Application for a Permit to Construct or Demolish This form is authorized under subsection 8(1.1) of the Building Code Act.

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Application for a Permit to Construct or Demolish This form is authorized under subsection 8(1.1) of the Building Code Act. For use by Principal Authority Application number: Permit number (if different): Date received: Roll number: Application submitted to: (Name of municipality, upper-tier municipality, board of health or conservation authority) A. Project information Building number, street name Unit number Lot/con. Municipality Postal code Plan number/other description Project value est. $ Area of work (m 2 ) B. Purpose of application New construction Proposed use of building Addition to an existing building Alteration/repair Demolition Conditional Permit Current use of building Description of proposed work C. Applicant Applicant is: Owner or Authorized agent of owner Last name First name Corporation or partnership Street address Unit number Lot/con. Municipality Postal code Province E-mail Telephone number Fax Cell number D. Owner (if different from applicant) Last name First name Corporation or partnership Street address Unit number Lot/con. Municipality Postal code Province E-mail Telephone number Fax Cell number Application for a Permit to Construct or Demolish Effective January 1, 2011

E. Builder (optional) Last name First name Corporation or partnership (if applicable) Street address Unit number Lot/con. Municipality Postal code Province E-mail Telephone number Fax Cell number F. Tarion Warranty Corporation (Ontario New Home Warranty Program) i. Is proposed construction for a new home as defined in the Ontario New Home Warranties Plan Act? If no, go to section G. Yes No ii. Is registration required under the Ontario New Home Warranties Plan Act? Yes No iii. If yes to (ii) provide registration number(s): G. Required Schedules i) Attach Schedule 1 for each individual who reviews and takes responsibility for design activities. ii) Attach Schedule 2 where application is to construct on-site, install or repair a sewage system. H. Completeness and compliance with applicable law i) This application meets all the requirements of clauses 1.3.1.3 (5) (a) to (d) of Division C of the Building Code (the application is made in the correct form and by the owner or authorized agent, all applicable fields have been completed on the application and required schedules, and all required schedules are submitted). Payment has been made of all fees that are required, under the applicable by-law, resolution or regulation made under clause 7(1)(c) of the Building Code Act, I992, to be paid when the application Yes Yes No No is made. ii) This application is accompanied by the plans and specifications prescribed by the applicable by-law, resolution or regulation made under clause 7(1)(b) of the Building Code Act, 1992. Yes No iii) This application is accompanied by the information and documents prescribed by the applicable bylaw, resolution or regulation made under clause 7(1)(b) of the Building Code Act, 1992 which enable Yes No the chief building official to determine whether the proposed building, construction or demolition will contravene any applicable law. iv) The proposed building, construction or demolition will not contravene any applicable law. Yes No I. Declaration of applicant I declare that: (print name) 1. The information contained in this application, attached schedules, attached plans and specifications, and other attached documentation is true to the best of my knowledge. 2. If the owner is a corporation or partnership, I have the authority to bind the corporation or partnership. Date Signature of applicant Personal information contained in this form and schedules is collected under the authority of subsection 8(1.1) of the Building Code Act, 1992, and will be used in the administration and enforcement of the Building Code Act, 1992. Questions about the collection of personal information may be addressed to: a) the Chief Building Official of the municipality or upper-tier municipality to which this application is being made, or, b) the inspector having the powers and duties of a chief building official in relation to sewage systems or plumbing for an upper-tier municipality, board of health or conservation authority to whom this application is made, or, c) Director, Building and Development Branch, Ministry of Municipal Affairs and Housing 777 Bay St., 2nd Floor. Toronto, M5G 2E5 (416) 585-6666. Application for a Permit to Construct or Demolish Effective January 1, 2011

Town of Oakville Building Permit Application Additional Information Permit # - Project Address Personal Information on this form is collected and used for the purpose collected under the authority of Municipal Act, as amended. Questions about the collection of personal information should be directed to: Records and Freedom of Information Officer, Clerk s Department, 905-815-6053. Zoning: Special Provision: CAV#: SPCA#: Company: HVAC Contact: Street: Postal code: Town of Oakville license # City: Telephone: Fax: Company: Plumber Contact: Street: Postal code: Town of Oakville license # City: Telephone: Fax: Drain Layer Company: Contact: Street: Postal code: Town of Oakville license # City: Telephone: Fax: Signature Date OFFICE USE ONLY Item rate x area Total Paid Owing Receipt chq cash debit

Applicable Law Checklist Pursuant to Subsection H(iii) of an Application to Construct or Demolish Town of Oakville Building Services Department Application no. Address Date The following approval processes must be completed if they apply to this project, before a building permit can be issued. This listing is provided for convenience purposes only and does not necessarily describe every approval which may be necessary. For more detailed information about the application of these laws to any project, please contact the listed agency, or refer to the actual text of the legislation. For assistance in completing this form, please contact a Building Services Representative. Completing this form accurately and providing necessary documents will expedite the issuance of your building permit. Please check [ ] the items that apply, and attach approval documents where applicable. LOCAL MUNICIPALITY FORM OF APPROVAL REQUIRED DOCUMENTS RECEIVED Planning & Zoning MINOR VARIANCE Planning Act s. 45 Where application doesn t comply with all zoning provisions Final & binding decision by Committee of Adjustment Contact: Oakville Building Services, Secretary-Treasurer to the Committee of Adjustment 905-845-6601 ext. 3281, 7170 ZONING BY-LAW AND AMENDMENTS Planning Act s. 34 Zoning by-law final & binding Where development requires amended zoning by-law Contact: Oakville Planning Services 905-845-6601 ext. 3917 DIVISION OF LAND Ref. Planning Act Part VI Where land division required for zoning compliance Registration of Plan or Deed Contact: Oakville Building Services 905-845-6601 ext. 3281, 7170 PROVINCIAL ZONING ORDERS Planning Act s. 47 Approval of the Minister For areas covered by Minister s zoning orders Contact: MMAH Services Office 1-800-668-0230 SITE PLAN APPROVAL Planning Act s. 41 For development in site plan control areas Approval of site plans by municipality Contact: Oakville Planning Services 905-845-6601 ext. 3917 Planning & Development Act Approval of the Minister Where Provincial planning control has been applied Contact: MMAH Services Office 1-800-668-0230 Heritage HERITAGE PERMITS Ontario Heritage Act s. 30(2), 33, 34 Where property is designated or undergoing designation Ontario Heritage Act s. 27 Demolition or removal of building listed in municipal register Ontario Heritage Act s. 42 Where land is in a heritage conservation district Ontario Heritage Act s. 40.1 Property is in heritage conservation study area Consent of Council to alter or demolish Contact: Oakville Planning Services, Heritage 905-845-6601 ext. 3875, 3870 Expiration of 60 day notice of intent to Council Contact: Oakville Planning Services, Heritage 905-845-6601 ext. 3875, 3870 Heritage permit issued by Council Contact: Oakville Planning Services, Heritage 905-845-6601 ext. 3875, 3870 Compliance with heritage conservation study by-law Contact: Oakville Planning Services, Heritage 905-845-6601 ext. 3875, 3870 Ontario Heritage Act s. 34.5 & 34.7(2) Consent of Minister to alter or demolish Where property is designated by Minister of Culture Contact: MOC Regional Conservation Advisor, 416-314-7136 CONSERVATION AUTHORITY FORM OF APPROVAL REQUIRED DOCUMENTS RECEIVED Conservation AUTHORITY PERMIT Conservation Authorities Act s. 28 Construction & full permit Where construction affects the control of flooding, erosion, Contact: Halton Conservation Authority Office 905-336-1158 dynamic beaches, pollution or conservation of land OR Credit Valley Conservation Authority Office 905-670-1615

PROVINCIAL APPLICABLE LAWS FORM OF APPROVAL REQUIRED DOCUMENTS RECEIVED Agriculture & Food Ministry of Agriculture & Food Nutrient Management Act 2002 s. 11 reg 267/03 Record of Approval of NMS issued by MAF Farm buildings housing animals or animal manure Contact: P. Engineer 519-826-6366 Milk Act s. 14 Where building used as a milk processing plant Child Care Centres Permit issued by the Director, MAF Contact: Food Inspection Branch 1-888-466-2372 ext. 6-4180 Ministry of Children & Youth Services Day Nurseries Act s. 5 reg 262 Ministry plan approval Where building is used for a daycare Contact: Regional Office 905-567-7177 Education Ministry of Education DEMOLITION OF SCHOOLS Minister s approval of demolition Education Act s. 194 Contact: Architect 416-325-2015 Where a school is proposed to be demolished Environment Ministry of the Environment Environmental Assessment Act s. 5 Minister s approval of Terms of reference & EA Major industrial or commercial enterprises & Contact: MOE Assessment & Approvals 1-800-461-6290 Government projects BROWNFIELD REDEVELOPMENT Record of Site Condition filed with MOE Environmental Protection Act s. 168 Conformance with Certificate of Property Use Where industrial or commercial property changed Contact: MOE Central Region 416-326-4840 to residential or parkland use FORMER WASTE DISPOSAL SITES Minister s approval to use the land Environmental Protection Act s. 46 Contact: MOE Investigations & Enforcement 416-326-6700 Where building on former landfill or waste disposal site RENEWABLE ENERGY APPROVAL Minister s Renewable Energy Approval Environmental Protection Act s. 47.3 Contact: MOE Assessment & Approvals 1-800-461-6290 For renewable energy projects that use wind, solar and bio-energy to generate electricity SOURCE WATER PROTECTION Risk Management Official Approval Clean Water Act, s.59 Contact: Region of Halton 311 Special land use restrictions may apply if a water source protection plan is in effect in the area where the building is located. Highways Ministry of Transportation MTO PERMIT Public Transportation Act s. 34/38 Building & Land Use permit issued by MTO Where construction is within 45m of a highway, 180m Contact: Regional Office of MTO 416-235-5385 from any highway intersection, or within 800m of a highway and will generate major traffic. Long Term Care Homes Ministry of Health & Long Term Care Elderly Persons Centres Act s. 6 reg. 314 Contact: Planning & Renewal Branch 1-877-767-8889 Electrical Conductor Clearances Electrical Safety Authority Are any overhead power lines located either above Contact: Customer Service Centre 877-372-7233 or within 5.5m of the proposed building? The personal information accompanying your submission is collected under the authority of the Planning Act and forms part of the public record which may be released to the public. Questions about this collection should be directed to the Building Services Department at 1225 Trafalgar Road, Oakville ON L6J 905 845-7376.

ADDRESS OF DEMOLITION: DATE OF DEMOLITION: PROPERTY OWNER(S): OWNER(S) ADDRESS: CONTRACTOR: CONTRACTOR ADDRESS: Building Services Demolition Permit Clearances Please Note: This Clearance form must accompany demolition permit applications. Obtain signatures from all authorities regardless of whether or not the service is provided to the property. Demolition permits cannot be issued without approval from the listed authorities. Please see reverse for demolition requirements *** Please return this form, once completed along with a Demolition Application to the Building Services Department *** PHONE # : EMAIL: PHONE # : Authority Town of Oakville - Fire Dept. 1225 Trafalgar Road, Oakville (905) 845-6601 Fax (905) 815-2023 Town of Oakville-Engineering and Construction Department 1225 Trafalgar Road, Oakville (905) 845-6601 Fax (905) 338-4159 Oakville Hydro 861 Redwood Square, Oakville (905) 825-9400 Region of Halton-Public Works 1151 Bronte Rd., Oakville (905) 825-6000 Fax (905) 847-0982 Union Gas 1-855-228-4898 x5111115 Fax: (905)-333-5955 Email haltplan@uniongas.com Town of Oakville - Forestry Central Operations 1140 South Service Rd. W. (905) 845-6601 Town of Oakville Planning Services 1225 Trafalgar Road Oakville (905) 845-6601 Notes Must comply with Section 8 of the Ontario Fire Code. Please note: ***No open-burning permitted*** Locations of storm sewers and storm sewer easements on property. See: Vince Blosser ext. 3313 Email vince.blosser@oakville.ca Signature Date Schedule appointment for removal of hydro meter. See: Judy ext. 2251 or Nancy ext. 2278 Regional facilities such as water service and sanitary sewers. See: Gary Brown ext. 7879 or Don Goshgarian ext. 7878 Call 4-5 weeks ahead to schedule appointment for disconnect of gas service. This form will only be signed once disconnect has been completed. Private tree permit IS / IS NOT required Review of arborist report and plan of work is required for clearance See: Tree Protection Inspector Structure to be demolished IS / IS NOT included in the Town of Oakville's Heritage Register. See: Heritage Planner Further construction on this property may require site plan approval under Section 41 of the Planning Act. For further information, please contact the relevant District Planning Manager in the Planning Services department. Once a demolition permit has been issued and the demolition has been completed contact the Building Services Department at (905)338-4220 to request a post-demolition inspection. Demolition Permit Application # :

Demolition Requirements All demolition projects shall comply with the following: 1. In accordance with Section 21(3) of Regulation 903 under the Ontario Water Resources Act, any well on a property that is not being used or maintained for future use must be abandoned. Therefore, the owner/agent is required to submit a record of well abandonment (issued by a licensed well contractor) to the Region of Halton Health Department to verify the decommissioning of the well(s) on the property. 2. The contractor shall make every effort to minimize the amount of dust generated during demolition. A method of dust control can be, but is not limited to, wettingdown the construction debris during the actual demolition. Dust complaints are regulated under the Town of Oakville s Nuisance By-law. 3. In accordance with Part 3, Section 30 of the Occupational Health and Safety Act (OHS&A) before beginning a demolition, the owner shall determine whether any designated substances are present at the project site and shall have a report prepared of all designated substances (DSR) that are present at the site. The requirement for a DSR is regulated by the Ministry of Labour (MOL). Failing to provide a DSR to a MOL officer may result in the stoppage of work. 4. All windows shall be broken INWARDS prior to the start of the demolition. 5. Hours of work are regulated by the Town of Oakville s Noise By-law. This would include the noise generated by construction equipment, the delivery of materials and/or idling trucks. 6. It is the responsibility of the property owner and/or person to whom a permit is issued to maintain a safe construction site. This may include, but is not limited to requiring and maintaining the installation of a fence to prevent unwanted access to the construction site. 7. Excavations shall be done in a manner to prevent damage to adjacent properties, existing structures, existing fences etc. at all stages of construction. Contractors shall assess site conditions and location of excavations with respect to property lines to determine if shoring is necessary. It is advisable that if necessary, a professional engineer assess the site prior to and during the excavation to determine if additional measures need to be taken to protect adjacent properties. Failure to protect adjacent properties from damage may result in the stoppage of work. 8. The issuance of a building permit does not give the permit holder and contractors/sub-trades the right to access adjacent private property without the express consent given by the adjacent property owner. 9. At all times RESPECT the rights and properties of adjacent property owners. Construction projects should build good neighbor relationships not just safe buildings.

PRECAUTIONS DURING EXCAVATIONS for HOUSING and SMALL BUILDINGS - DECLARATION In order to address the Ontario Building Code (OBC) requirement of Div. B, Sentence 9.12.1.4.(1) which states Every excavation shall be undertaken in such a manner to prevent damage to adjacent property 1, existing structures, utilities, roads and sidewalks at all stages of construction, this form is to be completed by a person with suitable knowledge and experience, such as an engineer, architect, BCIN designer or property owner, as per the OBC. This person will be responsible for ensuring OBC compliance relating to the excavation, (consideration should be given for OBC Div. B, Subsection 4.2.5 for the subject building permit application). Documentation demonstrating OBC compliance shall be attached to this completed declaration. 1 Please note adjacent property includes landscaping, walkways, fences etc. Where distances to property lines allow for an open cut excavation, please provide dimensioned proposed excavation sections to illustrate compliance. Project Location: Permit Application No. ------------------------------------------------------------------------------------------------------------- I declare that I have suitable knowledge and experience and I am responsible for ensuring code compliance relating to OBC Div. B, Sentence 9.12.1.4. (1) for the subject building permit application noted above. Designer s Name: Signature -------------------------------------------------------------------------------- Firm: ---------------------------------------------------------------- Please be aware of your obligations under the Ministry of Labour (MOL). Excavations are to be in accordance with MOL regulations, section 230-234. Excavations over 1.2 meters deep require either an engineered design soil support system or a letter in accordance with MOL regulations, from an engineer stating a soil support system is not required. At the time of the required backfill inspection, the building inspector will require demonstration of MOL compliance. If MOL compliance is not demonstrated, the building inspector will not permit the construction to proceed and if necessary will call in the MOL.