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Certificate of Occupancy

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Please use this form for general improvement permit applications.

* Denotes a required field

Description of Proposed Work

Property Owner's First Name

Property Owner's Last Name

Address

City

State

ZIP

Zip-Zip +4
Second portion of ZIP Code is optional.

Property Owner's Phone

Property Owner's Phone Area Code-Property Owner's Phone Prefix-Property Owner's Phone Line Number ext Property Owner's Phone Extension

Address

City

State

ZIP

Zip-Zip +4
Second portion of ZIP Code is optional.

Builder's First Name

Builder's Last Name

Address

City

State

ZIP

Zip-Zip +4
Second portion of ZIP Code is optional.

Builder's Phone Number

Builder's Phone Number Area Code-Builder's Phone Number Prefix-Builder's Phone Number Line Number ext Builder's Phone Number Extension

Builder's Email

Approx. Costs

Description of Proposed Work

Present Use

Proposed Use

Single Family Dwelling

Multi-Family Dwelling

Commercial

Industrial

Zoning Classification of Property

Lot Width

Lot Depth

Living Area Sq. Ft.

Garage Area Sq. Ft.

Total Area Sq. Ft.

Date of State Design Release

MonthDay Year,

Design Release Number

Please Do Not Complete The Following Field

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