Remodeling a Dental Office in Northern Virginia: Permits, X-ray Shielding and Occupancy, Step by Step (2026)

Key takeaways

• Fairfax County requires a commercial Addition/Alteration (ALTC) permit for interior alterations, including work for an existing tenant or owner and new tenant layouts.
• Plumbing, electrical and mechanical work are trade permits, filed after the building permit is issued.
• Virginia's radiation protection rules require floor plans, shielding specifications and equipment layout for new or modified X-ray rooms to be available for review before construction.
• A new Certificate of Occupancy (Non-RUP) is needed for a new tenant space or a change in owner or tenant name. Fairfax County does not issue Non-RUPs for businesses in the Town of Vienna.
• Cabinetry, paint, trim and floor finishes alone are listed as minor renovations that do not need a county permit.

What does a dental office remodeling contractor in Northern Virginia handle?

A dental office remodeling contractor builds the approved design: demolition, framing, plumbing and electrical to each operatory, HVAC changes, shielded walls built to the physicist's specification, and finishes, with inspections lined up at each stage. The contractor is one of several parties, and a remodel goes smoother when each one knows their part from the start.

Dzala General Contractor remodels existing commercial interiors, and healthcare practices, including dental offices, eye clinics and medical practices, are the largest part of that work. Dzala General Contractor does not take on ground-up construction. See our commercial remodeling page for the service.

Sources: Fairfax County ALTC permit page and Virginia Department of Health: Dental X-ray Machines.

Which Fairfax County permits does a dental office remodel need?

A dental office remodel in Fairfax County needs a commercial Addition/Alteration (ALTC) permit for the interior work, plus electrical, plumbing and mechanical trade permits. The county lists interior alterations for an existing tenant or owner, interior demolition, metal stud work and new tenant layouts as ALTC work, applied for online in PLUS.

• Trade permits: electrical (ELEC) and plumbing (PLBC) permits are filed after the building permit is issued and linked to it; plans are not required. Mechanical (MECHC) permits follow the same path.
• New HVAC: an Air Leakage/Duct Leakage Test form must be submitted and approved before the final inspection is called.
• Who reviews the plans: the Permit Application Center, Building Plan Review, the Site Technician team, the Fire Marshal's Office, Wastewater and Zoning, plus the Health Department when the property is on a well or septic system.
• What needs no county permit: Fairfax County lists minor renovations (floor finishes, paint and wallpaper, trim, cabinetry) and direct like-for-like replacement of plumbing fixtures with no change in location as commercial work that does not need a permit (Does My Project Require a Permit?).
• Towns: projects in the Towns of Vienna or Clifton need separate Town approval, uploaded to the county record.

Arlington County, the City of Alexandria, the City of Falls Church, Montgomery County and Washington DC each run their own commercial permit offices. Confirm the jurisdiction from the property address before the architect starts the code review.

When does the X-ray shielding plan have to be ready?

Before construction. Under 12VAC5-481-280, the floor plans, shielding specifications and equipment arrangement for all new X-ray installations, or changes to existing ones, must be available to the Virginia Department of Health for review before construction starts. The agency may require a private inspector to determine the shielding first.

• What the physicist needs: the room dimensions, the wall, floor, ceiling and door construction, what the rooms next to, above and below the X-ray room are used for, the make and model of the equipment, and the expected weekly workload.
• Records to keep: after installation, the practice must keep a scale drawing of each room with a stationary X-ray system, showing either survey results or the type and thickness or lead equivalency of each protective barrier. Ask your contractor for the shielding materials and locations in writing.
• Exposure switch location: the Virginia Department of Health says exposure switches should be permanently mounted outside the operatory, and stretch cords are not allowed in new office settings. That puts a fixed device box in the wall plan.
• After installation: VDH recommends registering each machine within 30 days and having a private inspector review its performance within 30 days of registration. Dental X-ray machines are inspected every 3 years, and VDH invoices a $100 registration fee every three years (as of November 11, 2026).

Do you need a new Certificate of Occupancy after a dental office remodel?

Sometimes. Fairfax County's Fire Marshal summary of the building code says that when an existing tenant space with a valid Certificate of Occupancy is renovated, the final inspection approvals may serve as the revised certificate. A new Certificate of Occupancy, called a Non-RUP in Fairfax County, is required for a new tenant space, a change of group classification, a change in floor area, or a change in owner or tenant name (Use and Occupancy Requirements).

• Buying an existing practice or opening in a new suite usually means a new Non-RUP, even when the remodel itself is small.
• The Non-RUP is the last inspection Fairfax County issues for commercial projects. Apply in PLUS at least five business days ahead. The fee is $95 (as of November 11, 2026).
• Fairfax County does not issue Non-RUPs for businesses located in the Town of Vienna. The Town handles that step.

How do you plan a dental office remodel, step by step?

1. Confirm the jurisdiction and the current Certificate of Occupancy. The address decides which county, city or town reviews the work, and the current certificate tells you whether a new Non-RUP will be needed.
2. Pick the equipment before the layout is final. Chairs, vacuum, compressor and imaging set the plumbing, electrical and floor-box locations.
3. Bring in the medical physicist early. The shielding design has to be ready before construction and affects wall construction and door choices.
4. Finish the drawings and apply for the ALTC permit in PLUS. Include Town approval if the office is in Vienna or Clifton.
5. Answer review comments and get the permit. Then file the electrical, plumbing and mechanical trade permits.
6. Build and inspect. Build the shielded walls to the physicist's specification, document them, and call the in-wall inspections before finishes cover the work.
7. Close out. Finish all final inspections, then apply for the Non-RUP when the change of owner, tenant or space calls for one.
8. Install and register the X-ray equipment. The installer files FDA Form 2579, the practice registers the machine with VDH, and a private inspector reviews it.

What should you ask a dental office remodeling contractor before you sign?

Ask questions that show how the contractor will handle the permits, the shielding and the schedule, not just the finishes. The answers should be specific to your suite and your county.

• Who will be listed as the permit applicant, and which commercial permit offices have you worked with?
• How will you coordinate with our architect, medical physicist and equipment dealer?
• How will the shielding materials and locations be documented for our records?
• Can we see a written, itemized scope, and how are changes priced before they are agreed?
• What will be closed off, and when, if the practice keeps seeing patients during the work?
• Can you confirm your contractor license on the Virginia DPOR website? Fairfax County links to that lookup on its permit pages.

Frequently asked questions

Planning a dental office remodel? Start with the address and the X-ray plan

Dzala General Contractor is a remodeling contractor based at 8609 Westwood Center Dr Ste 110, Unit 119, Tysons, VA 22182, remodeling dental offices and other healthcare practices in Northern Virginia, Washington DC, and Bethesda and Potomac, Maryland. See commercial remodeling, request a quote or call (703) 919-1645.

General information as of November 11, 2026, not legal advice. Permit and code requirements change; confirm your project with the permit office for your address.

Sources

• Fairfax County: Addition/Alteration (ALTC) - Commercial (checked November 11, 2026)
• Fairfax County Land Development Services: Does My Project Require a Permit? (checked November 11, 2026)
• Fairfax County: Certificate of Occupancy (Non-Residential Use Permit) (checked November 11, 2026)
• Fairfax County Fire Marshal: Use and Occupancy Requirements (checked November 11, 2026)
• Virginia Administrative Code 12VAC5-481-280: Shielding plan review (checked November 11, 2026)
• Virginia Department of Health: Dental X-ray Machines (checked November 11, 2026)