Application Form For Appeal Under Uniform Construction Code
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1Township of Falls
188 Old Lincoln Highway
Fairless Hills, PA 19030
(215) 949-9000
Fax: (215) 949-9015
__________________________________________________________________________________
APPLICATION FOR APPEAL UNDER UNIFORM CONSTRUCTION CODE
Application Fee:
Residential $150.00
Commercial
$250.00
PROPERTY ADDRESS: _________________________________________
TMP # ________________
APPLICANT NAME: _____________________________________________________________________
ADDRESS: ___________________________________________________
PHONE # ______________
A.
Building Permit Data:
_____ Not obtained/not issued (if checked, please go to “B”)
1.
2.
Permit Number: __________________ Issue Date: ___________________
Issued by: ________________________________________________________
(Municipality or Third Party Agency)
B.
Contractor:
Name: ________________________________________________ Phone # ________________
Address: ______________________________________________
______________________________________________
C.
Type of Appeal: (check all that apply)
________
Incorrect Interpretations
________
Provisions of the Code do not fully apply
________
Equivalent form of construction proposed
________
Request for time extension
________
Other (please explain) ______________________________________________
D.
Provision of Code Appealed:
ICC Code Name: ______________________________________________________________
Chapter:________________
Section: _________________ Subsection: ______________
Chapter:________________
Section: _________________ Subsection: ______________
E.
Attachments Required:
The applicant MUST attach a written statement explaining, in detail, the relief requested including how
such relief would meet the intent and spirit of the Code. Matters of a structural nature must be submitted
with structural design drawings and calculations.
______________________________________________
___________________________
Signature of Applicant
Date
Section 403.122(e) of the Pennsylvania Uniform Construction Code states that a hearing must be held within
60 days from the date of an applicant’s request unless the applicant agreed in writing to an extension. It also
states that a hearing shall convene within 30 days involving the construction of a one- or two- family
residential building.
******************************************************************************************
Receipt No. ____________________
Date of application submittal: ______________
Hearing Date: ___________ Decision Date: ___________
Board Decision: ______________________
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