Certificate of Occupancy Application

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Certificate of Occupancy Application New Occupancy Change of Ownership Business Information Name Address (Physical) Description of Proposed Business Hours of Operation Mailing Address Tenant Name Emergency Number Property Owner/Landlord Information Name Address Number E mail Occupancy Questions Previous Building Use How many existing vehicle parking spaces? Date Last Occupied How many are handicap accessible? Which utilities will need to be released? Electric Gas Water Yes No Complete the following questionnaire Will the facility be remodeled, renovated, or altered? If so, a separate permit is required prior to commencement of any work. Will there be any spray painting on the premises? Will hazardous or toxic materials be stored on the premises? Will food be prepared, served, or sold on premises? Will any goods, merchandise, or raw materials be stored or displayed outdoors? Page 1 of 6

Yes No Complete the following questionnaire Will any electrical or plumbing fixtures be installed or relocated? Are you connected to City sewer? Are the parking spaces properly striped? Will there be a dumpster used? If so, it must be screened in accordance with Chapter 90 of the Code of Ordinances. Is signage proposed? If so, a separate permit is required before installation of any signage. I hereby certify that I have read the information contained in this document and know the same to be true and correct. Print Name REVOCATION The Building Official may, in writing, suspend or revoke a Certificate of Occupancy issued under the provisions of the ordinance whenever the Certificate of Occupancy is issued in error, or issued on the basis of incorrect information supplied, or when it is determined that the building, structure, or portion thereof is in violation of any ordinance, regulation, or any of the provisions of the most current adopted Building, Plumbing, Mechanical, Fire, National Electrical Codes, or City Ordinances. A building or structure may not be occupied by persons or possessions until the Building Official has issued a Certificate of Occupancy. Signature Date For Office Use: Inspection Date Fee Paid Permit # Receipt # Received by Date Zoning Use IBC Use Current Load To Fire Dept. on Fire Dept. Approval by on Notes: Page 2 of 6

Statement of Facts Site Location (Address) Zoning Type of Use Activities Involved Dwelling Yes No Sales Yes No Processing Yes No What type of product? Yes No Storage? Amount? Nature/Type? Enclosed? Open? What amount of the following is likely to be generated by the proposed use? Noise Odor Fumes Dust Toxic Material Vibration What does the business do? Page 3 of 6

How many employees will this business have? Page 4 of 6

Certificate of Occupancy Information Sheet Once an application is made: Zoning for your location will be confirmed and your intended use will be reviewed and classified to ensure compliance. Note: If the proposed use is more intensive than allowed in the zoning district, your application will be denied. An initial inspection is performed. Arrangements must be made to have the space open for inspection. If the space cannot be open, please provide a contact name and phone number for us to call to coordinate an inspection time. Inspection will be made by the Building Inspector to ensure compliance with Zoning, Building, Plumbing, Mechanical, and Electrical Codes. An additional inspection will be made by the Fire Department to ensure compliance with Fire Codes. Both inspections are required and corrections, if any, must be made prior to final approval and release of TXU utilities, gas and/or electric. Note: Arrangements must be made by Certificate of Occupancy applicant with TXU for utility service. The City of Richland Hills does not coordinate this effort. After approval and release, a Certificate of Occupancy will be mailed to you. Please direct questions regarding this process to the City of Richland Hills Planning and Community Development Department (817) 299 1870. Questions relating specifically to Fire Code provisions should be directed to the Fire Department at (817) 299 1850. Page 5 of 6

Checklist for New Businesses (Existing Structures) Please read thoroughly. Initial each line, sign and date on the space provided. Provide Tax Sales and Use Tax Permit showing the City of Richland Hills as the city of Taxing Jurisdiction. If commercial property abuts residentially used or residentially zoned property, a six foot tall decorative wall and a five foot wide buffer yard are required on the commercial property. A Certificate of Occupancy application must be filled out completely. Inspections from the and Fire Departments are required. Items noted as in need of repair must be repaired prior to occupancy. A building or structure may not be occupied by persons or possessions until the Building Official has issued a Certificate of Occupancy. The proposed use must meet the minimum requirements of the zoning at the desired location. If a Special Use Permit is required, the property owner or authorized agent must submit an application to the Department. The applicant must contact the Tarrant County Health Department prior to submitting an application for a Certificate of Occupancy to determine if additional County requirements are necessary. Copies of all required County permits must be submitted to the City of Richland Hills prior to issuance of a Certificate of Occupancy. My signature below indicates I have been advised of and understand the information provided. Applicant s Signature Date Page 6 of 6