Fillable Certificate Of Occupancy VILLAGE OF LINCOLNSHIRE

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Certificate Of Occupancy VILLAGE OF LINCOLNSHIRE

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The Certificate Of Occupancy VILLAGE OF LINCOLNSHIRE form is 2 pages long and contains:

  • 2 signatures
  • 10 check-boxes
  • 59 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Village of Lincolnshire

BROWSE VILLAGE OF LINCOLNSHIRE (IL) FORMS

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1 Olde Half Day Road, Lincolnshire, IL 60069
www.lincolnshireil.gov
P: 847-883-8600
F: 847-883-8608
Page 1 of 2
STAMP HERE
CERTIFICATE OF OCCUPANCY APPLICATION
COMMERCIAL
TEMPORARY
FINAL
TEMPORARY
FINAL
PROJECT INFORMATION
Projected Date of Occupancy:
Business Type:
Property Address (including lot / suite #):
Project / Business Name:
Applicant Name:
Company:
Email:
Address:
City:
State:
Zip Code:
Phone:
Cell:
Fax:
Building Permit #:
Building/Tenant Area (sq. ft.):
Occupant Load (Commercial Only):
Hazard Rating (Commercial Only):
Proposed Use of Building/Space
(Commercial Only):
Present Use of Building/Space:
(Commercial Only)
Use Group Classification (Commercial Only):
Type of Construction (Commercial Only):
Civil Record Drawings Required (4 Copies):
 Yes
No
Subdivision (if applicable):
Landscape Record Drawings Required (3 Copies):
 Yes
No
Sprinkler Record Drawings Required (3 Copies):
 Yes
No
CONTACT INFORMATION
Applicant Information (if applicable)
Name:
Company:
Email:
Address (including suite #):
City:
State:
Zip Code:
Phone:
Cell:
Fax:
Owner Information (if different than applicant)
Name:
Company:
Email:
Address (including suite #):
City: State: Zip Code:
Phone:
Cell:
Fax:
Occupancy Application – Village of Lincolnshire, IL – Community & Economic Development
1 Olde Half Day Road, Lincolnshire, IL 60069
www.lincolnshireil.gov
P: 847-883-8600
F: 847-883-8608
Page 2 of 2
SUBMITTAL STATEMENT
I, , certify that the information contained in this application,
attached plans, and specifications, and other attached documentation is true to the best of my
knowledge. I also recognize that as the permit applicant, all fees and requirements associated with the
review and future approval of the work described herein are my responsibility.
Signature: Date:
ARCHITECT / DESIGN PROFESSIONAL INFORMATION (if required by Building Official)
Name:
Company:
Email:
Address (including suite #):
City: State: Zip Code:
Phone:
Cell:
Fax:
License #:
I, , declare that I have reviewed and/or designed the documents
associated with this application, and therefore, take responsibility for the design work on behalf of a
registered design firm. In addition, I certify that the information contained on the attached plans and
specifications, and other attached documentation is true to the best of my knowledge, and accurately
depicts the subject site on the date these documents were prepared.
Signature:
Date:
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Certificate Of Occupancy VILLAGE OF LINCOLNSHIRE

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Completed 13 July 2020

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