CITY OF PORTAGE
ZONING AND OCCUPANCY PERMIT APPLICATION
Fee: New use: $ 150.00
Existing use prior to Jan.
1,
2008: No Fee
New construction (single and two family): No Fee
This form will
be
completed as per City of Portage Ordinance Section 30-82 and
90-34. Site
and
Building plans, when applicable, must be submitted with
application.
Name
of
Applicant:
______________________
_
Address of Applicant:
_____________________
_
Business Name:
Phone Number:
--------------
------
Owner's Name (if not the same):
_________________
_
Phone Number:
--------------
Emergency Contact: Name:
----------------
Number:
_______
_
Name:
Number:
----------------
-------
Address/Location of Property:
__________________
_
Current Use:
-----------------------------
Check all that apply:
New Construction
New Occupancy
Moving Building
Addition/Structural Alteration
Change
of
Use
Other
Proposed Use of Building:
If
the current or proposed use
is
business/commercial/industrial
or
three or more
residential units, please complete the following:
Days
and
hours
of
operation:
________________
_
Total number of employees:
____________________
_
Number of residential units:
--
Fire alarm system: Yes No
Pull Stations: Yes
No
Designate location
of
alarm panel
on
attached plans. (continued
on
back)
Smoke/heat detection system: Yes No
Whole coverage:
__
Partial coverage:
__
Heat
in
mechanical rooms: Yes
No
Battery back-up: Yes No
Sprinkler system: Yes No
Wet
system: Dry system:
Fire department connections:
__
Yes No
If yes, location, type
and
size:
________________
_
Detailed site plan and building plans including fire detection and suppression
information, along with dimension
of
all buildings and other pertinent data
is
to
be
submitted with all applications. A Knox Box key box
is
required to
be
installed on the building where applicable. A Knox Box application can be
obtained at the Portage Fire Department.
Prior to occupancy, a formal inspection must be conducted by the Fire Inspector
and/or Building Inspector. Compliance is required prior to receiving
an
occupancy permit.
Please return to City Hall at 115 West Pleasant Street. Any questions, please
call 742-2176.
Applicant Name
Applicant Signature Date
.................................................
$.
0
•••••••••••••••••••••
City
of
Portage Use:
Current Zoning:
____
_
Conforming: Yes
No
Comment:-.
_________________________
_
Permit Approval:
Zoning Administration
Fire Inspector
Date
Date
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome