Form Per-12 - Sep - Professional Certification Audits And Inspections Appointment Request Form

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SEP - Professional Certification Audits and Inspections
Appointment Request Form
Application must be typewritten
Tel: 718-286-8370 Fax: 718-286-0934
1 Attendee
Required for all applications.
Name
ID Number
Office Phone
Mobile Number
Fax Number
Email
2 Location Information:
Required for all applications.
Address
Job Number
Document Number
Applicant
P.E.
R.A.
License Number
Plan Examiner
3 Appointment Request for:
Post Approval Amendment
Audit (Attach Objection Sheet)
Plan Examiner Reassignment
Audit Signoff Completion
Permit Rescission*
Application Withdrawal
Superseding Applicant of Record*
Other:
* Professional must attend meeting
4 Appeal
Issue For Review:
Building Code Interpretation/Determination (CCD1)
TPPN Interpretation
Zoning Resolution Interpretation / Determination (ZRD1)
Other:
Multiple Dwelling Law Interpretation (CCD1)
Buildings staff who have reviewed this application:
Plan Examiner Supervisor
Chief Plan Examiner
Deputy Director
Director
5 Comments: Description of issue to be discussed.
INTERNAL USE ONLY
APPOINTMENT APPROVED:
YES
NO
DATE OF APPOINTMENT:
TIME OF APPOINTMENT: ______ : ______
AM
PM
CONFIRMATION NUMBER:
PER12 06/14

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