Block
{[PNAME]}
Zoning District
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
www.upperprovmcpa.gov
Property Information
Property Address
Lot
Parcel #
Subdivision Name
Begin typing address and select from the populated dropdown
Unit
  • Contacts
  • Project Details
  • Floodplain
  • Attachments & Certification
Name
Email
Address
Person in Charge is the
Email
Address
Business Name (if applicable)
Fax #
City, State, ZIP
Fax #
Email
Name
Address
Contractor Information
Phone #
Name
Applicant Information
City, State, ZIP
Relationship to Owner
Email
City, State, ZIP
Phone #
Phone #
Name
Person in Responsible Charge Information (Primary Point of Contact)
If Other, Please Specify
Phone #
Property Owner Information
Electrical
New Building
(Please Specify)
Other
Solar Panels
Change in Use
Addition
Roofing
Project Type(s)
Water Service
# of Stories
Fuel Source
Mechanical
Existing Building Area (Sqft)
# of Plumbing Fixtures/Traps
Alteration
Total Project Cost
Height of Structure Above Grade
Project Information
Project Type
Building Moving Permit
Minor Work (Plumbing)
Demolition
Plumbing
Description of Work
If Other (Please Specify)
Plan Review
Sewer Service
Pool
# of Units
Proposed Building Area (Sqft)
With Utilities
Total Building Area (SqFt)
Deck
Demolition - Interior (Commercial)
Is Building Equipped with an Automatic Sprinkler System?
Property Type
All Applicants building an addition, a new home or a new building MUST provide the following Site Information:
For New and Additions, Please provide the following Building Information:
Total Sqft
Floodway Classification
Minimum Improvement
Substantial Improvement Determination
Earth moving (grading, filling, excavation) in a floodplain/floodway
Floodplain Source ID
Value of Improvement(s)
New Construction
If other, please specify
Elevation of the 100-year floodplain (ft)
Has the Township of Upper Providence previously issued a:
Elevation + Freeboard requirement (ft)
Routine Exterior Maintenance (i.e., roofing, window replacement, etc.)
Date (If Issued)
Floodplain Classification of Application
Check one or more as applicable:
Substantial Damage Estimate
Site Elevation
Total Cost
Property/Structure Valuation
Date (If Issued)
If yes, please specify the date
Source of pre-improvement structure value
Additional Required Information
Montgomery County Recorder of Deeds Assessed Value of Structure
Describe the size, construction, and use of the proposed changes to the property
Pre-Improvement Value
Substantial Improvement
Has the property filed an Elevation Certificate with Township or other agency?
Elevation of the proposed construction/improvement (ft)
Breakdown of Costs used to determine value
Type Full Name :
Sign With Hand
I hereby certify that the proposed work is authorized by the owner of record and that I am the homeowner or have been authorized by the owner to make this application as his/her authorized agent and we agree to all applicable laws and payment of fees of this.

PLEASE NOTE: Before any application can be given to a Building Inspector for review, the following IS REQUIRED:

1) Payment of all Application fees.


2) Stamped Electrical Plans from an Electrical Inspection Agency IF you are doing additions, new dwellings or any commercial electrical work.


3) A Site or Plot Plan MUST be included with this application showing all Street locations, all set backs from property lines to proposed work, and all easements, Rights of way, basins and any other restricted features on site.


4) If required, a copy of your Home Owners Association (HOA) approval letter MUST be attached for all outside work.


5) Change of tenant form if required.

 

Certification
Attachments
Applicant Signature