CERTIFICATE OF OCCUPANCY BUILDING INSPECTION REQUEST (No construction to be done to building)

The purpose of the inspection is to ensure the business location is in compliance with fire, building and safety codes. Once the inspection is passed, a Certificate of Occupancy will be issued to the business. The Business License and Certificate of Occupancy will not be issued until all inspections are completed. Please schedule the inspection once you have moved in and are ready to open the business. Inspection fee $40.00

Business Name Business Address _________________________________________ Bldg#

Unit #

Center/Plaza_____________________________ Number of Levels_________ Total Sq. Ft.___________ Describe the business activity ___________________________________________________________ Phone Number ( ) ____________

Business Owner

Please illustrate in the box below the location of the bathrooms (Please list the dimensions of the bathrooms), exits, meeting rooms, hall ways, shelving, and displays. Please also include the name of the businesses that share a common wall with your business space, if applicable. Additional information may be required based on use.

I herby certify that the information provided on this form are complete and correct and request the issuance of the Certificate of Occupancy.

Applicant Signature

Date Internal Use Area

Bin No.

Date Received _________

Permit No. ____________________ Check # _________ Submittal Amount _______ 8/19/2014