Facilities Administration Council
Space Change Request Form
All Space Changes must be reviewed and recommended for approval
by the Facilities Administration Council.
Request Type(s) :
Move/ Relocation within defined space
Space Changes or Alterations
Increase in Space Allocation
New Space Needs
Primary User of Proposed Space :
Name :
Dept. :
Bldg. :
Email :
Administrative Office Contact :
Name :
Dept. :
Bldg. :
Email :
Phone : Phone :
Description of Project :
Purpose of Project : (Attach any pertinent information including space change checklist, sketches, correspondence, grant proposals, ETC.)
Location/ Rooms Affected:
Rooms are Currently
Assigned To :
Dept./ Lab/ Center
Affected :
Amount of Add'l Space Requested (Total SF) :
If additional space,
is Change Required:
Yes No
Number of People Using Space:
Prior to Change: After Change:
Note any Programmatic or operational changes expected to influence Project :
Schedule Requirements, Range of Dates for
Desired Completion or Space Reassignment :
Impact if NOT completed
within this Range :
List any Financial
Requirements :
List anticipated primary funding below in chart. Please indicate sources of cost-sharing.
Source Amount $
Account #
REQUIRED Signatures :
Submitted By : Date :
Vice President : Date :
All requests for space change require the approval of the appropriate Vice President prior to submission to the Facilities Council for
review and approval. ALL Academic and administrative units should be aware of the institution's current space constraints when
considering new projects or expansion of current activities. Every attempt should be made to house these activities within currently
assigned space(s). The investigation for obtaining new or additional space requires significant lead time.
Once the appropriate approvals have been obtained the form is to be submitted to physicalplant@fairmontstate.edu or
physicalplant@pierpont.edu
Additional Notes :
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