other responsible person in charge of work must notify this agency when work is ready for any requiredinspections specified below. Requests for inspections must be made at least 24 hours prior to the time the inspection isdesired. Inspections will be performed within three business days of the time for which they are requested. The work mustnot proceed in a manner which will preclude the inspection until it has been made and approval given.
A final inspection is required for each applicable subcode area before a final Certificate of Occupancy or Approval may beissued. The final inspections include the installation of all interior and exterior finish materials, sealing of exterior joints,mechanical system and other required equipment; electrical wiring, devices and fixtures; plumbing pipes, trim and fix-tures; tests required by any provision of the adopted subcodes, Barrier Free accessibility, if applicable; and verification ofcompliance with NJAC 5:23-3.5, "Posting structures".A complete copy of released plans must be kept on the job site.
All structural framing, connections, wall and roof sheathing and insulation; electrical rough wiring, panel and service installation;rough plumbing. The framing inspection shall take place after the rough electrical and plumbing inspections and after the instal-lation of the heating, ventilation and/or air conditioning duct system. The insulation inspection shall be performed after all othersubcode rough inspections and prior to the installation of any interior finish material.
Utility services, including septic.3.
4.
Required inspections for all subcodes for one- and two-family dwellings are as follows:The bottom of footing trenches before placement of footings, except that in the case of pile foundations, inspections shall be made in accordance with the requirements of the building subcode.
1.
Foundations and all walls up to grade level prior to back filling.2.
Additional required inspections for all subcodes of construction, for other than one- and two-family dwellings, are firesuppression systems, heat producing devices and Barrier Free subcode accessibility, if applicable.
Required special inspections. The applicant by accepting the permit will be deemed to have consented to theserequirements:
106
Date IssuedControl #Permit #
CONSTRUCTION PERMIT NOTICE
This notice shall be posted conspicuously at the work site and shall remain so until issuance of a certificate.
U.C.C. F180(rev. 3/03)
Description of Work:
OTHERELEVATOR DEVICESPLUMBINGBUILDING
AUTHORIZED FOR:
ELECTRICALFIRE PROTECTIONDEMOLITION
Work Site Location:
Block Lot
CONSTRUCTION PERMIT NOTICEQualification Code
_
Sample
Sample
Sample
107
FINAL PAYMENT TO THE CONTRACTORIS NOT REQUIRED TO BE MADEBEFORE A FINAL INSPECTION
IS PERFORMED.
FOR INSPECTION ON CONSTRUCTION PERMITS FOR:BUILDINGELECTRICPLUMBING
FIRE PROTECTIONOR
ELEVATOR
N.J. DIVISION OFCONSUMER AFFAIRS RULE:N.J.A.C. 13:45A - 16.2(a)10.ii
U.C.C. F180-2(rev. 6/97)
108
PERMIT UPDATEDate Update IssuedPermit #Date Permit Issued
PAYMENTS (Office Use Only)Building _________________________Electrical ________________________Plumbing ________________________Fire Protection ___________________Elevator Devices __________________Other ___________________________State Permit Surcharge Fee _________Cert. of Occupancy ________________Other ___________________________Total ___________________________Check No. _______________________Cash ___________________________Collected by _____________________
1 WHITE—INSPECTOR 2 CANARY—OFFICE 3 PINK—OFFICE 4 GOLD—APPLICANTU.C.C. F190 (rev. 1/04)
Construction Official
Estimated Cost of Work $
DESCRIPTION OF WORK:
Date
Is hereby granted permission to perform the following work:
IDENTIFICATION BlockWork Site Location
Owner in FeeAddress
Address
Tel. ( ______ )
Tel. ( ______ )Lic. No. or Bldrs. Reg. No.
ContractorLot Qualification Code
[ ] BUILDING [ ] PLUMBING [ ] LEAD HAZARD ABATEMENT[ ] ELECTRICAL [ ] FIRE PROTECTION [ ] DEMOLITION[ ] ELEVATOR DEVICES [ ] ASBESTOS ABATEMENT [ ] OTHER
(Subchapter 8 only)
NOTE: If construction does not commence within one (1) year of date of issuance, orif construction ceases for a period of six (6) months, this permit is void.
_
Sample
Sample
Sample
109
To
U.C.C. F200(rev. 3/04)
Availablity/Comments
Inspection Requested
Work Site Location
Block Lot
Telephone ( ) Permit #
Owner/Agent
Time Date By
Qualification Code
INSPECTION NOTICE
110
NO
TIC
E O
F VI
OLA
TIO
N A
ND
O
RD
ER T
O T
ERM
INAT
E
Per
mit
#D
ate
Issu
ed
NO
TIC
E of
Vio
latio
n an
d O
RD
ER to
Ter
min
ate:
If yo
u ha
ve a
ny q
uest
ions
con
cern
ing
this
mat
ter,
plea
se c
all:
Your
app
licat
ion
for a
ppea
l mus
t be
in w
ritin
g, s
ettin
g fo
rth y
our a
ddre
ss a
nd n
ame,
the
addr
ess
of th
e bu
ildin
g or
site
inqu
estio
n, th
e pe
rmit
num
ber,
the
spec
ific
sect
ions
of t
he R
egul
atio
ns in
que
stio
n, a
nd th
e ex
tent
and
nat
ure
of y
our r
elia
nce
on th
em.
You
may
incl
ude
a br
ief s
tate
men
t set
ting
forth
you
r pos
ition
and
the
natu
re o
f the
relie
f sou
ght b
y yo
u. Y
ou m
ayal
so a
ppen
d an
y do
cum
ents
that
you
con
side
r use
ful.
If yo
u w
ish
to c
onte
st th
is O
RD
ER, y
ou m
ay re
ques
t a h
earin
g be
fore
the
Con
stru
ctio
n B
oard
of A
ppea
ls o
f the
____
____
____
____
____
____
____
____
____
of _
____
____
____
____
____
____
____
____
____
_, w
ithin
15
days
of r
ecei
ptof
this
OR
DER
as
prov
ided
by
N.J
.A.C
. 5:2
3A-2
.1.
The
App
licat
ion
to th
e C
onst
ruct
ion
Boa
rd o
f App
eals
may
be
used
for
this
pur
pose
.
Furt
her,
take
NO
TIC
E th
at fa
ilure
to c
ompl
y w
ith th
is O
RD
ER m
ay re
sult
in th
e as
sess
men
t of p
enal
ties
of u
p to
$2,0
00 p
er w
eek
per v
iola
tion,
and
a c
ertif
icat
e of
occ
upan
cy w
ill no
t be
issu
ed u
ntil
such
pen
alty
has
bee
n pa
id.
TAK
E N
OTI
CE
that
you
hav
e be
en fo
und
to b
e in
vio
latio
n of
the
Stat
e U
nifo
rm C
onst
ruct
ion
Cod
e A
ct a
nd R
egul
atio
nspr
omul
gate
d th
ereu
nder
in th
at:
AC
TIO
N
Wor
k S
ite L
ocat
ion
Ow
ner i
n Fe
e
Add
ress
Blo
ck
Age
nt/C
ontra
ctor
IDEN
TIFI
CAT
ION
Lot
To:
Oth
er:
Age
nt/C
ontra
ctor
Ow
ner
U.C
.C. F
211
(rev.
1/2
004)
Add
ress
Dat
e:S
ubC
ode
Offi
cial
You
are
here
by O
RD
ERED
to te
rmin
ate
the
said
vio
latio
ns o
n or
bef
ore
.
No
Cer
tific
ate
of O
ccup
ancy
or A
ppro
val w
ill be
issu
ed u
nles
s th
e sa
id v
iola
tions
are
cor
rect
ed.
Qua
lific
atio
n C
ode
- or
-
Con
trol #
The
fee
for a
n ap
peal
is $
___
____
____
____
____
_ a
nd s
houl
d be
forw
arde
d w
ith y
our a
pplic
atio
n to
the
Con
stru
ctio
nB
oard
of A
ppea
ls O
ffice
at :
DAT
E O
F TH
IS N
OTI
CE
:C
OM
PLI
AN
CE
DU
E D
ATE
:D
ATE
OF
INS
PE
CTI
ON
:
Sample
Sample
Sample
111
Ther
efor
e, y
ou a
re h
ereb
y O
RD
ERED
to p
ay a
pen
alty
in th
e am
ount
of $
___
____
___
for e
ach
viol
atio
n fo
r a to
tal
pena
lty o
f $ _
____
____
_.
Furt
her,
take
NO
TIC
E th
at fo
r eac
h [
] w
eek
[
] day
that
any
of t
he s
aid
viol
atio
ns re
mai
n ou
tsta
ndin
g af
ter
____
____
____
____
____
____
, an
add
ition
al p
enal
ty o
f $ _
____
____
_ p
er [
] w
eek
[
] day
sha
ll re
sult.
NO
TIC
E A
ND
OR
DER
OF
PEN
ALT
Y
Per
mit
#D
ate
Issu
ed
Your
app
licat
ion
for a
ppea
l mus
t be
in w
ritin
g, s
ettin
g fo
rth y
our a
ddre
ss a
nd n
ame,
the
addr
ess
of th
e bu
ildin
g or
site
inqu
estio
n, th
e pe
rmit
num
ber,
the
spec
ific
sect
ions
of t
he R
egul
atio
ns in
que
stio
n, a
nd th
e ex
tent
and
nat
ure
of y
our r
elia
nce
on th
em.
You
may
incl
ude
a br
ief s
tate
men
t set
ting
forth
you
r pos
ition
and
the
natu
re o
f the
relie
f sou
ght b
y yo
u. Y
ou m
ayal
so a
ppen
d an
y do
cum
ents
that
you
con
side
r use
ful.
If yo
u w
ish
to c
onte
st th
is O
RD
ER, y
ou m
ay re
ques
t a h
earin
g be
fore
the
Con
stru
ctio
n B
oard
of A
ppea
ls o
fth
e
of
, with
in 1
5 da
ys o
f rec
eipt
of t
his
OR
DER
as
pro-
vide
d by
N.J
.A.C
. 5:2
3A-2
.1.
The
App
licat
ion
to th
e C
onst
ruct
ion
Boa
rd o
f App
eals
may
be
used
for t
his
purp
ose.
AC
TIO
N
IDEN
TIFI
CAT
ION
On
____
____
____
_ , y
ou w
ere
foun
d to
be
in v
iola
tion
of th
e St
ate
Uni
form
Con
stru
ctio
n C
ode
Act
and
Reg
ula-
tions
pro
mul
gate
d th
ereu
nder
. A
[ ]
Not
ice
of V
iola
tion
and
Ord
er to
Ter
min
ate
[
] Not
ice
of U
nsaf
eSt
ruct
ure
[
] Not
ice
of Im
min
ent H
azar
d w
as is
sued
. R
eins
pect
ion
of th
e w
ork
site
on
____
____
____
_re
veal
ed th
e fo
llow
ing
viol
atio
n(s)
rem
ain:
On
____
____
____
_ , y
ou w
ere
foun
d to
be
in v
iola
tion
of th
e St
ate
Uni
form
Con
stru
ctio
n C
ode
Act
and
Reg
ula-
tions
pro
mul
gate
d th
ereu
nder
. A
Stop
Con
stru
ctio
n O
rder
was
issu
ed.
Rei
nspe
ctio
n of
the
wor
k si
te o
n__
____
____
___
reve
aled
a fa
ilure
to c
ompl
y w
ith th
at S
top
Con
stru
ctio
n O
rder
.
PEN
ALT
Y
- or
-
Con
trol #
The
fee
for a
n ap
peal
is $
___
____
____
____
____
_ a
nd s
houl
d be
forw
arde
d w
ith y
our a
pplic
atio
n to
the
Con
stru
ctio
nB
oard
of A
ppea
ls O
ffice
at :
NO
TIC
E an
d O
RD
ER o
f Pen
alty
:D
ate:
Con
stru
ctio
n O
ffici
al
If yo
u ha
ve a
ny q
uest
ions
con
cern
ing
this
mat
ter,
plea
se c
all:
Wor
k S
ite L
ocat
ion
Blo
ckLo
tQ
ualif
icat
ion
Cod
e
Ow
ner i
n Fe
eA
ddre
ssA
gent
/Con
tract
orA
ddre
ss
Ow
ner
To:
Oth
er:
Age
nt/C
ontra
ctor
On
____
____
____
_ , y
ou w
ere
foun
d to
be
in v
iola
tion
of th
e St
ate
Uni
form
Con
stru
ctio
n C
ode
Act
and
Reg
ula-
tions
pro
mul
gate
d th
ereu
nder
, in
that
you
[ ]
mad
e a
fals
e or
mis
lead
ing
writ
ten
stat
emen
t, or
om
itted
requ
ired
info
rmat
ion
in a
n ap
plic
atio
n or
requ
est f
or a
ppro
val;
or
[ ]
faile
d to
obt
ain
a co
nstr
uctio
npe
rmit;
or
[ ]
faile
d to
requ
est r
equi
red
insp
ectio
ns; o
r [
] a
llow
ed o
ccup
ancy
prio
r to
rece
ivin
g a
cert
ifica
te o
f occ
upan
cy.
U.C
.C. F
212
(4/2
003)
Sample
Sample
Sample
112
NO
TIC
E O
F VI
OLA
TIO
N A
ND
O
RD
ER T
O T
ERM
INAT
E
NO
TIC
E of
Vio
latio
n an
d O
RD
ER to
Ter
min
ate:
If yo
u ha
ve a
ny q
uest
ions
con
cern
ing
this
mat
ter,
plea
se c
all:
Your
app
licat
ion
for a
ppea
l mus
t be
in w
ritin
g, s
ettin
g fo
rth y
our a
ddre
ss a
nd n
ame,
the
addr
ess
of th
e bu
ildin
g or
site
inqu
estio
n, th
e sp
ecifi
c se
ctio
ns o
f the
NO
TIC
E an
d O
RD
ER in
que
stio
n, a
nd th
e ex
tent
and
nat
ure
of y
our o
bjec
tion
to th
em.
You
may
incl
ude
a br
ief s
tate
men
t set
ting
forth
you
r po
sitio
n an
d th
e na
ture
of t
he r
elie
f sou
ght b
y yo
u. Y
ou m
ay a
lso
appe
nd a
ny d
ocum
ents
that
you
con
side
r use
ful.
If ei
ther
nam
ed p
arty
wis
hes
to c
onte
st th
is N
OTI
CE
and
OR
DER
, he
or s
he m
ay re
ques
t a h
earin
g be
fore
the
Con
stru
c-tio
n B
oard
of A
ppea
ls o
f the
___
____
____
____
____
____
____
____
____
_ of
___
____
____
____
____
____
____
____
___,
with
in 1
5 da
ys o
f rec
eipt
of t
his
NO
TIC
E an
d O
RD
ER a
s pr
ovid
ed b
y N
.J.A
.C. 5
:23A
-2.1
. Th
e A
pplic
atio
n to
the
Con
stru
c-tio
n B
oard
of A
ppea
ls m
ay b
e us
ed fo
r thi
s pu
rpos
e.
Failu
re to
com
ply
with
this
OR
DER
may
resu
lt in
the
asse
ssm
ent o
f pen
altie
s of
up
to $
2,00
0 pe
r wee
k pe
r vio
latio
n.
TAK
E N
OTI
CE
that
vio
latio
ns o
f the
Sta
te U
nifo
rm C
onst
ruct
ion
Cod
e A
ct a
nd R
egul
atio
ns p
rom
ulga
ted
ther
eund
er a
repr
esen
t at s
ubje
ct lo
catio
n as
follo
ws:
AC
TIO
N
IDEN
TIFI
CAT
ION
To:
Con
tract
or/B
uild
er:
Ow
ner i
n fe
e:
U.C
.C. F
213
(2/2
005)
Dat
e:S
ubC
ode
Offi
cial
You
are
here
by O
RD
ERED
to te
rmin
ate
the
said
vio
latio
ns o
n or
bef
ore
.
Ord
er N
o:
The
fee
for a
n ap
peal
is $
___
____
____
____
____
_ a
nd s
houl
d be
forw
arde
d w
ith y
our a
pplic
atio
n to
the
Con
stru
ctio
nB
oard
of A
ppea
ls O
ffice
at :
DAT
E O
F TH
IS N
OTI
CE
:C
OM
PLI
AN
CE
DU
E D
ATE
:D
ATE
OF
INS
PE
CTI
ON
:(Pos
t-Cer
tific
ate
of O
ccup
ancy
-Res
iden
tial C
onst
ruct
ion)
Wor
k S
ite L
ocat
ion
Blo
ckLo
tQ
ualif
icat
ion
Cod
e
AN
D
Furt
her,
take
NO
TIC
E, y
ou m
ust o
btai
n a
Con
stru
ctio
n P
erm
it fo
r rem
edia
tion
wor
k ne
cess
ary
to b
ring
abou
t com
pli-
ance
. Th
e bu
ilder
or c
ontra
ctor
mus
t obt
ain
the
prop
erty
ow
ner's
con
sent
in w
ritin
g an
d pr
ovid
e su
ch w
ith th
e C
onst
ruc-
tion
Per
mit
App
licat
ion.
The
prop
erty
ow
ner b
ears
join
t res
pons
ibili
ty w
ith th
e bu
ilder
or c
ontra
ctor
for b
ringi
ng a
bout
com
plia
nce.
Furt
her t
ake
NO
TIC
E th
at th
e fo
llow
ing
item
s, w
hich
wer
e in
clud
ed in
the
owne
r's c
ompl
aint
dat
ed _
____
____
___
have
bee
n fo
und
not t
o co
nstit
ute
viol
atio
ns o
f the
New
Jer
sey
Uni
form
Con
stru
ctio
n C
ode
(N.J
.A.C
. 5:2
3):
_
Sample
Sample
Sample
113
NO
TIC
E A
ND
OR
DER
OF
PEN
ALT
Y
Your
app
licat
ion
for a
ppea
l mus
t be
in w
ritin
g, s
ettin
g fo
rth y
our a
ddre
ss a
nd n
ame,
and
the
addr
ess
of th
e bu
ildin
g or
site
in q
uest
ion.
You
may
incl
ude
a br
ief s
tate
men
t set
ting
forth
you
r pos
ition
and
the
natu
re o
f the
relie
f sou
ght b
y yo
u. Y
ou m
ayal
so a
ppen
d an
y do
cum
ents
that
you
con
side
r use
ful.
The
hom
eow
ner w
ill be
pro
vide
d an
opp
ortu
nity
to e
xpla
in th
eir d
enia
lof
con
sent
at a
ny h
earin
g.
If yo
u w
ish
to c
onte
st th
is N
OTI
CE
and
OR
DER
, you
may
requ
est a
hea
ring
befo
re th
e C
onst
ruct
ion
Boa
rd o
f App
eals
of
the
o
f
,
with
in 1
5 da
ys o
f rec
eipt
of t
his
NO
TIC
E an
d O
RD
ER a
s pr
ovid
ed b
y N
.J.A
.C. 5
:23A
-2.1
. Th
e A
pplic
atio
n to
the
Con
stru
ctio
n B
oard
of A
ppea
ls m
ay b
eus
ed fo
r thi
s pu
rpos
e.
Ther
efor
e, y
ou a
re h
ereb
y O
RD
ERED
to p
ay a
pen
alty
in th
e am
ount
of $
___
____
___
for e
ach
viol
atio
n fo
r a to
tal p
enal
tyof
$ _
____
____
_.
Furt
her,
take
NO
TIC
E th
at fo
r eac
h w
eek
that
any
of t
he s
aid
viol
atio
ns re
mai
n ou
tsta
ndin
g af
ter
____
____
____
____
____
____
, an
add
ition
al p
enal
ty o
f $ _
____
____
_ p
er w
eek
shal
l res
ult.
NO
TIC
E
IDEN
TIFI
CAT
ION
On
____
____
____
____
, yo
u w
ere
foun
d to
be
in v
iola
tion
of th
e St
ate
Uni
form
Con
stru
ctio
n C
ode
Act
and
Reg
ulat
ions
prom
ulga
ted
ther
eund
er.
A N
otic
e of
Vio
latio
n an
d O
rder
to T
erm
inat
e w
as is
sued
. R
eins
pect
ion
of th
e w
ork
site
on
____
____
____
____
reve
aled
the
follo
win
g vi
olat
ion(
s) re
mai
n:
PEN
ALT
Y
The
fee
for a
n ap
peal
is $
___
____
____
____
____
_ a
nd s
houl
d be
forw
arde
d w
ith y
our a
pplic
atio
n to
the
Con
stru
ctio
nB
oard
of A
ppea
ls O
ffice
at :
NO
TIC
E an
d O
RD
ER o
f Pen
alty
:D
ate:
Con
stru
ctio
n O
ffici
al
If yo
u ha
ve a
ny q
uest
ions
con
cern
ing
this
mat
ter,
plea
se c
all:
U.C
.C. F
214
(2/2
005)
(Pos
t-Cer
tific
ate
of O
ccup
ancy
-Res
iden
tial C
onst
ruct
ion)
O
rder
No:
Wor
k S
ite L
ocat
ion
Blo
ckLo
tQ
ualif
icat
ion
Cod
e
To: C
ontra
ctor
/Bui
lder
Cop
y:H
omeo
wne
r
_
Sample
Sample
Sample
114
Date Inspector[ ] Footing[ ] Foundation[ ] Frame[ ] Insulation[ ] Mechanical[ ] Other[ ] Other[ ] Final
U.C.C. F221(rev. 3/96)
APPROVAL FORBUILDING
For Information Call:Permit No.:
_
Sample
Sample
Sample
115
U.C.C. F222A
APPROVAL FOR
For Information CallPermit #
[ ][ ] Service[ ] Other
Rough
Date Inspector
ELECTRICAL
Final [ ]
_
Sample
Sample
Sample
116
U.C.C. F223 (rev. 2/03)
[ ] Slab[ ] Rough[ ] Water[ ] Gas
[ ] Mechanical[ ] Sewer[ ] Other[ ] Other[ ] Final
Date Inspector
APPROVAL FORPLUMBING
For Information Call:
Permit No.
[ ] LPGas Tank
_
Sample
Sample
Sample
117
APPROVAL FOR
For Information CallPermit #
Date Inspector
FIRE PROTECTION
Sprinklers
Alarm
OtherMechanical
Special Supp.Standpipes
[ ][ ][ ]
[ ]
[ ]
[ ]
[ ]
Final
U.C.C. F224A
_
Sample
Sample
Sample
118
Date
( )( ) Car/Floor( ) Hoistway/Pit
Machine Room
( ) Temp. 30 DayOther( )
( ) Final
Inspector
U.C.C. F225
APPROVAL FORELEVATOR
Elevator Number ____________
For Information CallPermit #
_
Sample
Sample
Sample
119
For Information CallPermit #
BUILDINGPLUMBING
ELECTRICALFIREPROTECTION
ELEVATOR DEVICES
Date InspectorComments
U.C.C. F230B
NOT APPROVED
OTHER
Type of Inspection
_
Sample
Sample
Sample
120
IDEN
TIFI
CAT
ION
AC
TIO
NTa
ke N
OTI
CE
that
as
a re
sult
of th
e in
spec
tions
con
duct
ed b
y th
is a
genc
y on
o
nth
e ab
ove
prop
erty
, an
unsa
fe c
ondi
tion
has
been
foun
d to
exi
st p
ursu
ant t
o N
.J.S
.A. 5
2:27
D-1
32 a
nd N
.J.A
.C. 5
:23-
2.32
.Th
e bu
ildin
g or
stru
ctur
e, o
r por
tion
ther
eof,
deem
ed a
n un
safe
con
ditio
n is
des
crib
ed a
s fo
llow
s:
If yo
u w
ish
to c
onte
st th
is O
RD
ER, y
ou m
ay re
ques
t a h
earin
g be
fore
the
Con
stru
ctio
n B
oard
of A
ppea
ls o
fth
e
of
with
in 1
5 da
ys o
f rec
eipt
of t
his
notic
eas
pro
vide
d by
N.J
.A.C
. 5:2
3A-2
.1.
The
App
licat
ion
to th
e C
onst
ruct
ion
Boa
rd o
f App
eals
may
be
used
for t
his
purp
ose.
NO
TIC
E O
F U
NSA
FE S
TRU
CTU
RE
Per
mit
#D
ate
Issu
ed
You
are
here
by O
RD
ERED
to:
U.C
.C. F
241(
rev.
1/2
004)
Blo
ckLo
tQ
ualif
icat
ion
Cod
e
The
fee
for a
n ap
peal
is $
___
____
____
____
____
_ a
nd s
houl
d be
forw
arde
d w
ith y
our a
pplic
atio
n to
the
Con
stru
ctio
nB
oard
of A
ppea
ls O
ffice
at :
Your
app
licat
ion
for a
ppea
l mus
t be
in w
ritin
g, s
ettin
g fo
rth y
our n
ame
and
addr
ess,
the
addr
ess
of th
e bu
ildin
g or
site
inqu
estio
n, th
e sp
ecifi
c se
ctio
ns o
f the
Uni
form
Con
stru
ctio
n C
ode
in q
uest
ion
and
the
exte
nt a
nd n
atur
e of
you
r rel
ianc
e on
them
. Y
ou m
ay in
clud
e a
brie
f sta
tem
ent s
ettin
g fo
rth y
our p
ositi
on a
nd th
e na
ture
of t
he re
lief s
ough
t by
you,
and
you
may
also
app
end
any
docu
men
ts th
at y
ou c
onsi
der u
sefu
l.
Ow
ner i
n Fe
eAg
ent
Add
ress
Add
ress
To:
Oth
er:
Age
nt/C
ontra
ctor
Ow
ner
Wor
k S
ite L
ocat
ion
-
or
-C
ontro
l #:
[ ] V
acat
e th
e ab
ove
stru
ctur
e by
.
[ ] D
emol
ish
the
abov
e st
ruct
ure
by
, o
r cor
rect
the
abov
e no
ted
unsa
fe
co
nditi
ons
by n
o la
ter t
han
.
By
OR
DER
of :
CO
NST
RU
CTI
ON
OFF
ICIA
LD
ate:
If yo
u ha
ve a
ny q
uest
ions
con
cern
ing
this
mat
ter,
plea
se c
all:
Failu
re to
cor
rect
the
unsa
fe c
ondi
tion
or re
fusa
l to
com
ply
with
this
OR
DER
will
resu
lt in
this
mat
ter b
eing
forw
arde
d to
lega
lco
unse
l for
pro
secu
tion
and
asse
ssm
ent o
f pen
altie
s up
to $
2,00
0 pe
r wee
k pe
r vio
latio
n. Y
ou m
ust i
mm
edia
tely
dec
lare
toth
e C
onst
ruct
ion
Offi
cial
, you
r acc
epta
nce
or re
ject
ion
of th
e te
rms
of th
is O
RD
ER.
Any
build
ing
or s
truct
ure
vaca
ted
purs
uant
to th
is O
RD
ER s
hall n
ot b
e re
occu
pied
unl
ess
and
until
a c
ertif
icat
e of
occ
upan
cyis
issu
ed b
y th
e C
onst
ruct
ion
Offi
cial
.
DAT
E O
F TH
IS N
OTI
CE
:D
ATE
OF
INS
PE
CTI
ON
:
_
Sample
Sample
Sample
121
IDEN
TIFI
CAT
ION
AC
TIO
NTa
ke N
OTI
CE
that
as
a re
sult
of th
e in
spec
tions
con
duct
ed b
y th
is a
genc
y on
ofth
e ab
ove
prop
erty
, an
imm
inen
t haz
ard
has
been
foun
d to
exi
st p
ursu
ant t
o N
.J.S
.A. 5
2:27
D-1
32 a
nd N
.J.A
.C. 5
:23-
2.32
.Th
e bu
ildin
g or
stru
ctur
e, o
r por
tion
ther
eof,
deem
ed a
n im
min
ent h
azar
d is
des
crib
ed a
s fo
llow
s:
Failu
re to
rend
er th
e st
ruct
ure
tem
pora
rily
safe
and
sec
ure
and/
or d
emol
ish
the
stru
ctur
e in
acc
orda
nce
with
this
OR
DER
will
resu
lt in
this
mat
ter b
eing
forw
arde
d to
lega
l cou
nsel
for p
rose
cutio
n, a
nd a
sses
smen
t of p
enal
ties
up to
$2,
000
per w
eek
per
viol
atio
n. Y
ou m
ust i
mm
edia
tely
dec
lare
to th
e C
onst
ruct
ion
Offi
cial
, you
r acc
epta
nce
or re
ject
ion
of th
e te
rms
of th
is O
RD
ER.
By
OR
DER
of :
CO
NST
RU
CTI
ON
OFF
ICIA
L
NO
TIC
E O
F IM
MIN
ENT
HA
ZAR
D
Per
mit
#D
ate
Issu
ed
As
such
, you
are
her
eby
OR
DER
ED to
imm
edia
tely
and
forth
with
vac
ate
the
abov
e st
ruct
ure
or p
ortio
n th
ereo
f.
Furth
er, y
ou a
re O
RD
ERED
to:
U.C
.C. F
242
(rev.
1/2
004)
Blo
ckLo
tQ
ualif
icat
ion
Cod
e
Dat
e:
If yo
u ha
ve a
ny q
uest
ions
con
cern
ing
this
mat
ter,
plea
se c
all:
Ow
ner i
n Fe
eAg
ent
Add
ress
Add
ress
To:
Oth
er:
Age
nt/C
ontra
ctor
Ow
ner
Wor
k S
ite L
ocat
ion
-
or
-C
ontro
l #:
DAT
E O
F TH
IS N
OTI
CE
:D
ATE
OF
INS
PE
CTI
ON
:
If yo
u w
ish
to c
onte
st th
is O
RD
ER, y
ou m
ust a
pply
for a
sta
y to
a c
ourt
of c
ompe
tent
juris
dict
ion
with
in 2
4 ho
urs.
Failu
re to
imm
edia
tely
com
ply
with
this
OR
DER
may
resu
lt in
the
nece
ssar
y co
rrec
tion
bein
g m
ade
by th
e C
onst
ruct
ion
Offi
cial
at t
he e
xpen
se o
f the
pro
perty
ow
ner p
ursu
ant t
o N
.J.A
.C. 5
:23-
2.32
(b)5
.
[ ]
Dem
olis
h th
e ab
ove
stru
ctur
e by
.
Imm
edia
tely
cor
rect
the
abov
e no
ticed
imm
inen
t haz
ards
so
as to
rend
er th
e st
ruct
ure
tem
pora
rily
safe
and
sec
ure.
[ ]
_
Sample
Sample
Sample
122
Date Issued
Block Lot
Address
THIS BUILDING IS DECLARED UNSAFEFOR HUMAN OCCUPANCY
NO INDIVIDUAL IS TO OCCUPYTHIS BUILDING UNTIL THE STRUCTURE
IS RENDERED SAFE AND SECURE
This notice shall be posted conspicuously at the site and shallremain so until permission for its removal is granted.
U.C.C. F245 (rev. 2/2003)
ORDER TO VACATEQualification Code
_
Sample
Sample
Sample
123
Per
mit
#D
ate
Issu
ed
STO
P C
ON
STR
UC
TIO
N O
RD
ER
U.C
.C. F
250
(rev.
1/2
004)
By
OR
DER
of:
Sub
Cod
e O
ffici
al
If yo
u ha
ve a
ny q
uest
ions
con
cern
ing
this
mat
ter,
plea
se c
all:
The
fee
for a
n ap
peal
is $
___
____
____
____
____
_ a
nd s
houl
d be
forw
arde
d w
ith y
our a
pplic
atio
n to
the
Con
stru
ctio
nB
oard
of A
ppea
ls O
ffice
at :
If yo
u w
ish
to c
onte
st th
is O
RD
ER, y
ou m
ay re
ques
t a h
earin
g be
fore
the
Con
stru
ctio
n B
oard
of A
ppea
ls o
fth
e
of
,
with
in 1
5 da
ys o
f rec
eipt
of
this
OR
DER
as
prov
ided
by
N.J
.A.C
. 5:2
3A-2
.1.
The
App
licat
ion
to th
e C
onst
ruct
ion
Boa
rd o
f Ape
als
may
be
used
for t
his
purp
ose.
If ne
cess
ary,
the
enfo
rcin
g ag
ency
will
con
curr
ently
see
k th
e O
rder
of a
cou
rt of
com
pete
nt ju
risdi
ctio
n re
stra
inin
g fu
rther
wor
k at
the
abov
e lo
catio
n.
Per
mis
sion
to re
sum
e co
nstru
ctio
n m
ay b
e ob
tain
ed fr
om th
is e
nfor
cing
age
ncy
afte
r the
follo
win
g co
nditi
ons
are
met
:
This
OR
DER
is e
nter
ed p
ursu
ant t
o N
.J.A
.C. 5
:23-
2.31
(d) f
or v
iola
tion
of _
____
____
____
____
____
____
____
____
_w
hich
pro
vide
s:
You
are
here
by O
RD
ERED
to S
TOP
Bui
ldin
g
E
lect
rical
Plu
mbi
ng
F
ire P
rote
ctio
n
M
echa
nica
l
El
evat
or
A
ll C
ON
STR
UC
TIO
Nat
the
abov
e Lo
catio
n as
of _
____
____
____
____
____
____
_ u
ntil
furth
er n
otic
e fro
m th
is e
nfor
cing
age
ncy.
AC
TIO
N
IDEN
TIFI
CAT
ION
-
or
-C
ontro
l #
Dat
e:
Your
app
licat
ion
for a
ppea
l mus
t be
in w
ritin
g, s
ettin
g fo
rth y
our n
ame
and
addr
ess,
the
addr
ess
of th
e bu
ildin
g or
site
inqu
estio
n, th
e pe
rmit
num
ber,
the
spec
ific
sect
ions
of t
he R
egul
atio
ns in
que
stio
n, a
nd th
e ex
tent
and
nat
ure
of th
e re
lief
soug
ht b
y yo
u. Y
ou m
ay a
ppen
d an
y do
cum
ents
that
you
con
side
r use
ful.
Furt
her,
take
NO
TIC
E th
at fa
ilure
to c
ompl
y w
ith th
is O
RD
ER m
ay re
sult
in th
e as
sess
men
t of p
enal
ties
of u
p to
$2,
000
per d
ay p
er v
iola
tion,
and
a c
ertif
icat
e of
occ
upan
cy w
ill no
t be
issu
ed u
ntil
such
pen
alty
has
bee
n pa
id.
DAT
E O
F TH
IS N
OTI
CE
:D
ATE
OF
INS
PE
CTI
ON
:
Wor
k S
ite L
ocat
ion
Blo
ckLo
tQ
ualif
icat
ion
Cod
e
Add
ress
Ow
ner i
n Fe
eA
gent
Add
ress
To:
Oth
er:
Age
nt/C
ontra
ctor
Ow
ner
1_
Sample
Sample
Sample
124
Date Issued
STOP CONSTRUCTION NOTICEBlock Lot
Work Site Location:
This notice shall be posted conspicuously at the site and shallremain so until permission for its removal is granted.
U.C.C. F255 (rev. 2/04)
YOU ARE HEREBY ORDEREDTO STOP CONSTRUCTIONAT THE ABOVE ADDRESSUNTIL FURTHER NOTICE
FROM THIS ENFORCING AGENCY
Qualification Code
Permit #Date Issued
- or -Control #
119
Sample
Sample
Sample
125
CERTIFICATEIDENTIFICATION
Fee $ _____________________________________________Paid [ ] Check No. ________________________________Collected by: _________________________________________
1 WHITE — APPLICANT 2 CANARY — OFFICE 3 PINK — TAX ASSESSORU.C.C. F260(rev. 8/05)
CONSTRUCTION OFFICIAL DATE
CERTIFICATE OF OCCUPANCYThis serves notice that said building or structure has been constructed in accordancewith the New Jersey Uniform Construction Code and is approved for occupancy.
CERTIFICATE OF APPROVALThis serves notice that the work completed has been constructed or installed in accor-dance with the New Jersey Uniform Construction Code and is approved. If the permitwas issued for minor work, this certificate was based upon what was visible at the time ofthe inspection.
TEMPORARY CERTIFICATE OF OCCUPANCY/COMPLIANCEIf this is a temporary Certificate of Occupancy or Compliance, the following conditionsmust be met no later than ________________________ or will be subject to fine ororder to vacate:
CERTIFICATE OF CONTINUED OCCUPANCYThis serves notice that based on a general inspection of the visible parts of the buildingthere are no imminent hazards and the building is approved for continued occupancy.
CERTIFICATE OF CLEARANCE — LEAD ABATEMENT 5:17This serves notice that based on written certification, lead abatement was performedas per NJAC 5:17, to the following extent:[ ] Total removal of lead-based paint hazards in scope of work[ ] Partial or limited time period ( _____ years); see file
CERTIFICATE OF COMPLIANCEThis serves notice that said potentially hazardous equipment has been installed and/ormaintained in accordance with the New Jersey Uniform Construction Code and isapproved for use until ________________________.
BlockWork Site Location
Owner in Fee
Lot
Address
Tel. ( _____ )
Address
Tel. ( _____ ) FAX ( _____ )Lic. No. or Bldrs. Reg. No.
Federal Employer No.
Contractor
Home Warranty No.Type of Warranty Plan: [ ] State [ ] Private
Use Group
Maximum Live Load
Construction Classification
Maximum Occupancy Load
Description of Work/Use:
Qualification Code
Permit #Date Issued - or -
Control #
Certificate Issued Date:
120
Sample
Sample
Sample
126
OW
NE
RA
GE
NT
U.C
.C. F
270
(rev.
5/2
003)
SIG
NED
:O
WN
ER
/AG
EN
T
I her
eby
atte
st th
at to
the
best
of m
y kn
owle
dge,
the
com
plet
ed p
roje
ct m
eets
the
cond
ition
s of
the
cons
truct
ion
perm
it an
d al
l prio
r app
rova
ls, a
nd a
ll wor
k ha
s be
en c
ompl
eted
sub
stan
tially
in a
ccor
danc
e w
ith th
e co
de a
nd w
ithth
ose
porti
ons
of th
e pl
ans
and
spec
ifica
tions
con
trolle
d by
the
code
, with
any
sub
stan
tial d
evia
tions
not
ed.
Inco
m-
plet
e ite
ms
liste
d on
a T
empo
rary
Cer
tific
ate
of O
ccup
ancy
will
be
com
plet
ed b
y th
e da
te o
n th
e C
ertif
icat
e.
DE
SC
RIP
TIO
N O
F W
OR
K/U
SE
:
If yo
u ar
e re
ques
ting
a Te
mpo
rary
Cer
tific
ate
of O
ccup
ancy
, ple
ase
expl
ain
why
in th
e sp
ace
belo
w.
FIN
AL
CO
ST O
F C
ON
STR
UC
TIO
N:
(Incl
ude
valu
e of
any
new
stru
ctur
e, a
ll on
-site
impr
ovem
ents
, bui
lt-in
furn
ishi
ngs
and
fixtu
res
and
all i
nteg
ral
equi
pmen
t exc
lusi
ve o
f pro
cess
or m
anuf
actu
ring
equi
pmen
t.)
$U
SE
GR
OU
PPr
evio
usC
urre
nt
AC
TIO
N
CE
RTI
FIC
ATE
OF
CO
NTI
NU
ED
OC
CU
PAN
CY
LEA
D H
AZA
RD
AB
ATE
ME
NT
CE
RTI
FIC
ATE
OF
CLE
AR
AN
CE
TEM
PO
RA
RY
CE
RTI
FIC
ATE
OF
OC
CU
PAN
CY
IDEN
TIFI
CAT
ION
Ow
ner i
n Fe
e
Con
tract
or
Wor
k S
ite L
ocat
ion
Blo
ckLo
tQ
ualif
icat
ion
Cod
e
Des
crib
e be
low
any
sub
stan
tive
devi
atio
n in
dim
ensi
on, l
ay o
ut o
r app
eara
nce
of th
e bu
ildin
g or
stru
ctur
e fro
m th
ere
leas
ed p
lans
and
spe
cific
atio
ns fi
led
with
the
cons
truct
ion
perm
it ap
plic
atio
n. P
leas
e no
te, a
set
of a
men
ded
draw
ings
may
be
requ
ired.
Per
mit
#D
ate
Issu
ed
Cer
tific
ate
App
licat
ion
Rec
eive
d:C
ertif
icat
e Is
sued
:
Tel.(
)
Fede
ral E
mpl
oyee
No.
Add
ress
Add
ress
Lice
nse
No.
(
)Te
l.
- or
-
Con
trol #
APP
LIC
ATIO
N F
OR
CER
TIFI
CAT
E
CE
RTI
FIC
ATE
OF
OC
CU
PAN
CY
*
121
127
T.C.O. CONTROL CARD
Compliance Deadline Permit #
Temporary Certificate Issuance Date
Owner/Agent
Work Site Location
Telephone ( )
Conditions to be resolved
U.C.C. F280B
122
128
ON-GOING INSPECTIONCONTROL CARD
Owner/Agent
Date of Initial Service
Address
Telephone ( ) Block Lot Qual.
Number and Type(s) of Equipment
U.C.C. Form F290 (rev. 3/04)
Inspection Month
123
129
INSPECTOR
Name LocationNumber and Type
of Inspection
RESULT INSPECTION
InspectionDate
#Pass
Amountof Fee
#Not
Done
Owner/AgentNotification
Date
RESULT#
Fail#
Pass#
Fail
ON-GOINGINSPECTIONS SCHEDULE
DateSchedule
U.C.C. F300(rev. 3/04)
124
130
ELEV
ATO
R IN
SPEC
TIO
N
Pg
1 of
___
U.C
.C. F
310-
1(r
ev. 2
/07)
18.
17.
16.
15.
14.
13.
12.
11.
10.9.8.7.6.5.4.3.2.1.
Enc
losu
reD
oor,
Clo
sers
& A
cces
sorie
sD
oor
Inte
rlock
s/E
mer
genc
y K
ey/A
cces
s K
eys
Gui
de R
ails
: Mai
n &
Cou
nter
wei
ght
Sw
itche
s an
d C
ams
Pit/
Stop
Sw
itch/
Ligh
t/Lad
der
Cou
nter
wei
ght G
uard
Buf
fers
: Spr
ing
or O
ilR
opes
: Hoi
st, G
over
nor,
Cou
nter
wei
ght,
Com
pens
atin
g, T
ail
Trav
elin
g C
able
and
Wiri
ngP
lung
er, C
ylin
der a
nd G
land
Gov
erno
r Rop
e Te
nsio
n S
heav
e &
Ass
embl
yC
ompe
nsat
ing
She
ave
or C
hain
Cle
aran
ces
and
Run
byS
eals
, Pla
tes,
Lab
els,
Tag
sH
all S
tatio
n/H
all P
ositi
on In
dica
tor (
if re
quire
d), H
all L
ante
rnR
outin
e M
aint
enan
ce
14.
11.
10.9.8.7.6.5.4.3.2.1. 16.
15.
13.
12.
Rou
tine
Mai
nten
ance
Cou
nter
wei
ght/C
ar &
Cou
nter
wei
ght S
heav
esFi
refig
hter
Ser
vice
PH
I & II
Sea
ls, P
late
s, L
abel
s, U
nit I
D, T
ags,
Sig
nsS
afet
ies
& A
cces
sorie
sE
mer
genc
y E
xits
/Top
/Sid
eE
mer
genc
y S
igna
ls &
Com
mun
icat
ion
Car
Ope
ratin
g St
atio
n/St
op S
witc
h/In
dica
tors
Top-
of-C
ar O
pera
ting
Stat
ion/
Stop
Sw
itch
Rop
e H
itche
s/P
late
n H
itch
Car
Lig
htin
g/St
anda
rd &
Em
erge
ncy
Car
Gat
e or
Doo
r Ope
rato
rC
ar G
ate/
Doo
r/Acc
esso
ries/
Car
Doo
r Reo
peni
ng D
evic
e(s)
Gui
de S
hoes
/Rol
lers
Car
Enc
losu
re/P
latfo
rm/S
ling/
Floo
ring
C.
HO
ISTW
AY, H
OIS
TWAY
EN
TRA
NC
ES A
ND
PIT
B.
ELEV
ATO
R C
AR
AN
D C
OU
NTE
RW
EIG
HT
12.
11.
10.9.8.7. 13.6.5.4.3.2.1.
Rou
tine
Mai
nten
ance
Sea
ls, P
late
s, L
abel
s, U
nit I
D, T
ags,
Sig
nsH
ydro
Flu
id H
oses
or P
ipe
Oil/
Hyd
ro F
luid
, Lea
ks, L
evel
Req
uire
d D
isco
nnec
tsR
elie
f & C
heck
Val
ves
Gov
erno
r(s)
Con
trolle
r/Sel
ecto
rM
otor
Gen
erat
or S
et/S
CR
Driv
eH
ydro
Pow
er M
otor
Uni
tM
achi
ne/B
rake
/Gea
rs/M
otor
Enc
losu
re/L
Ight
ing/
Vent
sA.
MA
CH
INE
RO
OM
& M
AC
HIN
E R
OO
M E
QU
IPM
ENT
SU
SS
SS
SU
UU
UU
DEV
ICE
TYPE
DEV
ICE
NU
MB
ERTY
PE O
F IN
SPEC
TIO
N/T
EST
S =
SAT
ISFA
CTO
RY
U =
UN
SAT
ISFA
CTO
RY
(Use
NA
Whe
n N
ot A
pplic
able
)
Nam
eA
ddre
ss
BU
ILD
ING
RE
GIS
TRAT
ION
NO
.If
FA, P
erm
it N
o.
TYP
E O
F IN
SP
EC
TIO
N/T
ES
T
1
= FA
4 =
3 Y
r
7 =
Alte
ratio
n
2
= 6
Mo
5 =
5 Y
r
P =
Pas
seng
er
3
= 1
Yr
6 =
Rei
nspe
ctio
n
F =
Fre
ight
Dat
e
125
131
Pg
2 of
___
Not
e: W
hen
unsa
tisfa
ctor
y co
nditi
ons
are
note
d, s
ee “N
otic
e” a
ttach
ed.
AC
TIO
N T
AK
EN
2. 3.
Dev
ice
Num
ber
Rem
oved
from
Ope
ratio
n
1.R
ecom
men
ded
Type
of C
ertif
icat
e (C
yclic
al In
spec
tions
Onl
y)
F.A
PPLI
CA
BLE
CO
DES
5.4.3.2.1.C
ar R
egis
tratio
n N
umbe
rW
orki
ng P
ress
ure
Rel
ief P
ress
ure
Cap
acity
Tags
HYD
RO
ELE
VATO
R D
EVIC
ES (P
ass
or F
ail)
1. 2. 3. 4. 5.
Dev
ice
Num
ber
Car
Rat
ed S
peed
Ove
rspe
ed S
witc
hTr
ippi
ng S
peed
Cap
acity
E.TE
STS:
TR
AC
TIO
N E
LEVA
TOR
DEV
ICES
(Pas
s or
Fai
l)
23.
20.
15.
14.
13.
12.
22.
21.
19.
18.
17.
16.
11.
10.9.8.7.6.5.4.3.2.1.
Sig
ns, S
eals
, Pla
nks,
Lab
els,
Uni
t ID
, Tag
s
Test
sR
outin
e M
aint
enan
ceR
equi
red
Dis
conn
ect
Step
Lig
htin
g
Rol
ler S
hutte
r Dev
ice
Spee
d G
over
nor
Star
ting
& S
witc
hes
Mac
hine
/Bra
kes/
Gea
rs/M
otor
Esc
alat
or B
rake
sM
achi
nery
Acc
ess
Spac
e &
Lig
htin
gS
kirt
& S
teps
Cle
aran
ceP
rote
ctio
n of
Tru
sses
& M
achi
nery
Spa
ce (F
ire)
Cle
aran
ces
Kio
sk/W
ellw
ay/S
afet
y Zo
neS
afet
y D
evic
esC
hain
s &
Spr
ocke
tsSt
eps,
Rol
lers
& T
rack
sE
mer
genc
y St
op S
witc
hes
She
ar P
oint
s P
rote
ctio
nB
alus
trade
/Han
drai
lsSt
air T
read
s/C
omb
Pla
tes
D.
ESC
ALA
TOR
/MO
VIN
G W
ALK
S (D
evic
e Ty
pe)
SU
SS
SS
SU
UU
UU
S =
SAT
ISFA
CTO
RY
U =
UN
SAT
ISFA
CTO
RY
(Use
NA
Whe
n N
ot A
pplic
able
)D
EVIC
E TY
PED
EVIC
E N
UM
BER
TYPE
OF
INSP
ECTI
ON
/TES
T
Insp
ecto
r’s N
ame
(prin
t) an
d Li
c. N
o.In
spec
tor’s
Sig
natu
re
U.C
.C. F
310-
2(r
ev. 2
/07)
ELEV
ATO
R IN
SPEC
TIO
N
126
132
ELEVATOR NOTICE(TO BE POSTED IN MOTOR ROOM)
Elevator #Address
# Street
Town State Zip
TYPE OFINSP.
DATE INSPECTOR SIGNATURE
U.C.C. F320A
FA = Final Acceptance; SA = Semi-Annual (6 Mo.); A = Annual (1 Yr.)3 Yr. = Three Year; 5 Yr. = Five Year; R = Reinspection.
TYPE OF INSP:
127
133
NOTICE Date Issued
THIS ELEVATOR DEVICE IS OUT OF OPERATION
Registration Number Device Number
Lot
Address
This Elevator Device Is Declared UNSAFE
No Person Is To Use This Elevator DeviceUntil It Is Made Safe
This notice shall be posted conspicuously at the siteand shall remain so until permission for its removal is granted.
U.C.C. F325(rev. 03/03)
Block Qualification Code
128
Sample
Sample
Sample
134
Nam
e(s)
of t
he in
jure
d:
Acc
iden
t res
ulte
d in
:In
jury
:
Last
insp
ectio
n pr
ior t
o ac
cide
nt:
Per
form
ed B
y:Na
me
Wer
e vi
olat
ions
cite
d:YE
SN
O
Atta
ch a
cop
y of
the
late
st in
spec
tion
repo
rt pr
ior t
o th
e ac
cide
nt a
nd a
cop
y of
the
list o
f vio
latio
ns w
hen
cite
d.
Type
:
Lice
nse
Num
ber
Late
st c
ertif
icat
e gr
ante
d:Ty
pe:
Dat
e Is
sued
:
Exp
iratio
n D
ate:
List
of C
odes
; Ref
eren
ce S
tand
ards
the
devi
ce s
hall
be in
com
plia
nce
with
:
Dat
e:
N
ame
S
igna
ture
Dev
ice
Dat
a:C
apac
ity:
Spee
d:#
of F
loor
s S
erve
d:
Mac
hine
type
:O
pera
tion(
s):
Doo
r typ
e:H
oist
way
Car
U.C
.C F
310
form
sha
ll be
use
d to
rec
ord
S/U
con
ditio
ns a
nd v
iola
tions
fou
nd d
urin
g a
spec
ial
insp
ectio
n.N
OTE
:
If ye
s, n
ame
of m
aint
enan
ce c
ompa
ny:
Dev
ice
Und
er M
aint
enan
ce C
ontra
ct:
YES
NO
Con
stru
ctio
n O
ffici
al:
U.C
.C. F
326
(rev.
6/0
8)
N
ame
S
igna
ture
Rep
ort p
repa
red
by:
Use
:
UC
C E
LEVA
TOR
DEV
ICES
- A
CC
IDEN
T/IN
CID
ENT
REP
OR
T
MU
NIC
IPAL
ITY:
DAT
E O
F A
CC
IDE
NT:
Acc
iden
t rep
orte
d by
:
Dat
e w
hen
acci
dent
is re
porte
d to
mun
icip
ality
:
Tele
phon
e #:
Bui
ldin
g A
ddre
ss:
Build
ing
Reg
istra
tion
#:
Insp
ectio
n C
ycle
:D
evic
e:ID
:Ty
pe:
Ow
ner:
Nam
e:
AD
DR
ESS
C
ITY
STAT
E
ZI
P C
OD
E
Nam
e:
Addr
ess:
Dea
th:
129
135
Municipality
Location Utility Co.
Block Lot
Occupant
"Installation in the above premises has been inspected and isin accordance with N.E.C. and DCA requirements."
Description of Service
FINAL
Installed By License #
Date InspectorPermit #
Called In License #
This approval is void after ________ days.
Owner
1 White - Utility 2 Canary - Office/File 3 Pink - Office/ContractorU.C.C. F350 (rev. 3/03)
Qualif. Code
TEMPORARY
CUT-IN-CARD
130
Sample
Sample
Sample
136
On
____
____
____
____
____
____
____
____
____
, ___
____
__ w
e re
ceiv
ed a
n ap
plic
atio
n fo
r a c
onst
ruct
ion
perm
it fo
r the
pro
ject
/wor
k lo
cate
d at
the
abov
e ad
dres
s. T
his
proj
ect/w
ork
invo
lves
the
follo
win
g:
This
app
licat
ion
is d
enie
d fo
r the
follo
win
g re
ason
(s):
If yo
u w
ish
to c
onte
st t
his
actio
n, y
ou m
ay r
eque
st a
hea
ring
befo
re t
he C
onst
ruct
ion
Boa
rd o
f A
ppea
ls o
f t
he__
____
____
____
____
____
_of_
____
____
____
____
__, w
ithin
15
days
of r
ecei
pt o
f thi
s no
tice
as p
rovi
ded
byN
.J.A
.C. 5
:23A
-2.1
. Th
e A
pplic
atio
n to
the
Con
stru
ctio
n B
oard
of A
ppea
ls m
ay b
e us
ed fo
r thi
s pu
rpos
e.
The
fee
for a
n ap
peal
is $
___
____
__ a
nd s
houl
d be
forw
arde
d w
ith y
our a
pplic
atio
n to
the
Con
stru
ctio
n B
oard
of A
ppea
lsO
ffice
loca
ted
at:
Your
app
licat
ion
for
appe
al m
ust b
e in
writ
ing,
set
ting
forth
you
r ad
dres
s an
d na
me,
the
addr
ess
of th
e bu
ildin
g or
site
inqu
estio
n, th
e co
ntro
l num
ber,
the
spec
ific
sect
ions
of t
he R
egul
atio
ns in
que
stio
n, a
nd th
e ex
tent
and
nat
ure
of y
our r
elia
nce
on th
em. Y
ou m
ay in
clud
e a
brie
f sta
tem
ent s
ettin
g fo
rth y
our p
ositi
on a
nd th
e na
ture
of t
he re
lief s
ough
t by
you.
You
may
als
oap
pend
any
doc
umen
ts th
at y
ou c
onsi
der u
sefu
l.
U.C
.C. F
360
(rev.
4/2
003)
Ow
ner i
n Fe
eW
ork
Site
Loc
atio
nB
lock
Add
ress
Lot
Agen
t/Con
tract
or
Tele
. ( _
__ )
Add
ress
IDEN
TIFI
CAT
ION
(Sig
natu
re)
Con
stru
ctio
n O
ffici
al:
____
____
____
____
____
____
____
____
____
____
____
____
__ D
ate:
___
____
____
____
____
____
1 W
hite
- A
pplic
ant
2 C
anar
y - O
ffice
Con
tract
or L
icen
se N
o.
DEN
IAL
OF
PER
MIT
Tele
. ( _
___
)
Qua
lific
atio
n C
ode
If yo
u ha
ve a
ny q
uest
ions
con
cern
ing
this
mat
ter,
plea
se c
all:
____
____
____
____
____
____
____
____
____
____
__
Dat
e Is
sued
:C
ontro
l #:
131
Sample
Sample
Sample
137
CH
IMN
EY V
ERIF
ICAT
ION
FO
RR
EPLA
CEM
ENT
OF
FUEL
-FIR
ED E
QU
IPM
ENT
FOR
MIN
OR
AN
D E
ME
RG
EN
CY
WO
RK
, TH
IS F
OR
M M
US
T B
E P
RO
VID
ED
WIT
H Y
OU
R P
ER
MIT
AP
PLI
CA
-TI
ON
. FO
R A
LL O
THE
R W
OR
K, T
HIS
FO
RM
MU
ST
BE
PR
ES
EN
TED
TO
TH
E C
OD
E O
FFIC
IAL
PR
IOR
TO
FIN
AL
INS
PE
CTI
ON
.A
ll a
pp
lica
ble
info
rma
tion
re
qu
est
ed
on
this
form
mu
st b
e s
up
plie
d.
Th
is fo
rm m
ay
no
t be
su
bm
itte
d b
y a
ho
me
ow
ne
r in
lie
u o
f th
e r
eq
uir
ed
insp
ect
ion
.U
.C.C
. F37
0 (re
v. 0
1/12
)
Dire
ct V
ent A
pplia
nce:
I her
eby
verif
y th
at th
e ap
plia
nce(
s) b
eing
inst
alle
d is
a d
irect
ven
t app
lianc
e. I
furth
er v
erify
that
the
exis
ting
chim
ney/
vent
is a
ppro
pria
tely
line
d an
d si
zed
for a
ny re
mai
ning
app
lianc
es.
Sig
natu
reD
ate
Verif
icat
ion
Not
Sub
mitt
ed:
I cho
ose
not t
o su
bmit
verif
icat
ion.
I un
ders
tand
that
I w
ill b
e re
quire
d to
be
pres
ent f
or th
e in
spec
tion
to re
mov
e an
dre
inst
all t
he c
him
ney
vent
con
nect
or.
Sig
natu
reD
ate
Sig
natu
reD
ate
Oil
to O
il or
Gas
to G
as R
epla
cem
ents
or N
ew/A
dditi
onal
App
lianc
es:
I hav
e ve
rifie
d th
at th
e ex
istin
g ch
imne
y/ve
nt is
in g
ood
repa
ir an
d cl
ear o
f obs
truct
ion.
I ha
ve v
erifi
ed th
at th
e ex
istin
gch
imne
y/ve
nt is
app
ropr
iate
ly li
ned
and
size
d fo
r the
app
lianc
e(s)
bei
ng in
stal
led
and/
or re
mai
ning
.
For O
il or
Coa
l to
Gas
Con
vers
ions
:I h
ave
verif
ied
that
the
chim
ney/
vent
is in
goo
d re
pair
and
clea
r of o
bstru
ctio
n an
d is
sub
stan
tially
cle
an o
f res
idue
from
its
prev
ious
use
ser
ving
an
oil o
r coa
l app
lianc
e. I
have
ver
ified
that
the
chim
ney/
vent
is a
ppro
pria
tely
line
d an
dsi
zed
for t
he a
pplia
nce(
s) b
eing
inst
alle
d.S
igna
ture
Dat
e
PLEA
SE S
IGN
ON
E O
F TH
E FO
LLO
WIN
G V
ERIF
ICAT
ION
STA
TEM
ENTS
Che
ck th
e A
ppro
pria
te B
ox(e
s):
Type
of R
epla
cem
ent:
[]
Oil
to G
as C
onve
rsio
n
[]
Gas
App
lianc
e R
epla
cem
ent
[]
Oil
to O
il R
epla
cem
ent
[]
Oth
er
[]
Gas
to O
il C
onve
rsio
n
Type
Fuel
Typ
eB
TU R
atin
g (in
put/h
our)
App
lianc
e 1:
App
lianc
e 2:
App
lianc
e 3:
Oil
/ Gas
/ O
ther
:O
il / G
as /
Oth
er:
Oil
/ Gas
/ O
ther
:C
HIM
NEY
LIN
ERIf
a ch
imne
y lin
er is
bei
ng in
stal
led,
all
docu
men
tatio
n on
the
liner
mus
t acc
ompa
ny th
e P
erm
it ap
plic
atio
n.
[]
Oth
er
[]
Mas
onry
Chi
mne
y-Ti
le L
ined
[]
Chi
mne
y-In
terio
r[
]C
him
ney-
Exte
rior
[]
Mas
onry
Chi
mne
y-U
nlin
ed
Exis
ting
Vent
/Chi
mne
y:
Siz
e[
]"B
" Lab
el V
ent
[]
"L" L
abel
Ven
t[
]Fl
exib
le L
iner
[]
Pow
er V
ent/E
xhau
ster
Man
ufac
ture
r:
Mod
el:
U
L Li
stin
g:
Mat
eria
l of L
iner
:
Stai
nles
s St
eel
A
lum
inum
Siz
e of
App
lianc
e Ve
nt:
Siz
e of
Lin
er:
H
eigh
t of C
him
ney:
Leng
th o
f Con
nect
or:
Vent
Con
nect
or R
ise:
How
doe
s th
e ap
plia
nce
vent
?
[
]
Nat
ural
Dra
ft
[
]
Fan-
assi
sted
[
] O
ther
:
BLO
CK
LOT
QU
ALI
FIC
ATIO
N C
OD
E
P
ER
MIT
#
WO
RK
SIT
E A
DD
RE
SS
Ow
ner i
n Fe
eVe
rifyi
ng In
divi
dual
Com
pany
Add
ress
Stre
etC
itySt
ate
Zip
Cod
e
Tel:
(
)
Fa
x: (
)
Sample Sample Sample
138
Plan Review Due Date
TICKLER/X-REF CARD
Plans Received Date
Plans Approved Date
Permit No. Block Lot
U C C F375
(rev. 3/04)
Date IssuedQualif. Code
133
139
Pro
ject
:
Dat
e:W
ork
Site
Loc
atio
n:
Sys
tem
:C
ontra
ctor
:
Zon
e:C
ontra
ctor
Add
ress
:
A
rea:
Fire
Spr
inkl
er H
ydra
ulic
Dat
a Pl
ate
SYST
EM D
ESIG
NH
azar
d: L
H
OH
-I
O
H-II
E
H-I
EH
-II
RE
SM
isc.
Sto
rage
up
to 1
2 ft.
-Cla
ss T
ype
is E
qual
to
H
azar
d
Mod
el
T
ype
K-
Fact
or
S
ize
Deg
ree
Q
ty
NFP
A St
anda
rd:
Edi
tion:
S
yste
m T
ype:
Area
/Spr
inkl
er:
s
q. ft
. use
d;
sq
. ft.
allo
wed
Man
ufac
ture
r:
CA
LCU
LATI
ON
DAT
AD
ensi
ty/A
rea:
gpm
/sf o
ver
s
q. ft
. are
aE
nd s
prin
kler
:
gpm
@
p
si N
o. o
f spr
inkl
ers
flow
ing
Hos
e st
ream
allo
wan
ce:
g
pm
R
ack
dem
and:
gpm
Dem
and:
At b
ase
of ri
ser
g
pm @
psi
At p
ump
disc
harg
e
gpm
@
ps
i
A
t sou
rce
gpm
@
ps
i
SUPP
LY D
ATA
Test
loca
tion:
Test
by:
Test
dat
e:P
ublic
: St
atic
p
si;
Res
idua
l
p
si;
Flo
w
gpm
Fire
Pum
p R
atin
g:
gpm
@
psi
;
Ele
ctric
[
]
Die
sel
[ ]
U.C
.C. F
380
(rev.
3/0
9)
Not
e: A
ny it
em n
ot a
pplic
able
mus
t be
mar
ked
as ‘N
/A’ i
n th
e sp
ace
prov
ided
.
PIPE
DAT
AC
-Fac
tor:
Abo
vegr
ound
=
Und
ergr
ound
=Ty
pe:
Sch
ed/4
0 [
]
L
t. W
all
[ ]
XL
[
]
CP
VC
[
]
Cop
per [
]
O
ther
[
] If
Oth
er, s
peci
fy:
RA
CK
STO
RA
GE
Com
mod
ity C
lass
:
M
ax. H
eigh
t
ft
. A
isle
Wid
th
ft.Fi
gure
No.
(NFP
A 13
):
C
urve
:
Sp
rinkl
er/le
vel t
o flo
w:
Rac
k D
eman
d:
g
pm @
psi
@ R
efer
ence
pt.
BA
CK
FLO
W P
REV
ENTE
R M
fg:
M
odel
134
Sample
Sample
Sample
140
F R A M I N G C H E C K L I S T
Note: All items should be as shown on the plans or as required by code.
Instructions: Builder or Builder’s representative checks boxes marked ‘B’. Building Inspector checks boxes marked ‘I’. Responsible Person in Charge of Work signs, initials and datesin spaces provided. Building Inspector initials and dates in spaces provided.
AAAAA. . . . . Basement or CrBasement or CrBasement or CrBasement or CrBasement or Craaaaawwwwwl Spacel Spacel Spacel Spacel Space
U.C.C. F390-1 (rev. 03/09)
B. B. B. B. B. Floor FFloor FFloor FFloor FFloor Frrrrraming and Flooraming and Flooraming and Flooraming and Flooraming and Flooringinginginging
3. Floor Jois3. Floor Jois3. Floor Jois3. Floor Jois3. Floor Joisttttt:::::
1st 2nd 3rd 4th Floor
Sized per Plan
Grade, Species
Pre-Engineered Components as Specified
Bearing
Nailing
Bridging
Cutting and Notching (as per code)
Point Loads -- Supported as per Plan
Span Hangers
Headers
Framed Openings
4. Floor4. Floor4. Floor4. Floor4. Flooring, Sheating, Sheating, Sheating, Sheating, Sheathing, or Deching, or Deching, or Deching, or Deching, or Decking:king:king:king:king:
1st 2nd 3rd 4th Floor
Material
Panel span, Thickness
Special Requirements
Edge Blocking (if required)
Gapping
Layout
5. S5. S5. S5. S5. Stttttair Aair Aair Aair Aair Attttttttttacacacacachmenthmenthmenthmenthment:::::
1st 2nd 3rd 4th Floor
Bearing
Nailing
11111. Bo. Bo. Bo. Bo. Box or Rim Joisx or Rim Joisx or Rim Joisx or Rim Joisx or Rim Joist, or Pt, or Pt, or Pt, or Pt, or Perererererimeimeimeimeimettttter Band Joiser Band Joiser Band Joiser Band Joiser Band Joisttttt:::::
1st 2nd 3rd 4th Floor
Size
Grade, Species
Single or Double
Pre-Engineered per Man-Facturer’s Specs
Cantilevers as per Design
2. Gir2. Gir2. Gir2. Gir2. Girderderderderders and Beams:s and Beams:s and Beams:s and Beams:s and Beams: Sized per Plan
Type
Grade, Species
Location and Relation to the Plan
Nailing
Attachment Schedule
Bearing
Lapping
11111. Anc. Anc. Anc. Anc. Anchorhorhorhorhoragagagagage:e:e:e:e: Bolts
Spacing
Size
Straps
Spacing (per manufacturer’s specs)
Size
2. Sill Plat2. Sill Plat2. Sill Plat2. Sill Plat2. Sill Plates:es:es:es:es: Size
Grade, Species
Treatment
Laps
Sill Sealer
Proper Treatment over Foundation Openings (bearing of joist)
Termite Protection
4. Columns:4. Columns:4. Columns:4. Columns:4. Columns: Sized per Plan
Attachment/Plates
Spacing/Location
Paint/Coating
B IB IB IB I
B IB I
B IB I
B IB I
B I
B I
B IB I
B I
B IB IB I
B IB IB IB I
B I
B IB IB I
B IB IB I
B IB IB I
B IB IB I
B IB IB I
B IB IB I
I hereby certify that I inspected this building using this checklist and it conforms to the released plans andto the requirements of the Uniform Construction Code, N.J.A.C. 5:23.
Responsible Person in Charge of Work: Date:
Building InspectorInitials:
Date:
3. Beam P3. Beam P3. Beam P3. Beam P3. Beam Pococococockkkkkeeeeets:ts:ts:ts:ts: Bearing/Shims
Termite Protection or Clearance
B IB I
B IB I
B IB IB IB IB I
B I
B I
B IB I
B IB IB IB I
B IB IB I
B I
B I
B IB IB IB I
B IB IB IB I
B IB IB IB I
B IB IB IB I
B IB IB I
B IB IB I
B I
B IB IB I
B IB I
B IB IB I
B IB IB I
B IB IB IB I
B IB IB IB I
B IB IB IB I
B IB IB IB I
LOT: __________ BLOCK: __________PERMIT # __________
135
141
B IB IB I
B IB IB IB IB IB I
B IB IB I
B IB IB I
B IB IB I
B IB IB I
B IB IB I
B IB IB I
B IB IB IB IB I
B I B I
B I B I
B I
B I
B I
Initials: Resp. Person in Charge of Work Building InspectorU.C.C. F390-2 (rev. 03/09)
B I B I B I
B I B I B I
B I B I B I
B I B I B I
B I B I B I
B I
B I
B I
B I
B I
B I
B I
D. D. D. D. D. RRRRRoof Foof Foof Foof Foof Frrrrramingamingamingamingaming11111. T. T. T. T. Trrrrruss Russ Russ Russ Russ Roof Foof Foof Foof Foof Frrrrraming (as per design):aming (as per design):aming (as per design):aming (as per design):aming (as per design):Approved Documents which Show:
Layout Plans
Truss Members
Connection Schedule
Permanent Bracing Details
Dormers/Roof Structures on Manufacturer’s Drawings
Equipment/Appliances on Man- ufacturer’s Drawings
Location as per Layout
Alignment
Bearing
Spacing
Connections to Bearing Points
No Connection to Non-Bearing Points
Damage and Defects
Engineered Method of Repair
2. P2. P2. P2. P2. Pererererermanent Tmanent Tmanent Tmanent Tmanent Trrrrruss-tuss-tuss-tuss-tuss-to-o-o-o-o-TTTTTrrrrruss Bruss Bruss Bruss Bruss Bracingacingacingacingacing (as per design): (as per design): (as per design): (as per design): (as per design):
Layout
Size
Type
Nailing
Overlap
Termination
Transition (i.e., Cross) Bracing
3. Gable End Br3. Gable End Br3. Gable End Br3. Gable End Br3. Gable End Bracing (as per design):acing (as per design):acing (as per design):acing (as per design):acing (as per design):
Layout
Size
Type
Nailing
Overlap
Termination
4. Solid Sa4. Solid Sa4. Solid Sa4. Solid Sa4. Solid Sawn Rwn Rwn Rwn Rwn Roof Foof Foof Foof Foof Frrrrraming:aming:aming:aming:aming:
Size
Grades, Species
Layout
Spacing
Span
Bearing
Fastening
Damage Caused by Fasteners (rafters not split by toenails)
Cutting, Notching, and Boring
Bridging
Ridge Size
Hurricane Ties Where Applicable
B IB IB IB IB IB IB I
B IB IB IB IB IB I
B IB I
B I
B IB I
B I
B IB IB IB I
B I
B I
B I
B IB I
B IB I
B IB I
B IB I
B IB I
B IB I
B IB I
B IB I
B I
B I
E. E. E. E. E. SheatSheatSheatSheatSheathinghinghinghinghing11111. Sheat. Sheat. Sheat. Sheat. Sheathing -- Exthing -- Exthing -- Exthing -- Exthing -- Exterererererior Wior Wior Wior Wior Walls:alls:alls:alls:alls:Material
Panel Span, Thickness
Special Requirements
Gapping Layout
Corner Bracing (if required)
2. Sheat2. Sheat2. Sheat2. Sheat2. Sheathing -- Rhing -- Rhing -- Rhing -- Rhing -- Roof:oof:oof:oof:oof:Material
Panel span, Thickness
Special Requirements
Blocking, Edge (if required) Gapping
Clips (if required) Layout
B I
B I
Sheathing, FRT -- Roof
Four Feet from Firewall
Noncorrosive Fasteners
B I B I
B I
B I
PERMIT # __________ LOT: __________ BLOCK: __________
B IB IB IB IB IB I
B I
1 1 1 1 1. Ext. Ext. Ext. Ext. Exterererererior Wior Wior Wior Wior Wall Fall Fall Fall Fall Frrrrrame:ame:ame:ame:ame: 1st 2nd 3rd 4th Floor
SizeSpace
Species and Grade
Cutting, Notching
and Boring
Header Sizes
Jack Stud Bearing
Top Plates
Nailing
Laps
Rafter Ties
Hurricane Straps
C. C. C. C. C. WWWWWall Fall Fall Fall Fall Frrrrramingamingamingamingaming3. Int3. Int3. Int3. Int3. Interererererior Nior Nior Nior Nior Non-Load-Bearon-Load-Bearon-Load-Bearon-Load-Bearon-Load-Bearing Wing Wing Wing Wing Walls:alls:alls:alls:alls: 1st 2nd 3rd 4th Floor
Size
Space
Species and Grade
Cutting, Notching and Boring
Fire Blocking
Header Sizes
Top Plate Nailing
2. Int2. Int2. Int2. Int2. Interererererior Load-Bearior Load-Bearior Load-Bearior Load-Bearior Load-Bearing Wing Wing Wing Wing Walls:alls:alls:alls:alls:1st 2nd 3rd 4th Floor
Size
Space
Layout - SupportBelow per CodeSpecies and Grade
Cutting, Notching and BoringFire Blocking
Header Sizes
Jack Stud Bearing
Top Plates
Nailing
Laps
Strapping
B IB IB I
B IB IB IB IB IB I
B IB IB I
B IB IB IB IB IB I
B IB IB I
B IB IB IB IB IB I
B IB IB I
B I
B I
B I
B IB I
B I
B I
B I
B I
B I
B I
B I
B I
(as required)
136
142
U.C
.C. F
391
( 3/2
012)
Sup
ervi
sing
Sta
tion
Ser
vice
Pro
vide
r N
ame
and
Tele
phon
e no
.
Ala
rm S
ervi
ce P
rovi
der
nam
e an
d te
leph
one
no.
IDEN
TIFI
CAT
ION
Per
mit
#D
ate
Issu
ed
DIG
ITA
L A
LAR
M C
OM
MU
NIC
ATO
R T
RA
NSM
ITTE
RS
(DA
CT)
UTI
LIZI
NG
MA
NA
GED
FA
CIL
ITY
VOIC
E N
ETW
OR
KS
(MFV
N)
VER
IFIC
ATIO
N F
OR
M
*
Con
tract
or
Wor
k S
ite L
ocat
ion
Lot
Qua
lific
atio
n C
ode
Fede
ral E
mp.
ID N
o.
Lice
nse/
Cer
tific
atio
n N
o.
Com
plia
nce
Che
cklis
t
Sig
na
ture
Dat
e
(
)(
)
Tel.
Tel.
Add
ress
Ow
ner i
n Fe
e
Add
ress
Blo
ck
DA
CT
tele
phon
e ci
rcui
t(s) c
onfig
ured
and
test
ed fo
r loo
p st
art.
DA
CT
tele
phon
e ci
rcui
t(s) c
onfig
ured
and
test
ed fo
r lin
e se
izur
e.
Min
imum
8-h
our s
tand
by b
atte
ry in
stal
led
and
test
ed in
MFV
N c
omm
unic
atio
ns e
quip
men
t.
MFV
N c
omm
unic
atio
ns e
quip
men
t ins
talle
d at
the
prot
ecte
d pr
emis
es w
ith s
afeg
uard
s to
pre
vent
una
utho
rized
acce
ss.
DA
CT
conn
ecte
d to
qua
lifie
d M
FVN
ser
vice
MF
VN
Pro
vide
r N
ame
and
Tele
phon
e no
.
Whe
n a
DA
CT'
s m
eans
of t
rans
mis
sion
is c
onve
rted
from
Pla
in O
ld T
elep
hone
Ser
vice
(PO
TS) t
o M
anag
ed F
acilit
y Vo
ice
Net
wor
k (M
FVN
) Ser
vice
, thi
s ch
eckl
ist i
s to
be
com
plet
ed b
y th
e lic
ense
d/ce
rtifie
d al
arm
ser
vice
pro
vide
r and
sub
mitt
edto
the
Fire
Pro
tect
ion
Sub
code
Offi
cial
of t
he L
ocal
Enf
orci
ng A
genc
y w
ithin
24
hour
s of
con
vers
ion.
DA
CT
alar
m, t
roub
le a
nd s
uper
viso
ry s
igna
l tra
nsm
issi
on re
test
ed to
Sup
ervi
sing
Sta
tion
succ
essf
ully.
143
In the checklist below, AB and I stand for the air barrier and insulation inspection components to be verified. The local code official will always verify the Icomponents. In the case where the local code official is not verifying the AB components, they may be verified by a person independent of the insulation installer,or by the use of a blower door test.
If the permit holder has elected use of a blower door test, documentation of test results verifying air leakage less than 7 air changes per hour when tested at apressure of 33.5 psf or 50 Pa shall be submitted with this checklist. A passing test demonstrates that the AB components are verified.
U.C.C. F392-1 (3/12)
AIR BARRIER AND INSULATION CHECKLIST
I
AB
AB
I
I
AB
I
I
AB
AB
I
IAB
AB
AB
AB
Insulation is installed to maintain permanent contact with underside ofsubfloor decking.
Air barrier is installed at any exposed edge of insulation.
Rim joists include an air barrier.
Rim joists are insulated.
Corners and headers are insulated.
Junction of foundation and sill plate is sealed.
Insulation is permanently attached to walls.
Exposed earth in unvented crawl spaces is covered with Class I vaporretarder with overlapping joints taped.
Space between window/door jambs and framing is sealed.
Air sealing is provided between the garage and conditioned spaces.
Insulation is placed between outside and pipes. Batt insulation is cut tofit around wiring and plumbing, or sprayed/blown insulation extendsbehind piping and wiring.
Showers and tubs on exterior walls have insulation.
Showers and tubs on exterior walls have an air barrier separating themfrom the exterior wall.
Air barrier extends behind boxes or air sealed-type boxes are installed.
Air barrier is installed in common wall between dwelling units.
Fireplace walls include an air barrier.
LOT: __________ BLOCK: __________PERMIT # __________
COMPONENT CRITERIA Y, N, OR N/A COMMENTS INITIALS DATE
GeneralWalls
Fireplace
Crawl spacewalls
Windows anddoors
GarageseparationPlumbing andwiring
Shower/tub onexterior wall
Rim joists
General
Electrical/phonebox on exteriorwalls
Common wall
Floors (including above-garage and cantilevered floors)
144
LOT: __________ BLOCK: __________PERMIT # __________
U.C.C. F392-2 (3/12)
Air barrier in any dropped ceiling/soffit is substantially aligned withinsulation and any gaps are sealed.
Attic access (except unvented attic), knee wall door, or drop downstair is sealed.
Recessed light fixtures penetrating the thermal envelope are air tight,IC-rated, and sealed to drywall.
Exterior thermal envelope insulation for framed assemblies isinstalled in substantial contact and continuous alignment with buildingenvelope air barrier.
Breaks or joints in the air barrier are filled or repaired.
Air-permeable insulation is not used as a sealing material.
Air-permeable insulation is inside of an air barrier.
Duct shafts, utility penetrations, knee walls and flue shafts opening toexterior or unconditioned space are sealed.
Batts in narrow cavities are cut to fit, or narrow cavities are filled bysprayed/blown insulation.
HVAC register boots that penetrate building envelope are sealed tosubfloor or drywall.
AB
AB
I
I
AB
AB
AB
AB
I
AB
CODE OFFICIAL: _______________________________________________ SIGNATURE: ______________________________ DATE: _________ CODE OFFICIAL: _______________________________________________ SIGNATURE: ______________________________ DATE: _________ CODE OFFICIAL: _______________________________________________ SIGNATURE: ______________________________ DATE: _________ CODE OFFICIAL: _______________________________________________ SIGNATURE: ______________________________ DATE: _________ NAME & COMPANY: ____________________________________________ SIGNATURE: ______________________________ DATE: _________ NAME & COMPANY: ____________________________________________ SIGNATURE: ______________________________ DATE: _________ NAME & COMPANY: ____________________________________________ SIGNATURE: ______________________________ DATE: _________
NAME & COMPANY: ____________________________________________ SIGNATURE: ______________________________ DATE: _________
GeneralCeiling/Attic
Air barrier andthermal barrier
Other/All
Recessedlighting
Shafts,penetrationsNarrow cavities
HVAC registerboots
COMPONENT CRITERIA Y, N, OR N/A COMMENTS INITIALS DATE
145
12345678901234567890123456789012123451234567890123456789012345678901212345123456789012345678901234567890121234512345678901234567890123456789012123451234567890123456789012345678901212345123456789012345678901234567890121234512345678901234567890123456789012123451234567890123456789012345678901212345
BLOCK/LOT/Qualif.
U.C.C. L700 (rev. 2/05)
USE
GR
OU
P TOTALVALUE
OFCONSTRUCT.
CENSUSITEMNO.
FEES COLLECTEDFORM OFPAYMENT
BUILD. PLUMB. ELEC. FIRE ELEV. MECH.DCA
TRAINING CERT. OTHER
PERMITNO.
TOTALCASH
CHECK
For the Month of: _________
DES
CR
IPTI
ON
NO. OFCUBIC FEET(NEW BLDG.OR ADDN.)
TOTAL
1234567812345678123456781234567812345678123456781234567812345678
OW
NER
SHIP
PRI./
PUB
.
PERMIT FEE LOG
Page No. _________
NEW ORADDITIONAL
AREA (SQ. FT.)
DATEISSUED
NAME/ADDRESS
LOSTRENTAL
LOSTSALE
HOUSING UNITS
GAINSALE
AllInc.
Rstr'td AllInc.
Rstr'td AllInc.
Rstr'td AllInc.
Rstr'td
GAINRENTAL
137
146
INSPECTION LOG
Permit#
Date Block Lot ConstructionLocation
NameType of
InspectionRequested
DateConducted
ConductedBy
InspectionResults
Fail
Pas
s
Not
Don
e
Comments
Page No ________
Qualif
U.C.C. L710 (rev. 2/05)
138
147
12345678123456781234567812345678123456781234567812345678
123456712345671234567123456712345671234567
123456789012345678901234567890121234567890123451234567890123456789012345678901212345678901234512345678901234567890123456789012123456789012345123456789012345678901234567890121234567890123451234567890123456789012345678901212345678901234512345678901234567890123456789012123456789012345
U.C.C. L720 (rev. 3/04)
CERTIFICATE LOG
FORM OFPAYMENT
CASHCHECK
Page No. __________
For the Month of: _________
TOTAL
CERTIFICATENO.
FEESCOLLECTED
($0 INDICATESFEE ALREADY
PAID)
CENSUSITEMNO.
TOTALVALUE
OFCONSTRUCT.
LOSTRENTAL
LOSTSALE
HOUSING UNITSGAINSALE
OW
NER
SHIP
PRI./
PUB
.NO. OFCUBIC FEET(NEW BLDG.OR ADDN.)
NEW ORADDITIONAL
AREA(SQ. FT.)
BLOCK/LOT/QUALIF.
DATEISSUED
GAINRENTAL
TCO
/TC
C
CC
O
CO CA
CCUSE
GROUPNAME/ADDRESS
DES
CR
IPTI
ON
CC
L N
.J.A
.C -
5:17
AllInc.
Rstr'td AllInc.
Rstr'td AllInc.
Rstr'td AllInc.
Rstr'td
139
148
ON-GOING INSPECTIONS
Name AddressBlock/Lot/
Qualif.Type of
EquipmentRegistry
No.
Dateof
InitialService
Dateof
Inspection
U.C.C. L730 (rev. 3/04)
19 ___ 19 ____
DATE OF FINAL PASSED INSPECTIONRESULT
No.Pass
No.Fail 3 Mo. 6 Mo. 9 Mo. 12 Mo. 3 Mo. 6 Mo. 9 Mo. 12 Mo.
TCCIssued
for(No. Days)
Dateof
Reinspection
RESULT
No.Pass
No.Fail Inspector
Amountof Fee
140
149
U.C.C. R800A
FOR THE DAY/WEEK OF INSPECTOR
TimeDate BlockPermit#
Lot Owner/Agent ConstructionLocation N
otD
one
Pas
sed
Faile
d
Comments
INSPECTIONRESULTS
DAILY/WEEKLYINSPECTOR'S REPORT
141
150
UC
C M
unic
ipal
Mon
thly
Act
ivity
Rep
ort (
Cer
tific
ates
)R
esid
entia
l Use
Gro
ups
Pag
e __
_ of
___
U.C
.C. R
811-
1 (r
ev. 0
6/04
)
For M
onth
of
Cou
nty
Mun
icip
ality
# of
Cer
tific
ates
Perm
Type
Use
Gro
up
CH
AR
AC
TER
ISTI
CS
# Pvt.
Ow
ned
#Pu
b.O
wne
dSA
LER
ENT
SALE
REN
T
Hou
sing
Uni
tsLo
stTo
tal
Valu
e of
Con
str.
Hou
sing
Uni
tsG
aine
d
# of
Squa
reFe
et
# of
Cub
icFe
et
12345678901234
12345678901234
12345678901234
12345678901234
12345678901234
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
R-1
12345678901234
12345678901234
12345678901234
12345678901234
12345678901234
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
R-2
12345678901234
12345678901234
12345678901234
12345678901234
12345678901234
12345678901234
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
R-3
Reha
b.
Reha
b.
Reha
b.
New
Dem
.
Add
.
New
Dem
.
Add
.
New
Dem
.
Add
.
R-4
12345678901234
12345678901234
12345678901234
12345678901234
12345678901234
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
R-5
12345678901234
12345678901234
12345678901234
12345678901234
12345678901234
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
1234567890123456789
Reha
b.
New
Dem
.
Add
.
Reha
b.
New
Dem
.
Add
.
142
151
U.C
.C. R
811-
2 (r
ev. 0
6/04
)
12345678
12345678
12345678
12345678
12345678
12345678
# of
Cer
tific
ates
123456789012345678901234
123456789012345678901234
123456789012345678901234
123456789012345678901234
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
123456789012345678901234
123456789012345678901234
123456789012345678901234
123456789012345678901234
123456789012345678901234
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
123456789012345678901234
123456789012345678901234
123456789012345678901234
123456789012345678901234
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
123456789012345678901234
123456789012345678901234
123456789012345678901234
123456789012345678901234
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
123456789012345678901234
123456789012345678901234
123456789012345678901234
123456789012345678901234
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
Tota
l
Pre
pare
d by
Cer
tific
ate
Fees
not
pre
viou
sly
colle
cted
$
Dat
e P
repa
red
For M
onth
of
Cou
nty
Mun
icip
alityU
CC
Mun
icip
al M
onth
ly A
ctiv
ity R
epor
t (C
ertif
icat
es)
Non
-Res
iden
tial U
se G
roup
s
Use
Gro
upPe
rmTy
pe#
ofSq
uare
Feet
# of
Cub
icFe
et
Hou
sing
Uni
tsG
aine
d
Hou
sing
Uni
tsLo
stTo
tal
Valu
e of
Con
str.
#Pu
b.O
wne
d
# Pvt.
Ow
ned
SALE
REN
TR
ENT
SALE
CH
AR
AC
TER
ISTI
CS
Dem
.123456789012345678901234
123456789012345678901234
123456789012345678901234
123456789012345678901234
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
New
Add
.R
ehab
.
Dem
.
New
Add
.R
ehab
.
Dem
.
New
Add
.R
ehab
.
Dem
.
New
Add
.R
ehab
.
Dem
.
New
Add
.R
ehab
.
Dem
.
New
Add
.R
ehab
.
123456789012345678901234
123456789012345678901234
123456789012345678901234
123456789012345678901234
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
12345678901234567890123456789012
Dem
.
New
Add
.R
ehab
.
143 152
UC
C M
unic
ipal
Mon
thly
Act
ivity
Rep
ort (
Perm
its)
Res
iden
tial U
se G
roup
s
U.C
.C. R
812-
1 (r
ev. 6
/04)
R-1Fo
r Mon
th o
fC
ount
yM
unic
ipal
ity
R-2
R-3
R-5
# of
Perm
# of
Upd
.Pe
rmTy
peU
seG
roup
Dem
.
Reco
nst.
New
Add
.
Repa
ir
Alt.
Reno
v.
Dem
.
Reco
nst.
New
Add
.
Repa
ir
Alt.
Reno
v.
Dem
.
Reco
nst.
New
Add
.
Repa
ir
Alt.
Reno
v.
Dem
.
Reco
nst.
New
Add
.
Repa
ir
Alt.
Reno
v.
R-4
Dem
.
Reco
nst.
New
Add
.
Repa
ir
Alt.
Reno
v.
1234567890123456789012345
1234567890123456789012345
1234567890123456789012345
1234567890123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
1234567890123456789012345
1234567890123456789012345
1234567890123456789012345
1234567890123456789012345
1234567890123456789012345
1234567890123456789012345
1234567890123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
1234567890123456789012345
1234567890123456789012345
1234567890123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
1234567890123456789012345
1234567890123456789012345
1234567890123456789012345
1234567890123456789012345
12345678901234
12345678901234
12345678901234
12345678901234
12345678901234
12345678901234
12345678901234
12345678901234
12345678901234
12345678901234
12345678901234
12345678901234
12345678901234
12345678901234
12345678901234
12345678901234
# Pvt.
Ow
ned
#Pu
b.O
wne
d
# of
Squa
reFe
et
# of
Cub
icFe
etSA
LESA
LER
ENT
SALE
REN
TR
ENT
SALE
REN
T
Tota
l Val
ueof
Con
str.
All
Uni
tsIn
com
e-re
stric
ted
All
Uni
tsIn
com
e-re
stric
ted
CH
AR
AC
TER
ISTI
CS Hou
sing
Uni
ts L
ost
Hou
sing
Uni
ts G
aine
d
144
153
UC
C M
unic
ipal
Mon
thly
Act
ivity
Rep
ort (
Perm
its)
Non
-Res
iden
tial U
se G
roup
s
U.C
.C. R
812-
2 (r
ev. 6
/04)
Fees
Col
lect
edFi
reEl
evat
orC
ertif
icat
eO
ther
$ $$
$
Build
ing
Elec
trica
lPl
umbi
ng$$
For M
onth
of
Cou
nty
Mun
icip
ality
# of
Perm
# of
Upd
.Pe
rmTy
peU
seG
roup
# Pvt.
Ow
ned
#Pu
b.O
wne
d
# of
Squa
reFe
et
# of
Cub
icFe
etSA
LESA
LER
ENT
SALE
REN
TR
ENT
SALE
REN
T
Tota
l Val
ueof
Con
str.
All
Uni
tsIn
com
e-re
stric
ted
All
Uni
tsIn
com
e-re
stric
ted
CH
AR
AC
TER
ISTI
CS Hou
sing
Uni
ts L
ost
Hou
sing
Uni
ts G
aine
d
Dem
.
Reco
nst.
New
Add
.
Repa
ir
Alt.
Reno
v.
1234567890123456789012345
1234567890123456789012345
1234567890123456789012345
1234567890123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
Dem
.
Reco
nst.
New
Add
.
Repa
ir
Alt.
Reno
v.
1234567890123456789012345
1234567890123456789012345
1234567890123456789012345
1234567890123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
Dem
.
Reco
nst.
New
Add
.
Repa
ir
Alt.
Reno
v.
1234567890123456789012345
1234567890123456789012345
1234567890123456789012345
1234567890123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456
123456
123456
123456
123456
Tota
l
Dat
e P
repa
red
Pre
pare
d by
$
Dem
.
Reco
nst.
New
Add
.
Repa
ir
Alt.
Reno
v.
1234567890123456789012345
1234567890123456789012345
1234567890123456789012345
1234567890123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
123456789012345
145
154
STAT
E PE
RM
ITSU
RC
HA
RG
E FE
ES
Mun
icip
ality
____
____
____
____
____
____
____
____
___
Cou
nty
____
____
____
____
____
____
____
____
____
___
U.C
.C. R
840
(rev
. 10/
05)
N.J
. Dep
artm
ent o
f Com
mun
ity A
ffairs
Div
isio
n of
Cod
es a
nd S
tand
ards
Att:
Fis
cal O
ffice
rP.
O. B
ox 8
02Tr
ento
n, N
ew J
erse
y 08
625-
0802
Plea
se s
ubm
it th
is fo
rm a
long
with
a m
unic
ipal
che
ck (v
ouch
ers
are
not a
ccep
tabl
e), p
ayab
le to
the
“Tre
asur
er,
Stat
e of
New
Jer
sey”
to:
Exem
pt F
ee P
erm
its
____
____
____
___
cubi
c fe
et o
f new
con
stru
ctio
n
$__
____
____
____
_in
val
ue o
f con
stru
ctio
n
____
____
____
____
____
____
____
____
____
___
____
____
____
_C
onst
ruct
ion
Offi
cial
(or D
esig
nee)
Dat
e
[]
1Ja
nuar
y 1
– M
arch
31,
___
__[
]2
Apr
il 1
– Ju
ne 3
0, _
____
[]
3Ju
ly 1
– S
epte
mbe
r 30,
___
__[
]4
Oct
ober
1 –
Dec
embe
r 31,
___
__
In a
ccor
danc
e w
ith N
.J.A
.C. 5
:23-
4.19
, the
am
ount
of $
____
____
____
____
____
___
in S
tate
Per
mit
Sur
char
ge F
ees,
bas
ed u
pon
____
____
____
____
____
____
____
____
____
____
___
cub
ic f
eet
of n
ewco
nstru
ctio
n, a
nd $
____
____
____
____
____
____
____
____
____
____
____
____
___
dolla
rs
of a
ll oth
er c
onst
ruct
ion
exce
pt a
s sp
ecifi
ed in
N.J
.A.C
. 5:2
3-4.
19 (b
) 1-5
, has
bee
n co
llect
ed b
y m
y of
fice
for
the
follo
win
g pe
riod
(che
ck o
ne):
TO:
Fisc
al O
ffice
r
FRO
M:
____
____
____
____
____
____
____
____
____
____
____
___
SU
BJE
CT:
Stat
e P
erm
it S
urch
arge
Fee
s
146
155
App
endi
x C
. –U
CC
Sta
ndar
d Fo
rms
Prin
t Spe
cific
atio
ns
Follo
win
g ar
e th
e pr
int s
peci
ficat
ions
for t
he U
nifo
rm C
onst
ruct
ion
Cod
e St
anda
rd F
orm
s.P
leas
e no
te th
at w
hile
in s
ome
case
s th
e ex
act w
eigh
t and
col
or o
f pap
er a
s w
ell a
s in
kco
lor i
s pr
escr
ibed
, in
othe
rs, o
nly
the
form
con
tent
is d
icta
ted,
thou
gh a
pap
er w
eigh
t and
colo
r, an
d/or
ink
colo
r may
be
reco
mm
ende
d.
Dis
tingu
ishi
ng b
etw
een
requ
ired
and
reco
mm
ende
d sp
ecifi
catio
ns re
sults
from
the
evol
utio
n of
the
cons
truct
ion
code
enf
orce
men
t man
agem
ent s
oftw
are,
suc
h as
the
depa
rtmen
t’s U
CC
AR
S a
nd n
ow, P
erm
itsN
J ap
plic
atio
ns, w
hich
pro
duce
som
e of
the
UC
Cst
anda
rd fo
rms
as s
yste
m o
utpu
t, an
d as
a m
atte
r of p
ract
ical
ity, a
ll in
bla
ck in
k on
whi
tepa
per.
REQ
UIR
ED F
OR
MS
–REQ
UIR
ED S
PEC
IFIC
ATIO
NS
FOR
M N
UM
BE
R D
ES
CR
IPTI
ON
& R
EQU
IRED
SP
EC
IFIC
ATIO
NS
UC
C-F
100
CO
NS
TRU
CTI
ON
PE
RM
IT A
PP
LIC
ATIO
N F
ILE
FO
LDE
R. 1
1 ¾
” X 1
7 ½
”Fl
at, f
olde
d on
cen
ter f
or le
tter s
ize
(or 1
4 ¾
x 1
7 ½
” fla
t, fo
lded
on
cent
er fo
r leg
al s
ize)
. 110
lb. m
anila
or b
uff i
ndex
or e
qual
. P
rint
blac
k in
k on
two
side
s.
UC
C-F
180
CO
NS
TRU
CTI
ON
PE
RM
IT N
OTI
CE
. 6”
x 8”
pla
card
, 150
lb. t
ag o
r equ
al in
brig
ht y
ello
w w
ith b
lack
ink
for p
rint.
Prin
t for
out
door
use
. (S
econ
dsi
de is
opt
iona
l. P
rint b
ack
to b
ack.
) N
ote:
Thi
s fo
rm is
for o
ffice
use
only
and
may
not
be
purc
hase
d by
the
publ
ic.
UC
C-F
221
INS
PE
CTI
ON
STI
CK
ER
AP
PR
OVA
L FO
R B
UIL
DIN
G. 4
” x 4
” per
man
ent
pres
sure
sen
sitiv
e w
hite
prin
ted
with
bla
ck in
k. N
ote:
Thi
s fo
rm is
for
offic
e us
e on
ly a
nd may
not
be
purc
hase
d by
the
publ
ic.
UC
C-F
222A
INS
PE
CTI
ON
STI
CK
ER
AP
PR
OVA
L FO
R E
LEC
TRIC
. 4” x
4” p
erm
anen
tpr
essu
re s
ensi
tive
whi
te p
rinte
d w
ith p
anto
ne p
urpl
e in
k. N
ote:
Thi
sfo
rm is
for o
ffice
use
onl
y an
d m
ay n
ot b
e pu
rcha
sed
by th
e pu
blic
.
UC
C-F
223
INS
PE
CTI
ON
STI
CK
ER
AP
PR
OVA
L FO
R P
LUM
BIN
G. 4
” x 4
” per
man
ent
pres
sure
sen
sitiv
e w
hite
prin
ted
with
refle
x bl
ue in
k. N
ote:
Thi
s fo
rmis
for o
ffice
use
onl
y an
d m
ay n
ot b
e pu
rcha
sed
by th
e pu
blic
.
UC
C-F
224A
INS
PE
CTI
ON
STI
CK
ER
AP
PR
OVA
L FO
R F
IRE
PR
OTE
CTI
ON
. 4”
x 4
”pe
rman
ent p
ress
ure
sens
itive
whi
te p
rinte
d w
ith w
arm
red
ink.
Not
e:Th
is fo
rm is
for o
ffice
use
onl
y an
d m
ay n
ot b
e pu
rcha
sed
by th
epu
blic
.U
CC
-F22
5IN
SP
EC
TIO
N S
TIC
KE
R A
PP
RO
VAL
FOR
ELE
VATO
R.
4” x
4” p
erm
anen
t
pre
ssur
e se
nsiti
ve w
hite
prin
ted
with
pan
tone
gre
en in
k. N
ote:
Thi
s
for
m is
for o
ffice
use
onl
y an
d m
ay n
ot b
e pu
rcha
sed
by th
e pu
blic
.U
CC
-F22
6
INS
PE
CTI
ON
STI
CK
ER
AP
PR
OV
AL
FOR
ME
CH
NIC
AL
INS
PE
CTI
ON
. 4" x
4"
p
erm
anen
t pre
ssur
e se
nsiti
ve w
hite
prin
ted
with
radi
ant y
ello
w in
k. N
ote:
T
his
form
is fo
r offi
ce u
se o
nly
and
may
not
be
purc
hase
d by
the
publ
ic.
156
REQ
UIR
ED F
OR
MS
–REQ
UIR
ED S
PEC
IFIC
ATIO
NS
(con
tinue
d)
FOR
M N
UM
BE
R
D
ES
CR
IPTI
ON
& R
EQU
IRED
SP
EC
IFIC
ATIO
NS
UC
C-F
230B
INS
PE
CTI
ON
STI
CK
ER
NO
T A
PP
RO
VE
D.
4” x
4” p
erm
anen
t pre
ssur
ese
nsiti
ve fl
uore
scen
t red
prin
ted
with
bla
ck in
k. N
ote:
Thi
s fo
rm is
for o
ffice
use
onl
y an
d m
ay n
ot b
e pu
rcha
sed
by th
e pu
blic
.
UC
C-F
245
UN
SA
FE S
TRU
CTU
RE
NO
TIC
E. 6
”x 8
” pla
card
, 150
lb. t
ag o
r equ
al.
Fluo
resc
ent r
ed p
rinte
d w
ith b
lack
lette
rs.
Prin
t for
out
door
use
.
UC
C-F
255
STO
P C
ON
STR
UC
TIO
N N
OTI
CE
. 6” x
8” p
laca
rd, 1
50 lb
. tag
or e
qual
.Fl
uore
scen
t red
prin
ted
with
bla
ck le
tters
. P
rint f
or o
utdo
or u
se.
UC
C-F
320A
ELE
VATO
R N
OTI
CE
. 5 ½
”x 8
½”,
110
lb. w
hite
. P
rint b
lack
ink
on o
ne s
ide.
UC
C-F
325
NO
TIC
E O
F E
LEVA
TOR
DE
VIC
E S
EA
LED
OU
T O
F O
PE
RAT
ION
. 6” x
8”
plac
ard,
150
lb. t
ag o
r equ
al.
Fluo
resc
ent r
ed p
rinte
d w
ith b
lack
lette
rs.
Prin
t for
out
door
use
.
UC
C-F
350
CU
T-IN
-CA
RD
. 4”x
5 ½
”, th
ree
part,
pre
-col
late
d, c
arbo
nles
s se
ts g
lued
on
left
side
. P
art I
whi
te, P
art 2
can
ary,
Par
t 3 p
ink.
Prin
t bla
ck in
k on
one
side
.
REQ
UIR
ED F
OR
MS
–REC
OM
MEN
DED
SPE
CIF
ICAT
ION
S
FOR
M N
UM
BE
R
DE
SC
RIP
TIO
N &
REC
OM
MEN
DED
SP
EC
IFIC
ATIO
NS
UC
C-F
101
CO
NS
EN
T TO
UN
DE
RTA
KE
PR
OP
OS
ED
WO
RK
. 8 ½
” X 1
1”, 2
0 lb
. bon
dw
hite
pap
er.
Prin
t bla
ck in
k on
one
sid
e.
UC
C-F
110
BU
ILD
ING
SU
BC
OD
E T
EC
HN
ICA
L S
EC
TIO
N. 8
½”X
11”
, fou
r par
t, pr
e-co
llate
d, c
arbo
nles
s se
ts to
be
glue
d on
left
edge
. P
art I
whi
te, P
art
2 ca
nary
, Par
t 3 p
ink,
Par
t 4 g
olde
nrod
. Not
e: W
hile
tech
nica
lse
ctio
ns m
ay b
e pr
inte
d in
any
col
or o
r col
ors
of in
k, w
e re
com
men
dal
l par
ts p
rint b
lack
ink
on o
ne s
ide.
UC
C-F
120
ELE
CTR
ICA
L S
UB
CO
DE
TE
CH
NIC
AL
SE
CTI
ON
. 8 ½
”x 1
1”, f
our p
art,
pre-
colla
ted,
car
bonl
ess
sets
to b
e gl
ued
on le
ft ed
ge.
Par
t I w
hite
, Par
t2
cana
ry, P
art 3
pin
k, P
art 4
gol
denr
od.
Not
e: W
hile
tech
nica
lse
ctio
ns m
ay b
e pr
inte
d in
any
col
or o
r col
ors
of in
k, w
e re
com
men
dal
l par
ts p
rint p
anto
ne p
urpl
e on
one
sid
e.
UC
C-F
130
PLU
MB
ING
SU
BC
OD
E T
EC
HN
ICA
L S
EC
TIO
N. 8
½”x
11”
, fou
r par
t, pr
e-co
llate
d, c
arbo
nles
s se
ts to
be
glue
d on
left
edge
. P
art I
whi
te, P
art
2 ca
nary
, Par
t 3 p
ink,
Par
t 4 g
olde
nrod
. N
ote:
Whi
le te
chni
cal
sect
ions
may
be
prin
ted
in a
ny c
olor
or c
olor
s of
ink,
we
reco
mm
end
all p
arts
prin
t ref
lex
blue
on
one
side
.14
8157
REQ
UIR
ED F
OR
MS
–REC
OM
MEN
DED
SPE
CIF
ICAT
ION
S (c
ontin
ued)
FOR
M N
UM
BE
R
DE
SC
RIP
TIO
N &
REC
OM
MEN
DED
SP
EC
IFIC
ATIO
NS
UC
C-F
140
FIR
E P
RO
TEC
TIO
N S
UB
CO
DE
TE
CH
NIC
AL
SE
CTI
ON
. 8 ½
”x 1
1”, f
our p
art,
pre-
colla
ted,
car
bonl
ess
sets
to b
e gl
ued
on le
ft ed
ge.
Par
t I w
hite
,P
art 2
can
ary,
Par
t 3 p
ink,
Par
t 4 g
olde
nrod
. N
ote:
Whi
le te
chni
cal
sect
ions
may
be
prin
ted
in a
ny c
olor
or c
olor
s of
ink,
we
reco
mm
end
all p
arts
prin
t war
m re
d on
one
sid
e.
UC
C-F
145
ME
CH
AN
ICA
L IN
SP
EC
TOR
TE
CH
NIC
AL
SE
CTI
ON
. 8
½”x
11”
, fou
r par
t,pr
e-co
llate
d, c
arbo
nles
s se
ts to
be
glue
d on
left
edge
. P
art I
whi
te,
Par
t 2 c
anar
y, P
art 3
pin
k, P
art 4
gol
denr
od.
Not
e: W
hile
tech
nica
lse
ctio
ns m
ay b
e pr
inte
d in
any
col
or o
r col
ors
of in
k, w
e re
com
men
dal
l par
ts p
rint b
lack
on
one
side
.
UC
C-F
150
ELE
VATO
R S
UB
CO
DE
TE
CH
NIC
AL
SE
CTI
ON
. 8 ½
” X 1
1”, f
our p
art,
pre-
colla
ted,
car
bonl
ess
sets
to b
e gl
ued
on le
ft ed
ge.
Par
t I w
hite
, Par
t2
cana
ry, P
art 3
pin
k, P
art 4
gol
denr
od.
Not
e: W
hile
tech
nica
lse
ctio
ns m
ay b
e pr
inte
d in
any
col
or o
r col
ors
of in
k, w
e re
com
men
dal
l par
ts p
rint p
anto
ne g
reen
on
one
side
.
UC
C-F
155
ELE
VATO
R S
UB
CO
DE
MU
LTIP
LE D
EV
ICE
S. 8
½” x
11”
, fou
r par
t, pr
e-co
llate
d, c
arbo
nles
s se
ts to
be
glue
d on
left
edge
. P
art I
whi
te, P
art
2 ca
nary
, Par
t 3 p
ink,
Par
t 4 g
olde
nrod
. Not
e: W
hile
tech
nica
lse
ctio
ns m
ay b
e pr
inte
d in
any
col
or o
r col
ors
of in
k, w
e re
com
men
dal
l par
ts p
rint p
anto
ne g
reen
on
one
side
.
UC
C-F
160
AP
PLI
CAT
ION
FO
R V
AR
IATI
ON
. 8 ½
” x 1
1”, 2
0 lb
. bon
d w
hite
pap
er.
Prin
tbl
ack
ink
on o
ne s
ide.
UC
C-F
170
CO
NS
TRU
CTI
ON
PE
RM
IT A
ND
RE
QU
IRE
D IN
SP
EC
TIO
NS
.
5 ½
” x 8
½”,
four
par
t, pr
e-co
llate
d, c
arbo
nles
s se
ts to
be
glue
d on
left
edge
. P
art
I whi
te, P
art 2
can
ary,
Par
t 3 p
ink,
Par
t 4 g
olde
n ro
d. P
rint o
n tw
osi
des;
sid
e on
e in
bla
ck in
k, s
ide
two
in b
lack
ink
scre
ened
to b
ere
adab
le.
This
form
is fo
r offi
ce u
se o
nly
and
may
not
be
purc
hase
dby
the
publ
ic.
UC
C-F
190
PE
RM
IT U
PD
ATE
. 5 ½
” x 8
½”,
four
par
t, pr
e-co
llate
d, c
arbo
nles
s se
ts to
be
glue
d on
left
edge
. P
art I
whi
te, P
art 2
can
ary,
Par
t 3 p
ink,
Par
t 4go
lden
rod.
Prin
t bla
ck in
k on
one
sid
e. T
his
form
is fo
r offi
ce u
seon
ly a
nd m
ay n
ot b
e pu
rcha
sed
by th
e pu
blic
.
UC
C-F
211
NO
TIC
E O
F V
IOLA
TIO
N A
ND
OR
DE
R T
O T
ER
MIN
ATE
. 8 ½
” X 1
1”, 2
0 lb
.bo
nd w
hite
pap
er.
Prin
t bla
ck in
k on
one
sid
e.
UC
C-F
212
NO
TIC
E A
ND
OR
DE
R O
F P
EN
ALT
Y. 8
½” X
11”
, 20
lb. b
ond
whi
te p
aper
.P
rint b
lack
ink
on o
ne s
ide.
149
158
REQ
UIR
ED F
OR
MS
–REC
OM
MEN
DED
SPE
CIF
ICAT
ION
S (c
ontin
ued)
FOR
M N
UM
BE
R
DE
SC
RIP
TIO
N &
REC
OM
MEN
DED
SP
EC
IFIC
ATIO
NS
UC
C-F
213
NO
TIC
E O
F V
IOLA
TIO
N A
ND
OR
DE
R T
O T
ER
MIN
ATE
(Pos
t-Cer
tific
ate
ofO
ccup
ancy
–R
esid
entia
l Con
stru
ctio
n). 8
½” X
11”
, 20
lb. b
ond
whi
tepa
per.
Prin
t bla
ck in
k on
one
sid
e.
UC
C-F
214
NO
TIC
E A
ND
OR
DE
R O
F P
EN
ALT
Y (P
ost-C
ertif
icat
e of
Occ
upan
cy –
Res
iden
tial C
onst
ruct
ion)
. 8 ½
” X 1
1”, 2
0 lb
. bon
d w
hite
pap
er.
Prin
tbl
ack
ink
on o
ne s
ide.
UC
C-F
241
NO
TIC
E O
F U
NS
AFE
STR
UC
TUR
E. 8
½” x
11”
, thr
ee p
art,
pre-
colla
ted,
carb
onle
ss s
ets
to b
e gl
ued
on le
ft ed
ge.
Par
t I w
hite
, Par
t 2 c
anar
y,P
art 3
pin
k. P
rint b
lack
ink
on o
ne s
ide.
UC
C-F
242
NO
TIC
E O
F IM
MIN
EN
T H
AZA
RD
. 8 ½
” x 1
1”, t
hree
par
t, pr
e-co
llate
d,ca
rbon
less
set
s to
be
glue
d on
left
edge
. P
art I
whi
te, P
art 2
can
ary,
Par
t 3 p
ink.
Prin
t bla
ck in
k on
one
sid
e.
UC
C-F
250
STO
P C
ON
STR
UC
TIO
N O
RD
ER
. 8 ½
”x 1
1”, t
hree
par
t, pr
e- c
olla
ted,
carb
onle
ss s
ets
to b
e gl
ued
on le
ft ed
ge.
Par
t I w
hite
, Par
t 2 c
anar
y,P
art 3
pin
k. P
rint b
lack
ink
on o
ne s
ide.
UC
C-F
260
CE
RTI
FIC
ATE
. 8 ½
” X 1
1”, t
hree
par
t, pr
e-co
llate
d, c
arbo
nles
s se
ts to
be
glue
d on
left
edge
. P
art I
whi
te, P
art 2
can
ary,
Par
t 3 p
ink.
Prin
tbl
ack
ink
on o
ne s
ide.
Thi
s fo
rm is
for o
ffice
use
onl
y an
d m
ay n
otbe
pur
chas
ed b
y th
e pu
blic
.
UC
C-F
270
AP
PLI
CAT
ION
FO
R C
ER
TIFI
CAT
E. 8
½”x
11”
, 20
lb. b
ond
whi
te p
aper
. P
rint
blac
k in
k on
one
sid
e.
UC
C-F
310
ELE
VATO
R IN
SP
EC
TIO
N. 8
½”x
11”
, 20
lb. b
ond
whi
te p
aper
. Prin
t bla
ck in
k.
UC
C-F
326
UC
C E
LEVA
TOR
DE
VIC
E A
CC
IDE
NT/
INC
IDE
NT
RE
PO
RT.
8 ½
” X 1
1”, 2
0 lb
.bo
nd w
hite
pap
er.
Prin
t bla
ck in
k on
one
sid
e.
UC
C-F
360
DE
NIA
L O
F P
ER
MIT
. 8 ½
” x 1
1”, t
wo
part,
pre
-col
late
d, c
arbo
nles
s se
ts g
lued
on le
ft si
de.
Par
t I w
hite
, Par
t 2 c
anar
y. P
rint b
lack
ink
on o
ne s
ide.
UC
C-F
370
CH
IMN
EY
CE
RTI
FIC
ATIO
N F
OR
RE
PLA
CE
ME
NT
OF
FUE
L FI
RE
DE
QU
IPM
EN
T. 8
½” x
11”
, 20
lb. b
ond
whi
te p
aper
. P
rint b
lack
ink
onon
e si
de.
UC
C-F
380
Fire
Spr
inkl
er H
ydra
ulic
Dat
a P
late
. 8 ½
”x11
”, 11
0-lb
. W
hite
inde
x or
equ
al.
Prin
t bla
ck in
k on
one
sid
e.
R
evis
ed:
7-20
1515
0159
OPT
ION
AL
FOR
MS
–REC
OM
MEN
DED
SPE
CIF
ICAT
ION
S
FOR
M N
UM
BE
R
DE
SC
RIP
TIO
N &
REC
OM
MEN
DED
SP
EC
IFIC
ATIO
NS
UC
C-F
200
INS
PE
CTI
ON
NO
TIC
E. 4
¼” x
5 ½
”, 20
lb. b
ond
or e
quiv
alen
t. P
rint b
lack
ink
on o
ne s
ide.
100
per
pad
w/o
chi
p bo
ard.
UC
C-F
280B
T.C
.O. C
ON
TRO
L C
AR
D. 3
” x 5
” car
d, 9
0lb.
whi
te in
dex
or e
qual
. P
rint b
lack
ink
on o
ne s
ide.
UC
C-F
290
ON
GO
ING
INS
PE
CTI
ON
CO
NTR
OL
CA
RD
. 3” x
5” c
ard,
90
lb. w
hite
inde
xor
equ
al.
Prin
t bla
ck in
k on
one
sid
e.U
CC
-F30
0O
NG
OIN
G IN
SP
EC
TIO
NS
SC
HE
DU
LE. 8
½” x
11”
, 20
lb. b
ond
whi
te p
aper
.P
rint b
lack
ink
on o
ne s
ide.
UC
C-F
375
TIC
KLE
R/X
-RE
F C
AR
D. 3
”x 5
” car
d, 9
0 lb
. whi
te in
dex
or e
qual
. P
rint b
lack
ink
on o
ne s
ide.
UC
C-R
800A
DA
ILY
/WE
EK
LY IN
SP
EC
TOR
S R
EP
OR
T. 8
½” x
11”
, 20
lb. b
ond
whi
te p
aper
.P
rint b
lack
ink
on o
ne s
ide.
REQ
UIR
ED L
OG
S –R
ECO
MM
END
ED S
PEC
IFIC
ATIO
NS
FOR
M N
UM
BE
R
DE
SC
RIP
TIO
N &
REC
OM
MEN
DED
SP
EC
IFIC
ATIO
NS
UC
C-L
700
PE
RM
IT F
EE
LO
G. 8
½” x
14”
, 20
lb. b
ond
whi
te p
aper
. P
rint i
n bl
ack
ink.
May
be
prin
ted
one
or tw
o si
des
for l
og b
ook.
UC
C-L
710
INS
PE
CTI
ON
LO
G. 8
½” x
11”
, 20
lb. b
ond
whi
te p
aper
. P
rint i
n bl
ack
ink.
May
be
prin
ted
one
or tw
o si
des
for l
og b
ook.
UC
C-L
720
CE
RTI
FIC
ATE
LO
G. 8
½” x
14”
, 20
lb. b
ond
whi
te p
aper
. P
rint i
n bl
ack
ink.
May
be
prin
ted
one
or tw
o si
des
for l
og b
ook.
UC
C-L
730
ON
GO
ING
INS
PE
CTI
ON
LO
G. 8
½” x
14”
, 20
lb. b
ond
whi
te p
aper
. P
rint i
nbl
ack
ink.
May
be
prin
ted
one
or tw
o si
des
for l
og b
ook.
REQ
UIR
ED R
EPO
RTS
–R
ECO
MM
END
ED S
PEC
IFIC
ATIO
NS
FOR
M N
UM
BE
R
DE
SC
RIP
TIO
N &
REC
OM
MEN
DED
SP
EC
IFIC
ATIO
NS
UC
C-R
811
MU
NIC
IPA
L M
ON
THLY
AC
TIV
ITY
RE
PO
RT
(Cer
tific
ates
). 8
½” x
11”
, 20
lb.
bond
whi
te p
aper
. P
rint b
lack
ink
on o
ne s
ide.
UC
C-R
812
MU
NIC
IPA
L M
ON
THLY
AC
TIV
ITY
RE
PO
RT
(Per
mits
). 8
½” x
11”
, 20
lb. b
ond
whi
te p
aper
. P
rint b
lack
ink
on o
ne s
ide.
UC
C-R
840
STA
TE P
ER
MIT
SU
RC
HA
RG
E F
EE
S. 8
½” x
11”
, 20
lb. b
ond
whi
te p
aper
.P
rint b
lack
ink
on o
ne s
ide.
151
160
Ow
ner
Dec
ides
to b
uild
, alte
r, re
pair,
etc
.
Ow
ner/A
gent
M
akes
app
licat
ion
for
Per
mit
F-10
0 &
Appl
. Pkt
.
Tech
Ass
t R
evie
ws
App
licat
ion
(See
5:2
3-2.
14)
F-10
0 &
App
l. P
kt.
Ow
ner Se
cure
s pr
ior
appr
oval
s.
Pem
it R
equi
red?
Initi
al A
pplic
atio
n?
Min
or W
ork?
Tech
Ass
t R
evie
ws
-prio
r app
rova
ls
& c
ompl
eten
ess.
(See
5:2
3-2.
15)
App
licat
ion
com
plet
e; s
tart
date
?
Tech
Ass
t Pl
an R
evie
w a
ssig
ned;
tic
kler
file
est
ablis
hed.
A1
Ord
inar
y M
aint
enan
ce.
(See
5:2
3-2.
7(c)
)
Res
ubm
ittal
of
Pla
ns?
Sto
p
Perm
it U
pdat
e?
Con
stru
ctio
n O
ffici
al
Ref
erre
d fo
r rev
iew
.
Var
iatio
n?
Con
stru
ctio
n O
ffici
al
Den
y re
ques
t. F-36
0
Tech
Ass
t R
evie
ws
for p
rior a
p-pr
oval
s &
com
plet
enes
s.(S
ee 5
:23-
2.17
A)
Tech
Ass
t/Con
st O
ffici
alM
inor
Wor
k P
erm
it pr
epar
ed &
issu
ed.
F-17
0, -1
80
Ow
ner/A
gent
N
otifi
es o
f com
plet
ion
of
wor
k.
Sub
code
Offi
cial
/Insp
. P
erfo
rms
req’
d in
spec
tion
w/in
30
days
.
Tech
Ass
t/Con
st O
ffici
alP
repa
res
& is
sues
C
ertif
icat
e of
App
rova
l.(S
ee 5
:23-
2.17
A(d
))F-
260
Pas
s?
A4
A3
Sto
p
NEW
JER
SEY
CO
NST
RU
CTI
ON
PR
OC
ESS
(Pa
ge 1
)
No
Yes
No
No
No
Yes
Yes
Yes
Pag
e 8
Pag
e 2
Pag
e 2
Page
9
No
Yes
No
Yes
Yes
No
Yes
No
Pag
e 7
Pag
e 3
Pag
e 8
Page
5
Pag
e 6
Pag
e 5
Key
Pla
yers
Tech
Ass
t = T
echn
ical
Ass
ista
nt to
the
Con
stru
ctio
n O
ffici
alC
onst
Offi
cial
= C
onst
ruct
ion
Offi
cial
Sub
code
Offi
cial
or S
CO
= S
ubco
de O
ffici
alIn
sp =
Insp
ecto
rO
wne
r = P
rope
rty O
wne
rA
gent
= P
rope
rty O
wne
r’s A
gent
CB
A =
Con
stru
ctio
n B
oard
of A
ppea
ls
Key
Pla
yer
Pro
cess
Des
crip
tion
Rul
eFo
rm N
o.
Dec
isio
n
Flow
of P
roce
ss
End
of P
roce
ssO
ff-P
age
Con
nect
orO
n-P
age
Con
nect
or
LEG
END
APPLICATION INTAKE, ROUTING AND FILE SETUP
152
A1
B1
I1
A2
C1
H2
A5
MIN
OR
WO
RK
SU
B-P
RO
CE
SS
H1P
age
8
161
E1
Pag
e 5
Pag
e 1
Pag
e 1/
Page
3
Sub
code
Offi
cial
Rev
iew
s co
mpl
eted
P
lan
Rev
iew
; cal
cula
tes
fee,
sig
ns o
ff on
Pla
ns.
Pla
ns a
ppro
ved?
Ow
ner/A
gent
ap
peal
s?
Tech
Ass
tP
repa
res
Con
stru
ctio
n P
erm
it an
d N
otic
e.F-
170,
F-1
80
Tech
Ass
tN
otifi
es O
wne
r/Age
nt
that
Per
mit
is re
ady.
Ow
ner/A
gent
Ret
urns
to C
CE
Offi
ce;
requ
ests
Per
mit.
Tech
Ass
tC
olle
cts
Per
mit
fee.
(See
5:2
3-4.
18(a
)2)
Con
st O
ffici
alS
igns
Per
mit.
(See
5:2
3-2.
16(d
) &
5:23
-4.5
(h))
F-17
0
Ow
ner/A
gent
Rec
eive
s P
erm
it, T
ech
Sec
s, li
st o
f req
’d
insp
ectio
ns.
F-17
0, F
-180
Ow
ner/A
gent
Req
uest
s in
spec
tions
.(S
ee 5
:23-
2.18
(c))
Ow
ner/A
gent
Cor
rect
s an
d co
mpl
ies.
,O
wne
r/Age
nt
appe
als?
I1
Tech
Ass
tR
ecor
ds fe
e; e
nter
s in
fo
on P
erm
it Fe
e Lo
g. L-70
0
Tech
Ass
tN
otifi
es T
ax A
sses
sor.
Tech
Ass
tU
pdat
es T
echn
ical
S
ectio
n(s)
.
Tech
Ass
tU
pdat
es ti
ckle
r file
with
P
erm
it no
.
Tech
Ass
tD
istri
bute
s Te
chni
cal
Sec
tion(
s).
No
Yes
No
Yes Pag
e 9
Pag
e 9
Pag
e 7
Pag
e 9
Pag
e 4
Pag
e 3
B2
B3
Pag
e 9
NEW
JER
SEY
CO
NST
RU
CTI
ON
PR
OC
ESS
-con
tinue
d.(P
age
2)
B1
B3
I1
D1
A3/
C3
No
Yes
PLAN REVIEW PERMIT RELEASE
153
G1
162
B2
NEW
JER
SEY
CO
NST
RU
CTI
ON
PR
OC
ESS
-con
tinue
d.(P
age
3)
C1
Tech
Ass
tR
evie
ws
requ
est f
or
insp
ectio
n.
Tech
Ass
tN
otifi
es In
spec
tor;
mak
es e
ntry
in lo
g. L-71
0
Min
or W
ork?
Tech
Ass
tU
pdat
es In
spec
tion
Log
entry
.L-
710
Insp
/Sub
code
Offi
cial
Rev
iew
s Te
ch S
ectio
n;
Pla
ns.
Insp
/Sub
code
Offi
cial
Pos
ts ‘A
ppro
ved’
st
icke
r.F-
221
thru
F22
5
Insp
/Sub
code
Offi
cial
Upd
ates
Tec
h S
ectio
n;
mak
es D
aily
Log
ent
ry.
L-71
0
Insp
/Sub
code
Offi
cial
Not
ifies
Ow
ner/A
gent
of
resu
lts o
f ins
pect
ion.
.
Sub
code
/Con
st O
ffici
alP
repa
res
and
sign
s S
top
Wor
k O
rder
.(S
ee 5
:23-
2.31
(d)
F-25
0
Insp
/Sub
code
Offi
cial
Not
ifies
Con
st O
ffici
al
and
Sub
code
Offi
cial
.
Insp
/Sub
code
Offi
cial
Per
form
s in
spec
tion(
s)
on-s
ite.
Insp
/Sub
code
Offi
cial
Upd
ates
Tec
h S
ectio
n;
post
s ‘N
ot A
ppro
ved
stic
ker.
F-23
0
Pro
per i
nspe
ctio
n re
ques
ted?
Vio
latio
ns?
(5:2
3-2.
30)
Sto
p W
ork
Ord
er?
Issu
es S
top
Wor
k O
rder
?
Issu
e N
otic
e of
V
iola
tion?
C4
Pag
e 2
Pag
e 6
F1
Pag
e 7
C2
Yes
Pag
e 1
No
No
Yes
Yes
No
No
Yes
No
Yes
Pag
e 7
No
Yes
Pag
e 2
C3
Pag
e 4
Pag
e 9 I2
CO
NS
TRU
CTI
ON
OFF
ICIA
L
INSPECTIONS COMPLIANCE
C3P
age
2
154
C2
163
C4
D1
NEW
JER
SEY
CO
NST
RU
CTI
ON
PR
OC
ESS
-con
tinue
d.(P
age
4)
Fina
l ins
pect
ion?
Insp
/Sub
code
Offi
cial
Com
plet
e Te
ch S
ectio
n;
Mar
ks ‘F
inal
’.F-
110
thru
F-1
50
Sub
code
Offi
cial
Rev
iew
s Te
ch S
ectio
n.
F-11
0 th
ru F
-150
Tech
Ass
tR
etrie
ves
file;
mak
es
final
revi
ew fo
r co
mpl
etio
n.
Tech
Ass
tP
repa
res
appr
op. C
ert
base
d on
pg.
3.
(See
5:2
3-2.
23 &
5:2
3-2.
23A
)F-
260
Ow
ner/A
gent
Req
uest
s C
ertif
icat
e.(S
ee 5
:23-
2.23
(g),
(i),
(m) a
nd (p
);&
5:2
3-2.
24) F-
270
Tech
Ass
tR
evie
ws
and
com
pare
s re
ques
t to
prep
ared
C
ertif
icat
e.
Tech
Ass
tC
olle
cts
fee,
if a
ny.
Con
st O
ffici
alS
igns
Cer
tific
ate.
(See
5:2
3-2.
23(j)
3 &
5:
23-4
.5(h
))F-
260
Tech
Ass
tN
umbe
rs a
nd is
sues
C
ertif
icat
e.
Ow
ner/A
gent
Rec
eive
s C
ertif
icat
e.
Tech
Ass
tC
ompl
etes
Cer
tific
ate
Log.
L-72
0
Tech
Ass
tU
pdat
es P
erm
it fil
e;
files
in C
entra
l File
.
Cor
rect
Cer
tific
ate
Req
uest
ed?
Tech
Ass
tR
esol
ves
corr
ect
Cer
tific
ate
with
Con
st
Offi
cial
.
A
A
Sto
p
No
Yes
No
Yes
Pag
e 3
Pag
e 2
FINAL INSPECTIONS CERTIFICATE 155
164
A1
E1
Tech
Ass
tD
istri
bute
s Te
ch
Sec
tion
Spe
cs; P
lans
.(S
ee 5
:23-
2.15
(f))
Tech
Ass
tP
repa
res
Tick
ler f
ile.
F-37
5
Tech
Ass
tTi
ckle
r file
rem
oved
; up
date
d w
ith P
erm
it no
.R
evie
w C
ompl
ete?
Build
ing
Pla
n R
evie
w?
Ele
ctric
al P
lan
Rev
iew
?
Plu
mbi
ng P
lan
Rev
iew
?
Fire
Pro
tect
ion
Pla
n R
evie
w?
Ele
vato
r Pla
n R
evie
w?
Pla
n R
evie
w
Com
plet
e?
Insp
/SC
O, B
uild
ing
Rev
iew
s P
lan;
reco
m-
men
ds jo
int;
initi
als.
[S
ee 5
:23-
3.4(
a)]
F-
110
Tech
Ass
tR
evie
w T
ech
Sec
tion(
s), i
nitia
l, da
te,
reco
mm
enda
tions
.
NEW
JER
SEY
CO
NST
RU
CTI
ON
PR
OC
ESS
-Sub
rout
ine
A: P
lan
Rev
iew
(P
age
5)
Insp
/SC
O, E
lect
rical
Rev
iew
s P
lan;
reco
m-
men
ds jo
int;
initi
als.
[
See
5:2
3-3.
4(a)
] F-12
0
Insp
/SC
O, P
lum
bing
Rev
iew
s P
lan;
reco
m-
men
ds jo
int;
initi
als.
[S
ee 5
:23-
3.4(
a)] F-
130
Insp
/SC
O, F
ire P
rote
ctio
nR
evie
ws
Pla
n; re
com
-m
ends
join
t; in
itial
s.
[S
ee 5
:23-
3.4(
a)] F-
140 Insp
/SC
O, E
leva
tor
Rev
iew
s P
lan;
reco
m-
men
ds jo
int;
initi
als.
[See
5:2
3-3.
4(a)
] F-15
0
Insp
/SC
O, M
echa
nica
lR
evie
ws
Pla
n; re
com
-m
ends
join
t; in
itial
s.
[S
ee 5
:23-
3.4(
d)] F-
145
Pag
e 2
Yes
No
No
Yes
No
No
No
No
Yes
Yes
Yes
Yes
No
Yes
Pag
e 1
P
age
6
156
F1
165
A2
NEW
JER
SEY
CO
NST
RU
CTI
ON
PR
OC
ESS
-Sub
rout
ine
B: P
erm
it U
pdat
e (P
age
6)
Tech
Ass
t
Ret
rieve
s P
erm
it Fi
le.
Tech
Ass
t
Col
lect
s fe
e.
Tech
Ass
tR
ecor
ds fe
e in
Per
mit
Fee
Log.
L-70
0
Tech
Ass
tU
pdat
es P
erm
it. F-10
0
Tech
Ass
tU
pdat
es T
ech
Sec
tion.
F-11
0 th
ru 1
50
Tech
Ass
tD
istri
bute
s Te
chni
cal
Sect
ion(
s) to
Insp
ecto
r/S
CO
(s).
F-11
0 th
ru 1
50
Pag
e 1
Page
s 3
and
5
157
F1
166
NEW
JER
SEY
CO
NST
RU
CTI
ON
PR
OC
ESS
-Sub
rout
ine
F: N
otic
e an
d O
rder
of P
enal
ty; N
otic
e of
Vio
latio
n an
d O
rder
to T
erm
inat
e (P
age
7)
Ord
er o
f Pen
alty
?
Sub
code
Offi
cial
Pre
pare
s &
sig
ns N
otic
e of
Vio
latio
n &
Ord
er to
Te
rmin
ate
F-21
1
Tech
Ass
tIs
sues
doc
umen
t to
Ow
ner/A
gent
; upd
ates
fil
e.
Sub
code
Offi
cial
Pre
pare
s O
rder
of
Pen
alty
.F-
212
Con
st O
ffici
alS
igns
Ord
er o
f Pen
alty
.
F-21
2
Tech
Ass
tIs
sues
doc
umen
t to
Ow
ner/A
gent
; upd
ates
fil
e.
No
Yes
Page
s 1
and
3
Pag
e 2
Pag
e 2
158
A5/
C2
G1
G1
167
H2
NEW
JER
SEY
CO
NST
RU
CTI
ON
PR
OC
ESS
-Sub
rout
ine
C: V
aria
tions
(P
age
8)
Con
st/S
ubco
de O
ffici
alG
ives
Ow
ner/A
gent
V
aria
tion
appl
icat
ion.
F-16
0
Con
st/S
ubco
de O
ffici
alA
ssis
ts O
wne
r/Age
nt
with
com
plet
ing
appl
icat
ion.
(See
5:2
3-4.
5(h)
-(i))
Ow
ner/A
gent
Com
plet
es a
nd fi
les
appl
icat
ion.
(See
5:2
3-2.
10) F-
160
Tech
Ass
tC
olle
cts
fee;
dis
tribu
tes
to a
ppro
pria
te S
ubco
de
Offi
cial
for r
evie
w.
Con
st/S
ubco
de O
ffici
alP
erfo
rms
revi
ew.
(See
5:2
3-2.
11)
Var
iatio
n A
ppro
ved?
H1
Pag
e 2
No
Yes
Pag
e 1
Page
1
159
A4
168
B3
Pag
e 3
Pag
e 2
Pag
e 1
and
2
I1
Tech
Ass
tG
ives
Ow
ner/A
gent
ap
plic
atio
n to
C
onst
ruct
ion
Bd
of
Appe
als.
Ow
ner/A
gent
File
s ap
peal
with
C
onst
ruct
ion
Bd
of
Appe
als.
Con
stru
ctio
n B
d of
A
ppea
ls h
ears
cas
e.(S
ee 5
:23A
-2.2
; 2.3
)
Tech
Ass
tR
ecei
ves
deci
sion
; no
tifie
s C
onst
/Sub
code
O
ffici
al; u
pdat
es fi
le.
Ow
ner u
phel
d?
Tech
Ass
tN
otifi
es C
onst
Offi
cial
of
Ow
ner/A
gent
inte
nt to
ap
peal
.
NEW
JER
SEY
CO
NST
RU
CTI
ON
PR
OC
ESS
-Sub
rout
ine
G: A
ppea
l Pro
cess
(P
age
9)
No
Yes
160
I2
169