Fillable STATE OF ARIZONA DEPARTMENT OF HOUSING PLAN REVIEW (Arizona)

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STATE OF ARIZONA DEPARTMENT OF HOUSING PLAN REVIEW (Arizona)

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Country of origin: US
File type: PDF

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STATE OF ARIZONA
DEPARTMENT OF HOUSING
1110 WEST WASHINGTON ST, SUITE 280
PHOENIX, ARIZONA 85007
Office: (602) 771-1000
PLAN REVIEW AND APPROVAL APPLICATION
NEW APPLICATION EFFECTIVE JULY 1, 2018
Submit minimum two (2) copies of this application, documents / plans for review and the following fee*:
Document / Plan review fee (includes one hour of plan review)
$175.00
Document / Plan Review fee per each additional hour (billed at completion of review)
$125.00
SECTION BELOW FOR OFFICE USE ONLY
RECEIPTING APPROVAL STAMP
Submittal fee
P
LAN LOG #
Less Fee Received
Payment No.
Receipt No.
Additional Hours ( ) x $125.00 / Hour
Copies Printed ( ) x $0.50 each
Balance Fee Owed
Payment No.
Receipt No.
*Make checks payable to: ARIZONA DEPARTMENT OF HOUSING
CONTRACTOR, INSTALLER, OTHER: (Complete section below)
Accessory Structure Flood Plain License No.: _______________ License Type: _____________
Factory Built Building Installation Factory Built Building (New Construction)
Occupancy Type: __________________
Building Size (Box): _________________
Utilities (Check all that apply):
Water Sewer Electric Gas
AZ manufacturer issued insignia number(s):
________________________________________________
Factory Built Building Reconstruction
Compliance Control Manual
Design Structural Package
Supplement Plan
Original AZ Plan Approval Number: ___________________
Supplement Plan
Original AZ Plan Approval Number: __________________
Applicant’s Name
(Contractor, Installer, Manufacturer, or Other)
Mailing & Shipping Address
Telephone Number
Contact Name & E-mail Address (Required)
Installation Site Address
(Exceptions: Compliance Control Manual,
Structural Package, or Typical Plan)
INCLUDE SELF ADDRESSED STAMPED PACKAGE, OR MEANS OF RETURN DELIVERY IF UNABLE TO RETRIEVE APPROVED PLANS FROM THE OFFICE
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STATE OF ARIZONA DEPARTMENT OF HOUSING PLAN REVIEW (Arizona)

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Completed 12 August 2020

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