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www.lambtononline.ca
Building Services Department
789 Broadway Street, Box 3000
Wyoming, ON N0N 1T0
Telephone: 519-845-5420
Toll-free: 1-866-324-6912
Fax: 519-845-3817
Building & Plumbing Permit
Application - Residential
A. Time Frame for Building Permit Issuance
This table is for information only to explain the time allowed for review of a
building permit application for a permit to be issued or refused.
B. Declaration of Applicant
The Declaration of Applicant must be completed to obtain a permit.
C. Checklist for Building Permit Applications
Please ensure that the Checklist For Building Permit Applications is reviewed,
completed & signed.
D. Application for a Permit to Construct or Demolish
The Application for a Permit to Construct or Demolish must be completed. Also
required is a site plan, lot grading plan & two copies of blueprints and/or plans.
E. Schedule 1:
Designer Information
Schedule 1 - Designer Information must be completed by every person engaged
in the business of providing design activities unless exempt from the requirement
under Section. 2.17.4.1 (3).
F. Energy Efficiency Design Summary
Please complete either the Prescriptive Method or the Performance & Other
Acceptable Compliance Methods, depending on your construction plans.
G.Schedule A:
Plumbing Permit Application
This schedule, as well as the Application for a Permit to Construct or Demolish,
must be completed to obtain a plumbing permit.
January, 2017
TIME FRAME FOR THE ISSUANCE OF BUILDING PERMITS
A building permit shall be issued in accordance with Table 2.4.1.1B of the Building Code unless:
(a).
the proposed building, construction or demolition will contravene the Building Code Act,
the Building Code, or any other applicable law;
(b).
the applicant is a builder or vendor as defined in the Ontario New Home Warranties Plan
Act and is not registered under that Act;
(c).
a person who prepared drawings, plans, specifications or other documents or gave an
opinion concerning the compliance of the proposed building or construction with the
building code does not have the applicable qualifications, if any, set out in the building
code or does not have the insurance, if any, required by the building code;
(d).
the plans review certificate, if any, required for the application does not contain the
prescribed information;
(e).
the application for the permit is not complete; or
(f).
any fees due have not been paid.
Table 2.4.1.1B
The period within which a building permit shall be issued or refused.
Row
Number
Class of Building
Time Period
1
(a). A detached house, semi-detached house, townhouse or
row house where no dwelling unit is located above another
dwelling unit.
(b). A detached structure that serves a building described in
Clause (a) and does not exceed 50 m2 in building area.
(c). A tent to which Section 3.13 of the building code applies.
(d). A sign to which Section 3.14 of the building code applies.
10 days
2
(a). Buildings described in Clauses 2.1.1.3.(1)(a),(b) and (c)
(Part 9 buildings) other than buildings described in Column
2 of any of Rows 1 and 4 of this table.
(b). Farm buildings that do not exceed 600 m2 in building
area.
15 days
3
(a). Buildings described in Clause 2.1.1.2.(1)(a) or (b) (Part 3
buildings), other than buildings in Column 2 of any of Rows
1 and 4 of this table.
(b). Farm buildings exceeding 600 m2 in building area.
20 days
4
(a) Post-disaster buildings.
(b). Buildings to which Subsection 3.2.6. (high buildings and
Group B buildings) or any provision in articles 3.2.8.2 to
3.2.8.11 applies.
30 days
Column 1
Column 2
Column 3
The time period above begins on the day on which a permit for the construction of a sewage
system serving the building (if required) is issued as per 2.4.1.1B. (9)(c). The period within
which a permit for a septic system shall be issued or refused is based on the class of building in
the above table as per 2.4.1.1B. (8)(b).
Declaration of Applicant
Section A
Is this project a commercial, agricultural, or industrial application?
Yes
No
Does the proposal involve fuel handling/storage ≥15,000 litres?
Yes
No
Section B
Are there any hydro poles/hydro easements on this property?
Yes
No
Is there any gas or oil or any other utility easement on this property?
Yes
No
Are there any Right-of-Way accesses on this property?
Yes
No
Are there any easements (of any nature) on this property?
Yes
No
Are there any closed private/municipal drains on this property?
Yes
No
Are there any agreements/leases attached to title (i.e. wind, gas/oil etc.)- Yes
No
If you answered YES to any of the questions in Section B - you are required to clearly indicate on your
site/plot/lot diagram the location of such items and provide sufficient documentation where
applicable/requested.
Section C
I understand that property locates are my sole responsibility.
Yes
No
I understand it is my sole responsibility to ensure all substantial completion inspections (as outlined in
the issued permit) are requested with 48 hours' notice, carried out and approved prior to proceeding to
the next stage of construction.
Yes
No
I understand that I will be responsible to remit all applicable fees prior to my permit being officially
issued and further I may be subject to the said fees if my application is denied, revoked or cancelled (by
myself), as per the applicable building permit by-law.
Yes
No
I,
certify that:
(Print name)
1. The information contained in this declaration, application, attached plans and specifications, and other attached
documentation is true to the best of my knowledge.
2. As the Owner/Agent/Contractor I take responsibility to ensure compliance to all federal, provincial and municipal
legislation and or regulations prior to, during and after construction.
3. I will not hold The County of Lambton or its employees liable for any actions by myself resulting in; non-issuance of a
permit, revoking of a permit, civil action and or possible fine.
4. I have authority to bind the corporation or partnership (if applicable).
(Date)
(Signature of Applicant)
Personal information contained in this form and schedules is collected under the authority of Section 7 Subsections 8(2) of the Building
Code Act, 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 to which this application is being made.
Please Note: This declaration must be completed in its entirety prior to the issuance of a
building/plumbing/septic permit, no exceptions.
Building Permit Application Checklist
- Completed Building Permit Application, including plumbing and septic (as
applicable), this includes all Designer Schedules and Energy Efficiency Design
summary
- Completed Declaration
- Site/Lot/Plot Plan/Diagram (2 copies) clearly demonstrating the following:
o Location of proposed building
o All other buildings on the property (including dimensions)
o Setbacks to property lines
o Include all easements, right-of-way, septic, wells, hydro wires (overhead
and underground) etc.
o Driveway location and dimensions
- Construction Plans including all structural/architectural/design details (2 copies)
o Foundation plan, showing type, wall height and height of backfill
o Footing size and location
o Elevations including top of finished ground to highest point on building
o Floor plan of each floor
o Finished basement plan if applicable
o Typical wall cross section
o Longitudinal cross section, if applicable
o Beam and lintel sizes and span, joist sizes, rafters, headers etc
o Professional Engineered components (i.e. roof truss, joists) layouts
submitted, reviewed and signed off by your designer
o Heat loss and design summary calculations and layout (applies to all
methods of heat: infloor, electric, forced air, etc.)
- Proposed Grading Plan (new construction, infill lots etc.) - as required (2 copies)
- External Approvals
o Minor Variance Approval - 1 copy
o Conservation Authority Approval - 1 copy
o Driveway/Access Approval - 1 copy
o Any other applicable law approval documents - 1 copy
Please Note: Incomplete applications will be subject to delay and prescribed time
frames for the issuance of said permits will not be applicable.
Exception: Permit fees will be calculated by staff and will be applicable at time of
permit issuance and are not required to be attached to the application.
Application for a Permit to Construct or Demolish
This form is authorized under subsection 8(1.1) of the Building Code Act,1992
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 (m2)
B. Purpose of application
New construction
Addition to an
Alteration/repair
Demolition
Conditional
existing building
Permit
Proposed use of building
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, 2014
Application for a Permit to Construct or Demolish - Effective January 1, 2014
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, 1992, to be paid when the
application is made.
Yes
Yes
No
No
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 by-
law, resolution or regulation made under clause 7(1)(b) of the Building Code Act, 1992 which enable
the chief building official to determine whether the proposed building, construction or demolition will
contravene any applicable law.
Yes
No
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, 2014
Schedule 1: Designer Information
Use one form for each individual who reviews and takes responsibility for design activities with respect to the project.
A. Project Information
Building number, street name
Unit no.
Lot/con.
Municipality
Postal code
Plan number/ other description
B. Individual who reviews and takes responsibility for design activities
Name
Firm
Street address
Unit no.
Lot/con.
Municipality
Postal code
Province
E-mail
Telephone number
(
)
Fax number
(
)
Cell number
(
)
C. Design activities undertaken by individual identified in Section B. [Building Code Table 3.5.2.1. of
Division C]
House
HVAC - House
Building Structural
Small Buildings
Building Services
Plumbing - House
Large Buildings
Detection, Lighting and Power
Plumbing - All Buildings
Complex Buildings
Fire Protection
On-site Sewage Systems
Description of designer's work
D. Declaration of Designer
I
declare that (choose one as appropriate):
(print name)
I review and take responsibility for the design work on behalf of a firm registered under subsection 3.2.4.of Division
C, of the Building Code. I am qualified, and the firm is registered, in the appropriate classes/categories.
Individual BCIN:
Firm BCIN:
I review and take responsibility for the design and am qualified in the appropriate category as an "other designer"
under subsection 3.2.5.of Division C, of the Building Code.
Individual BCIN:
Basis for exemption from registration:
The design work is exempt from the registration and qualification requirements of the Building Code.
Basis for exemption from registration and qualification:_
I certify that:
1.
The information contained in this schedule is true to the best of my knowledge.
2.
I have submitted this application with the knowledge and consent of the firm.
Date
Signature of Designer
NOTE:
1.
For the purposes of this form, "individual" means the "person" referred to in Clause 3.2.4.7(1) (c).of Division C, Article 3.2.5.1. of Division
C, and all other persons who are exempt from qualification under Subsections 3.2.4. and 3.2.5. of Division C.
2.
Schedule 1 is not required to be completed by a holder of a license, temporary license, or a certificate of practice, issued by the Ontario
Association of Architects. Schedule 1 is also not required to be completed by a holder of a license to practise, a limited license to practise, or a
certificate of authorization, issued by the Association of Professional Engineers of Ontario.
Application for a Permit to Construct or Demolish - Effective January 1, 2017
Energy Efficiency Design Summary: Prescriptive Method
(Building Code Part 9, Residential)
This form is used by a designer to demonstrate that the energy efficiency design of a house complies with the building code using the
prescriptive method described in Subsection 3.1.1. of SB-12. This form is applicable where the ratio of gross area of
windows/sidelights/skylights/glazing in doors and sliding glass doors to the gross area of peripheral walls is not more than 22%.
For use by Principal Authority
Application No:
Model/Certification Number
A. Project Information
Building number, street name
Unit number
Lot/Con
Municipality
Postal code
Reg. Plan number / other description
B. Prescriptive Compliance [indicate the building code compliance package being employed in this house design]
SB-12 Prescriptive (input design package): Package: _____________ Table:_____________
C. Project Design Conditions
Climatic Zone (SB-1):
Heating Equipment Efficiency
Space Heating Fuel Source
Zone 1 (< 5000 degree days)
≥ 92% AFUE
≥ 84% < 92% AFUE
Gas Propane Solid Fuel
Oil Electric Earth Energy
Zone 2 (≥ 5000 degree days)
Ratio of Windows, Skylights & Glass (W, S & G) to Wall Area
Other Building Characteristics
Area of walls = ______m2
or______ft2
W, S & G % =
Utilize window averaging: Yes No
Log/Post&Beam ICF Above Grade ICF Basement
Slab-on-ground Walkout Basement
Air Conditioning Combo Unit
Air Sourced Heat Pump (ASHP)
Ground Sourced Heat Pump (GSHP)
Area of W, S & G = _____m2
or_____ft2
D. Building Specifications [provide values and ratings of the energy efficiency components proposed]
Energy Efficiency Substitutions
ICF (3.1.1.2.(5) & (6) / 3.1.1.3.(5) & (6))
Combined space heating and domestic water heating systems (3.1.1.2.(7) / 3.1.1.3.(7))
Airtightness substitution(s)
Airtightness test required
(Refer to Design Guide Attached)
Table 3.1.1.4.B Required:
Permitted Substitution:
Table 3.1.1.4.C Required:
Permitted Substitution:
Required:
Permitted Substitution:
Building Component
Minimum RSI / R values
or Maximum U-Value(1)
Building Component
Efficiency Ratings
Thermal Insulation
Nominal
Effective
Windows & Doors Provide U-Value(1) or ER rating
Ceiling with Attic Space
Windows/Sliding Glass Doors
Ceiling without Attic Space
Skylights/Glazed Roofs
Exposed Floor
Mechanicals
Walls Above Grade
Heating Equip.(AFUE)
Basement Walls
HRV Efficiency (SRE% at 0o C)
Slab (all >600mm below grade)
DHW Heater (EF)
Slab (edge only ≤600mm below grade)
DWHR (CSA B55.1 (min. 42% efficiency))
#
Slab (all ≤600mm below grade, or heated)
Combined Heating System
(1) U value to be provided in either W/(m2-K) or Btu/(h-ft2-F) but not both.
E. Designer(s) [name(s) & BCIN(s), if applicable, of person(s) providing information herein to substantiate that design meets the building code]
Qualified Designer Declaration of designer to have reviewed and take responsibility for the design work.
Name
BCIN
Signature
Form authorized by OHBA, OBOA, LMCBO. Revised December 1, 2016.
Application for a Permit to Construct or Demolish - Effective January 1, 2017
Guide to the Prescriptive Energy Efficiency Design Summary Form
This form must accurately reflect the information contained on the drawings and specifications being submitted.
Refer to Supplementary Standard SB-12 for details about building code compliance requirements. Further
information about energy efficiency requirements for new buildings is available from the provincial building code
website or the municipal building department.
The building code permits a house designer to use one of four energy efficiency compliance options:
1. Comply with the SB-12 Prescriptive design tables (this form is for this option (Option 1)),
2. Use the SB-12 Performance compliance method, and model the design against the prescriptive standards,
3. Design to Energy Star, or
4. Design to R2000 standards.
COMPLETING THE FORM
B. Compliance Options
Indicate the compliance option being used.
- SB-12 Prescriptive requires that the building conforms to a package of thermal insulation, window and
mechanical system efficiency requirements set out in Subsection 3.1.1. of SB-12. Energy efficiency design
modeling and testing of the building is not required under this option. Certain substitutions are permitted. In
which case, the applicable airtightness targets in Table 3.1.1.4.A must be met.
C. Project Design Conditions
Climatic Zone: The number of degree days for Ontario cities is contained in Supplementary Standard SB-1
Windows, Skylights and Glass Doors: If the ratio of the total gross area of windows, sidelights, skylights, glazing
in doors and sliding glass doors to the total gross area of walls is more than 17%, higher efficiency glazing is
required. If the ratio is more than 22%, the SB-12 Prescriptive option may not be used. The total area is the sum of all
the structural rough openings. Some exceptions apply. Refer to 3.1.1.1. of SB-12 for further details.
Fuel Source and Heating Equipment Efficiency: The fuel source and efficiency of the proposed heating
equipment must be specified in order to determine which SB-12 Prescriptive compliance package table applies.
Other Building Conditions: These construction conditions affect SB-12 Prescriptive compliance requirements.
D. Building Specifications
Thermal Insulation: Indicate the RSI or R-value being proposed where they apply to the house design. Under
the SB-12 Prescriptive option, alternative ICF wall insulation is permitted in certain conditions where other
design elements meet higher standards. Refer to SB-12 for further details. Where effective insulation values
are being used, the Authority Having Jurisdiction may require supporting documentation.
BUILDING CODE REQUIREMENTS FOR AIRTIGHTNESS IN NEW HOUSES
All houses must comply with increased air barrier requirements in the building code. Notice of air barrier
completion must be provided and an inspection conducted prior to it being covered.
The air leakage rates in Table 3.1.1.4.A are not requirements. This provision is a voluntary provision for when
credits for airtightness are claimed. Credit for air tightness allows the designer to substitute the requirements of
compliance packages as set out in Table 3.1.1.4.B or 3.1.1.4.C. Neither the air leakage test nor compliance with
airtightness targets given in Table 3.1.1.4.A are required, unless credit for airtightness is claimed. Table
3.1.1.4.A provides airtightness targets in three different metrics; ACH, NLA, NLR. Any one of them can be used.
OBC Reference Default Air Leakage Rates (Table 3.1.1.4.A)
Building Type
Airtightness Targets
ACH @ 50 Pa
NLA @ 10 Pa
NLR @ 50 Pa
Detached dwelling
2.5
1.26 cm2/m2
1.81 in2/100ft2
0.93 L/s/m2
0.18 cfm50/ft2
Attached dwelling
3.0
2.12 cm2/m2
3.06 in2/100ft2
1.32 L/s/m2
0.26 cfm50/ft2
The building code requires that a blower door test be conducted to verify the air tightness of the house during
construction if the SB-12 Prescriptive option with airtightness credit being applied. Results of the airtightness
test may need to be submitted to the Authority Having Jurisdiction. Airtightness of less than 2.5 ACH @ 50 Pa
(or NLA or NLR equivalent) in the case of detached houses, or 3.0 ACH @ 50 Pa (or NLA or NLR equivalent) in
the case of attached houses is necessary to meet the required energy efficiency standard.
E. House Designer
The building code requires designers providing information about whether a building complies with the building
code to have a BCIN. Exemptions apply to architects, engineers and owners designing their own house.
Form authorized by OHBA, OBOA, LMCBO. Revised November 30, 2016.
Application for a Permit to Construct or Demolish - Effective January 1, 2017
Energy Efficiency Design Summary:
Performance & Other Acceptable Compliance Methods
(Building Code Part 9, Residential)
This form is used by a designer to demonstrate that the energy efficiency design of a house complies with the building code
using the Performance or Other Acceptable Compliance Methods described in Subsections 3.1.2. and 3.1.3. of SB-12,
This form must accurately reflect the information contained on the drawings and specifications being submitted. Refer to
Supplementary Standard SB-12 for details about building code compliance requirements. Further information about energy
efficiency requirements for new buildings is available from the provincial building code website or the municipal building
department.
For use by Principal Authority
Application No:
Model/Certification Number
A. Project Information
Building number, street name
Unit number
Lot/Con
Municipality
Postal code
Reg. Plan number / other description
B. Compliance Option [indicate the building code compliance option being employed in this house design]
SB-12 Performance* [SB-12 -
]
* Attach energy performance results using an approved software (see guide)
ENERGY STAR®* [SB-12 - 3.1.3.]
* Attach Builder Option Package [BOP] form
R-2000® *[SB-12 - 3.1.3.]
* Attach R-2000 HOT2000 Report
C. Project Building Design Conditions
Climatic Zone (SB-1):
Heating Equipment Efficiency
Space Heating Fuel Source
Zone 1 (< 5000 degree days)
≥ 92% AFUE
≥ 84% < 92% AFUE
Gas Propane Solid Fuel
Oil Electric Earth Energy
Zone 2 (≥ 5000 degree days)
Ratio of Windows, Skylights & Glass (W, S & G) to Wall Area
Other Building Characteristics
Area of walls = ______m2
or______ft2
W, S & G % =
Log/Post&Beam ICF Above Grade ICF Basement
Slab-on-ground Walkout Basement
Air Conditioning Combo Unit
Air Source Heat Pump (ASHP)
Ground Source Heat Pump (GSHP)
Area of W, S & G = _____m2
or_____ft2
SB-12 Performance Reference Building Design Package indicating the prescriptive package to be compared for compliance
SB-12 Referenced Building Package (input design package): Package:_______________ Table:__________________
D. Building Specifications [provide values and ratings of the energy efficiency components proposed, or attach ENERGY STAR BOP
form
Building Component
Minimum RSI / R values
or Maximum U-Value(1)
Building Component
Efficiency Ratings
Thermal Insulation
Nominal
Effective
Windows & Doors Provide U-Value(1) or ER rating
Ceiling with Attic Space
Windows/Sliding Glass Doors
Ceiling without Attic Space
Skylights/Glazed Roofs
Exposed Floor
Mechanicals
Walls Above Grade
Heating Equip.(AFUE)
Basement Walls
HRV Efficiency (SRE% at 0o C)
Slab (all >600mm below grade)
DHW Heater (EF)
Slab (edge only ≤600mm below grade)
DWHR (CSA B55.1 (min. 42% efficiency))
#
Sh
Slab (all ≤600mm below grade, or heated)
Combined Space / Dom. Water Heating
(1) U value to be provided in either W/(m2-K) or Btu/(h-ft2-F) but not both.
Application for a Permit to Construct or Demolish - Effective January 1, 2017
E. Performance Design Verification [Subsection 3.1.2. Performance Compliance]
The annual energy consumption using Subsection 3.1.1. SB-12 Reference Building Package is
GJ (1 GJ =1000MJ)
The annual energy consumption of this house as designed is ______________GJ
The software used to simulate the annual energy use of the building is:_______________________________________
The building is being designed using an air tightness baseline of:
OBC reference ACH, NLA or NLR default values (no depressurization test required)
Targeted ACH, NLA or NLR. Depressurization test to meet
ACH50 or NLR or NLA
Reduction of overall thermal performance of the proposed building envelope is not more than 25% of the
envelope of the compliance package it is compared against (3.1.2.1.(6)).
Standard Operating Conditions Applied (A-3.1.2.1 - 4.6.2)
Reduced Operating Conditions for Zero-rated homes Applied (A-3.1.2.1 - 4.6.2.5)
On Site Renewable(s): Solar:________________________
Other Types: ___________________
F. ENERGY STAR or R-2000 Performance Design Verification [Subsection 3.1.3. Other Acceptable Compliance
Methods]
The NRCan "ENERGY STAR for New Homes Standard Version 12.6 " technical requirements, applied to this building
design result in the building performance meeting or exceeding the prescriptive performance requirements of the
Supplementary Standard SB12 (A-3.1.3.1).
The NRCan,"2012 R-2000 Standard " technical requirements, applied to this building design result in the building
performance meeting or exceeding the prescriptive performance requirements of the Supplementary Standard SB12
(A-3.1.3.1).
Performance Energy Modeling Professional
Energy Evaluator/Advisor/Rater/CEM Name and company:
Accreditation or Evaluator/Advisor/Rater License #
ENERGY STAR or R-2000
Energy Evaluator/Advisor/Rater/ Name and company:
Evaluator/Advisor/Rater License #
G. Designer(s) [name(s) & BCIN(s), if applicable, of person(s) providing information herein to substantiate that design meets the building code]
Qualified Designer: Declaration of designer to have reviewed and take responsibility for the design work.
Name
BCIN
Signature
Form authorized by OHBA, OBOA, LMCBO. Revised December 1, 2016
Application for a Permit to Construct or Demolish - Effective January 1, 2017
Guide to the Energy Efficiency Design Summary Form for
Performance & Other Acceptable Compliance Methods
COMPLETING THE FORM
B. Compliance Options
Indicate the compliance option being used.
- SB-12 Performance refers to the method of compliance in Subsection 3.1.2. of SB-12. Using this approach
the designer must use recognized energy simulation software (such as HOT2000 V10.51 or newer), and
submit documents which show that the annual energy use of the proposed building is equal to or less than a
prescriptive (referenced) building package.
- ENERGY STAR houses must be designed to ENERGY STAR requirements and verified on completion by a
licensed energy evaluator and/or service organization. The ENERGY STAR BOP form must be submitted with
the permit
documents.
- R-2000 houses must be designed to the R-2000 Standard and verified on completion by a licensed energy
evaluator and/or service organization. The HOT2000 report must be submitted with the permit documents.
C. Project Design Conditions
Climatic Zone: The number of degree days for Ontario cities is contained in Supplementary Standard SB-1
Windows, Skylights and Glass Doors: If the ratio of the total gross area of windows, sidelights, skylights, glazing
in doors and sliding glass doors to the total gross area of walls is more than 17%, higher efficiency glazing is
required. The total area is the sum of all the structural rough openings. Some exceptions apply. Refer to 3.1.1.1.
of SB-12 for further details.
Fuel Source and Heating Equipment Efficiency: The fuel source and efficiency of the proposed heating
equipment must be specified in order to determine which SB-12 Prescriptive compliance package table applies.
Other Building Conditions: These construction conditions affect SB-12 Prescriptive compliance requirements.
D. Building Specifications
Thermal Insulation: Indicate the RSI or R-value being proposed where they apply to the house design. Refer
to SB-12 for further details.
E. Performance Design Summary
A summary of the performance design applicable only to the SB-12 Performance option.
F. ENERGY STAR or R-2000 Performance Method
Design to ENERGY STAR or R-2000 Standards.
G. House Designer
The building code requires designers providing information about whether a building complies with the building
code to have a BCIN. Exemptions apply to architects, engineers and owners designing their own house.
BUILDING CODE REQUIREMENTS FOR AIRTIGHTNESS IN NEW HOUSES
All houses must comply with increased air barrier requirements in the building code. Notice of air barrier
completion must be provided and an inspection conducted prior to it being covered.
The air leakage rates in Table 3.1.2.1. are not requirements. The Table is not intended to require or suggest that
the building meet those airtightness targets. They are provided only as default or reference values for the
purpose of annual energy simulations, should the builder/owner decide to perform such simulations. They are
given in three different metrics; ACH, NLA, NLR. Any one of them can be used. They can be used as a default
values for both a reference and proposed building or, where an air leakage test is conducted and credit for
airtightness is claimed, the airtightness values in Table 3.1.2.1. can be used for the reference building and the
actual leakage rates obtained from the air leakage test can be used as inputs for the proposed building.
OBC Reference Default Air Leakage Rates (Table 3.1.2.1.)
Detached dwelling
3.0 ACH50
NLA 2.12 cm2/m2
NLR 1.32 L/s/m2
Attached dwelling
3.5 ACH50
NLA 2.27 cm2/m2
NLR 1.44 L/s/m2
The building code requires that a blower door test be conducted to verify the air tightness of the house during
construction if the SB-12 Performance option is used and an air tightness of less than 3.0 ACH @ 50 Pa (or
NLA or NLR equivalent) in the case of detached houses, or 3.5 ACH @ 50 Pa (or NLA or NLR equivalent) in
the case of attached houses is necessary to meet the required energy efficiency standard.
ENERGY EFFICIENCY LABELING FOR NEW HOUSES
ENERGY STAR and R-2000 may issue labels for new homes constructed under their energy efficiency
programs. The building code does not currently regulate or require new home labeling.
Form authorized by OHBA, OBOA, LMCBO. Revised December 1, 2016
SCHEDULE 'A'
Plumbing Information
Owner Name:
Address of Proposed Work:
Plumber:
Municipality:
Please list the number of fixtures per floor on the following chart. (new or relocated)
FLOOR
Basement
1
2
3
4
Total Number
Toilet
Bath tub
Wash basin
Kitchen sink
Laundry tubs
Floor drain
Showers
Urinal
Clothes washer
Dish washer - domestic
Other sinks
Drinking fountain
Hot water heater
Sewage Pump
Grease Interceptor
TOTAL
No. of Dwelling Units
R.W.L.
Water Lines
Soil Vent Stacks
Sanitary Lateral
Oil Interceptor
Catch Basin
Storm Lateral
Backflow Preventer
Lawn Sprinkler System
Signature
Date