Project Address. Name of Project/business name. Owner of Property Phone . Emergency contact phone number. Parcel Number

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Commercial Permit Number All permit applications must be submitted with two sets of complete drawings. Approved plans and permit must be on the job site and accessible to the inspector. Payments not accepted at time of permit submittal. Payment due after permit has been approved. Checks made payable to the City of Delaware. NOTICE: A separate permit is required for plumbing and may be obtained from the County Health Department.. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance or construction. The City of Delaware, by issuing this permit, is not guaranteeing the quality of the materials or the workmanship of the contractor. The City reserves the right to revoke any registration or issue a stop work order for non-compliance with City Codes. List of subcontractors must be provided when submitting this permit. Commercial Condo (4 or more) Apartment (4 or more) Project Address Name of Project/business name Owner of Property Phone E-Mail Emergency contact phone number Parcel Number Contact Information when permit is ready Phone E-Mail Contractor(Primary/General) Phone E-Mail Architect/Engineer Phone E-Mail Cost of Projects Number of Buildings Does this add Dwelling Units?/# / Board of Zoning Appeal Approval # (If Applicable) Class of Work New Addition Alteration Repair Move Description Of Work: Building Use Group(s) Classification Per OBBC (Circle One) A1 A2 A3 A4 A5 B E F1 F2 H1 H2 H3 H4 I1 I2 I3 M R1 R2 R3 S1 S2 U Total (Include Mezzanines) Square Foot Change of Use From Change of Use To Occupant Load Construction Type (Circle One) 1A 1B 2A 2B 2C 3A 3B 4 5A 5B Electrical Work (if applies) New Construction Addition Alteration Size of Service in Amps (service in excess of 400 amps require sealed drawings to be submitted) City Hall 1 South Sandusky Street Delaware, Ohio 43015 PlanningAndDevelopment@delawareohio.net Tel: 740.203.1600 Fax: 740.203.1699 www.delawareohio.net

Mechanical Work (if applies) Heating system New Replacement Conversion Pre-Fab Fireplaces (Number) Heating BTU Cooling Tons Type of Fuel Furnaces (Number) Air Handlers Hot Water Boilers Roof Top Units AC Units Infra-Red Radiant Heaters Unit Heaters Electric heat Baseboard (Number) Ceiling Cable Ray Board Glass Radiant Grease Hoods (Number) Fire Suppression/Protection (if applies) Describe Proposed System Square Foot Is suppression system required Yes No System Demand GPM Storage Configuration/Aisle Width Hazard Classification-Light Ord 1 Ord 2 Ex 1 Ex 2 Other New Construction Alteration Repair or replacement Fire Alarm System Yes No Number of stations Existing Proposed Smoke detectors Yes No Number of detectors Existing Proposed Sprinklers Yes No Number of heads Existing Proposed Standpipes Yes No Number Commercial Kitchen Hoods Yes No Number of Heads Proposed Spray Booths Yes No Number of Heads Proposed Fire Detection System Yes No Number of Smoke Detectors Number of Heat Detectors Number of Fire Detectors Smoke Control System Yes No Square footage being suppressed The undersigned is either the property owner or a duly authorized agent of the property owner and do hereby verify the truth and correctness of all facts and information presented with this application and authorize on-site inspections by City Staff. Owner or Authorized Agent Date Approved By Date Planning/Zoning Date CBO Date Plans Examiner Date

COMMERCIAL FEE STRUCTURE- Payment due after approved! Not all fees are listed on fee sheet. Office Use Only Plan Review $50.00 New Building/Addition $140.00 plus $.07/sf Alteration/Tenant Space $60.00 plus $.04/sf Decks/Accessory Structures $60.00 plus $.03/sf Resubmitted Plan Review $100.00/hr Structural Permit $80.00 plus $.05/sf Electrical Permit $80.00 plus $.04/sf Heating/Ventilation/Air Conditioning (HVAC) $80.00 plus $.03/sf Insulation/Energy Conservation $80.00 plus $.02/sf Fire Suppression System/Fire Protection Change of Use Permit $60.00 Re-inspection (each inspection) $80.00 Re-issuance (permits/inspections cards) $50.00 Temporary Occupancy Permit $100.00 Certificate of Occupancy (C.O.) $75.00 State of Ohio Surcharge - 3% on above Zoning Plan Review $50.00 Zoning Compliance $100.00 plus $.03/sf Sewer Permit $35.00 Sewer Capacity Fee (Meter Size ) $ Water Permit $35.00 Water Capacity (Meter Size ) $ Grade Inspection $100.00 Park Exaction(if any) $ IMPACT FEES: Park Police Fire Municipal $ Transportation(if any) $ ERU $ $100.00 plus $5.00 -per Signaling System/Sprinkler head *up to 300 heads

Form A -DEVELOPMENT IMPACT FEE CALCAULATION FORM CITY OF DELAWARE, OHIO Applicant for Building Permit shall complete items 1 thru 11, which shall be consistent with all information on the Building Permit Application filed by the Applicant. This Form shall be submitted with the Building Permit Application. The Building Official shall verify information in items 1 thru 11, and forward the Development Impact Fee Calculation Form to the Planning Department. (1) Date (2) Name, Address & Phone of applicant (3) Name of property owner (4) Property parcel number and/or subdivision lot number (5) Date of building permit application/building permit application number (6) Building permit application NO s (internal use only) (7) Amount and type of proposed development Residential/DU s single-family, detached townhouse/duplex all other Total DU s: Non-Residential/1,000 sq. ft. GFA Com/shop Ctr 50,000 sf or less Com/shop Ctr 50,001-100,000 sf Com/shop Ctr 100,001-200,000 sf Com/shop Ctr over 200,000 sf Office/Inst. 25,000 sf or less Office/Inst. 25,001-50,000 sf Office/Inst. 50,001-100,000 sf Office/Inst. Over 100,000 sf Business Park Light Insdustrial Warehousing Manufacturing Total Non-residential

(8) Development Impact Fee Calculation: Amount & Type of Land Use Parks Police Fire/EMS Municipal Total Residential Development DU s Single-family, detached DU s Single-family, detached DU s All other DU s Total Non-Residential Development Com/Shop Ctr 50,000 sf or less Com/Shop Ctr 51,001-100,000 sf Com/Shop Ctr 100,001-200,000 sf Com/Shop Ctr over 200,000 sf Office/Inst. 25,000 sf or less Office/Inst 25,001-50,000 sf Office/Inst 50,001-100,000 sf Office/Inst over 100,000 sf Business Park Light Industrial Warehousing Manufacturing Total Amount $ $ $ $ $ Instructions: (a) In Column 1, insert the total amount of the proposed development, by land use categories as set forth. (b) In Columns 2 through 4, multiply the amount of development by land use category by the applicable Development Impact Fee for that land use category as set forth in the individual public facility Development Impact Fee ordinances currently in effect. (Note that not all land use categories will be filled in for a particular development and therefore that Development Impact Fees need not be calculated for all land use categories listed in Column 1. Note also that not all Development Impact Fees apply to every category of land use, e.g., the Park and Recreation Facilities Development Impact Fees apply only to residential development) (c) At the bottom of Columns 2 through 4, the total Development Impact Fees by public facility will be shown. (d) In Column 5, the total Development Impact Fees for all public facilities by land use category will be shown. (e) At the bottom of Column 5, the grand total of all Development Impact Fees to be imposed on the proposed development will be shown.

(9) Exemption requested [Exemption must be requested at time of Application for Building Permit]: Yes No [If yes, include copy of Form B-Request for Exemption From Development Impact Fees.] (10) Offset requested: [Offset must be requested at time of Application for Building Permit]: Yes No [If yes, include copy of Form C - Request for Offset Form] (11) All information submitted by applicant is true and accurate: [Applicant Signature] [Date] STOP. THE FOLLOWING CERTIFICATIONS ARE TO BE COMPLETED BY THE PLANNING DIRECTOR AND OTHER CITY DEPARTMENTS, STAFF AND OFFICIALS, AS APPROPRIATE. (12) Date of receipt of development impact fee calculation form: [ACTION - TRANSFER OF FORM AND SUPPORTING MATERIALS FROM BUILDING OFFICIAL TO PLANNING DIRECTOR] (13) Building permit official verification of items 1 through 11 and transfer of form to planning director. Date: (14) Form A reviewed by: Name: Title: Department: (15) Initial development impact fee calculation reviewed by Planning Director: Date: ; Approved Disapproved If disapproved, explain why: If disapproved, provide revised Development Impact Fee calculation: $ and notify Applicant. (16) If exemption was requested, Form B, request for exemption and supporting documentation reviewed by: Name: Title: Department: (17) Exemption request review completed: Date: (18) ACTION BY CITY ON REQUEST FOR EXEMPTION: Approved Approved, subject to the following conditions: Denied Inadequate information on which to base a decision [specify additional information needed]:

(19) IF OFFSET WAS REQUESTED, FORM C, OFFSET REQUEST AND SUPPORTING DOCUMENTATION REVIEWED BY: Name: Title: Department: (20) OFFSET REQUEST REVIEW COMPLETED: Date: (21) ACTION BY CITY ON REQUEST FOR OFFSET: Approved Approved, subject to the following conditions: Denied Inadequate information on which to base a decision [specify additional information needed]: (22) IF APPROVED OR APPROVED SUBJECT TO CONDITIONS, AMOUNT OF EXEMPTION/OFFSET (BY PUBLIC FACILITY DEVELOPMENT IMPACT FEE) Public Facility Amount of Fee Pursuant to Form A (Without Exemption or Offset) Exemption/Offset Amount Parks and Recreation $ $ $ Police $ $ $ Fire/EMS $ $ $ Municipal $ $ $ TOTAL: $ $ $ Revised Final Development Impact Fee (23) FINAL DEVELOPMENT IMPACT FEE CALCULATION VERIFICATION, INCLUDING EXEMPTION, IF APPROVED BY MAYOR AND CITY COUNCIL AND OFFSET, IF APPLICABLE AND APPROVED: [Planning Director Signature] [Date] (24) FINAL DEVELOPMENT IMPACT FEE CALCULATION AGREED TO BY APPLICANT: [Applicant Signature] [Date] s/planning/forms/building/permit forms/commercial new construction revised 6.4.15