RECEIVED BY CITY STAFF:_____________________________________________________
date
REQUEST FOR CERTIFICATE OF OCCUPANCY (CO)
DATE:_______________
ADDRESS:_______________________________________PERMIT NUMBER:____________
LEGAL DESCRIPTION
LOT:________ BLOCK:________ SUBDIVISION:_______________________________
PROPERTY OWNER:__________________________________________________________
USE OF PREMISSES:__________________________________________________________
PROPERTY OWNER
ADDRESS:___________________________________________________________________
TENANT:____________________________________________________________________
Requests for Certificate of Occupancy will be met upon verification of the following items:
o All required inspections as laid out in the architectural plan review have passed
inspection. If the inspection an inspection was missed, an engineer’s letter has
been provided certifying the integrity of the labor performed.
o A final fire safety inspection was performed (if required), and a recommendation of
Certificate of Occupancy was made by the Fire Chief.
o A final drainage review was performed (if required), and a recommendation of
Certificate of Occupancy was made by the City Engineer.
o All debts relating to construction have been satisfied, including but not limited to:
Inspections
Additional Plan or Drainage Review Fees
Outstanding Utility Bills
Upon verification of the following items, the Building Official shall issue a Certificate of Occupancy
within ten days. (Code of Ordinances sec. 101-133)
SIGNATURE:_______________________________________________________________
owner date
SIGNATURE:_______________________________________________________________
contractor date
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