Commercial Change of Occupancy
Site Address: Subdivision:
Mailing Address: Phone Number:
Emergency Contact: Phone Number:
Owner Name (Individual): Driver’s License Number:
Home Address: Home Number:
Cell Phone Number: Fax Number:
Email Address:
Name of Previous Business:
Name of Proposed Business **:
Number of Employees:
Feet of Space:
Feet of Space:
Does your business hold any state license or registration:
No If yes, please provide a copy
SEPARATE PERMITS ARE REQUIRED FOR REMODELING,
ELECTRICAL, PLUMBING, HEATING, VENTILATION AND AIR
CONDITIONING.
BY SIGNING BELOW, 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 HEREIN OR NOT, THE GRANTING OF A
CERTIFICATE OF OCCUPANCY DOES NOT PRESUME TO GIVE
AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY
OTHER STATE OR LOCAL LAW RELATING TO CONSTRUCTION OR
PERFORMANCE OF CONSTRUCTION.
I AM AWARE THAT I MUST APPLY FOR AND RECEIVE A SIGN
PERMIT BEFORE I ERECT ANY SIGN IN THE CITY OF STAFFORD.
Permit #:
State License Number:
Zoning Designation:
Zoning: Use, Parking, Landscaping
Approved Disapproved
Approved Disapproved
Title:
Approved Disapproved
Date: Certificate of Occupancy Fee:
$ 100.00
** The name of the business will be printed on your Certificate of Occupancy, please ensure this
information is clear and accurate.