Certificate Of Occupancy (Co) - Walk In Application Only
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1
2
3Certificate of Occupancy (CO)
Walk In Application Only
(Do Not Fax, Mail or Email application)
nd
101 W. Abram Street, 2
Floor – CD&P
(817) 459-6502
Please print clearly:
Tenant’s
Name*:
______
(individual-not company)
Tenant’s Mailing Address:
____
City:
State:
Zip Code:
Home/Cell Phone #: (_
)
Work Phone #: (
)
Fax #: (
)
Email*:
*A copy of a current government photo ID is required to be submitted for the tenant and applicant.
*A Certificate of Occupancy will be delivered to the Email provided above (Please verify email).
NOTE:
If the applicant is a different person than the tenant, then the following section must be completed by the applicant:
Applicant’s
Name*:
(individual-not company)
Applicant’s Mailing Address*:
City:
State:
Zip Code:
Home/Cell Phone #: (_
)
Work Phone #: (
)
Fax #: (
)
Email:
_
Business Owner’s (business or personal) Name:
Business Owner’s Representative
Name:
(individual-not company)
Representative’s Mailing Address:
City:
State:
Zip Code:
Home/Cell Phone #: (_
)
Work Phone #: (
)
Fax #: (
)
Email:
In the event of an emergency, who should the Fire Department contact? You may check up to two emergency contacts.
Please ensure that a home or cell phone number is provided for all emergency contacts.
Tenant
Applicant
Business Owner
Other
If you checked Other, please provide name:
Home/Cell Phone #: (_
)
Work Phone #: (
)
Fax #: (
)
Email:
_
CO Location Address:
Suite:
Proposed Business Name:
Mailing address, if different from location:
Please check only one:
New Tenant
Expanding/Increasing Lease Space
Existing Business/New Owner
Shell Building/House Lights
Same Business Owner/New Business Name
Clean and Show
Please check only one:
There is an Active Building Permit for this location
There is not an Active Building Permit for this location
I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and
ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any other state or local ordinances regulating construction, the
performance of construction or the use of any land or buildings.
All application fees for Certificate of Occupancy are non-refundable. The application review will not begin until all fees have been paid,
addresses verified, and the correct number and types of plans, if any, are received.
Signature of Permit Applicant
DATE
Applicant Name (Printed) ________________________ Applicant is
Tenant or
Authorized Agent
Please answer all the questions on the following page. Incomplete applications will not be accepted.
CofO Application
Page 1 of 3
Dec 2016
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Parent category: Business