Fillable CITY OF PORTAGE OCCUPANCY PERMIT APPLICATION (City of Portage)

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CITY OF PORTAGE OCCUPANCY PERMIT APPLICATION (City of Portage)

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BROWSE CITY OF PORTAGE (IN) FORMS

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CITY OF PORTAGE
BUILDING DEPARTMENT
CITY HALL
6070 CENTRAL AVENUE
PORTAGE, INDIANA 46368
TELEPHONE 762-4204 / FAX 764-5749
OCCUPANCY PERMIT APPLICATION
Application is hereby requested for: (check one)
New Construction _______ Change of Use ___________
Building Addition/Remodeling _______ Temporary Structure ______
Date: ________________ Zoning District: __________
(Please Print)
Address of Property: _________________________________________________________________
Owner: _____________________________________________Phone: _________________________
Address of Owner: ___________________________________________________________________
Applicant/Lessee: __________________________ Name of Business___________________________
Address: _________________________________________________ Phone: ____________________
For Change of Use Applications Only:
Description of Building Use: ___________________________________________________________
___________________________________________________________________________________
Proposed Improvements: _______________________________________________________________
____________________________________________________________________________________
For an occupancy permit to be issued each of the following must be successfully
completed, if applicable:
a. Demonstrate proof of being issued an improvement location permit and building permit.
b. Filling out and submitting the application for the occupancy permit.
c. Submit Curb Waiver/Sidewalk Agreement, Architect or Engineer’s Certificate of
Completion and Compliance, Deed of Dedication for Right-of-Way
d. Receive final inspection approval by the Utility Service Board and the Planning,
Engineering, Building and Fire Departments to occupy the building.
e. Submit a Confirmed Annual Energy Cost Compliance Certificate
f. Submit a Confirmed Energy Code Compliance Certificate
Due to weather or other circumstances, an occupancy permit may be issued without the (a)
landscaping, (b) building finishes, (c) parking lot finishes, or the like provided some sort of surety
has been posted to satisfy the Director of Community Development.
Planning Department Office Use Only:
Approved______________________Denied_________________________Date____________
__
***Do Not Write Below This Line --- Office Use Only***
Check Off List:
1. Completed Occupancy Permit Application ____________
2. Final Inspection Approvals:
A. Building Department ____________
B. Fire Department ____________
C. Engineering Department ____________
I. Site/Landscaping Inspection ____________
D. Utility Service Board ____________
E. Planning Department ____________
3. Park Impact Fee Paid (If Applicable) ____________
4. Architect or Engineer’s Certificate of Completion
and Compliance – Signed and Sealed (If Applicable) ____________
5. Curb Waiver/Sidewalk Agreement (If Applicable) ____________
6. Deed of Dedication for Right-of-Way (If Applicable) ____________
7. Winter Weather Policy Bonding at 125% of Estimate (If Applicable) ____________
A. Recorded Notice of Improvements and Right of Entry ____________
B. Written Subcontractor Estimate of Work Being Bonded ____________
8. Warehouse Policy (If Applicable) ____________
A. Floor Plan ____________
B. Evacuation Plan ____________
C. Industrial Steel Storage Rack Plans ____________
9. Stipulations Imposed by BZA and/or Plan Commission ____________
10. Confirmed Annual Energy Cost Compliance Certificate ____________
11. Confirmed Energy Code Compliance Certificate ____________
12. Comments_______________________________________________________________
________________________________________________________________________
Received By_________________________________________ Date: _______________
Revised 04-14
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CITY OF PORTAGE OCCUPANCY PERMIT APPLICATION (City of Portage)

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Completed 9 November 2021

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