Certificate of Occupancy

Certificate of Occupancy Application

 

Project Information

Permit #:
Name / Description:
Project Address:
Sq. Ft.:
Lot:
Block:
Subdivision:
INTENDED USE OF SPACE:
Total Occupancy of Building:
Number of Parking Spaces:

Owner Information

Company Name:
Contact Person:
Street Address:
Phone Number:
Fax Number:
Mobile Number:

Tenant Information

Company Name:
Contact Person:
Street Address:
Phone Number:
Fax Number:
Mobile Number:

Does your business involve the storage, sale or use of the following: (Check all that apply)

Painting with flammables
Combustible fibers
Cellulose Nitrate Film
Compressed Gas
Liquid Propane Gas
Vehicle Repair Garage
Welding or Cutting
Dry Cleaning Solvents
Dust producing process
Explosives / Ammunition
Recycling Waste
Magnesium
Vehicles in Building
Woodworking
Flammable / combustible liquids (10 gallons or more)
Floor drains in building
Food and/or beverage processing, storage or sales
Food products
High piled stock (over 12' in height)
Poisonous or hazardous chemicals/acids
X-ray Development
Alcohol
Smoking
Fireworks
 

**Provide chemical data sheets to the Building Inspection Department listing the maximum quantity of all hazardous materials.**

List any material discharged into the drainage system, ground, or atmosphere:

It shall be unlawful to use or occupy or permit the use or occupancy of any building or premises created, erected, changed, converted or altered or enlarged in its use or structure until a Certificate of Occupancy shall have been issued by the administrative official.  A permit becomes null and void if work or construction authorized is not commenced within 180 days, or if construction or work is suspended or abandoned for a period of 180 days at any time after work is commenced. 

 I hereby certify that I have read and examined this application and know the same to be true and correct.  All provisions of laws and ordinances governing this type of work will be complied with whether specified or not.  The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction.

Date: 

 


OFFICE USE ONLY

Approved by:
 
Zoning Approved:
 
Engr Approved by:
 
PW Approved by:
 
Fire Approved by:
Occupancy Type:
 
Occupancy Load:
 
Construction Type:
 
Zoning District:
BV Project #
Permit Fee:


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