Certificate of Occupancy Request - Alliance for Contractors

1. PROJECT INFORMATION

Project Name:

Request Date:

Property Address:

City, State, ZIP:

Parcel/Tax ID Number:

Building Permit Number:

Contractor Name:

License Number:

Property Owner:

Contact Phone:

2. INSPECTION CHECKLIST - MAJOR BUILDING SYSTEMS

3. COMPLIANCE VERIFICATION

International Building Code (IBC)

International Residential Code (IRC)

International Energy Conservation Code

International Fire Code

Local Zoning Requirements

Setback Requirements

Special Conditions/Requirements:

4. UTILITY SERVICE ACTIVATION

Utility Service	Provider	Account Number	Activation Date	Status
Electrical Service
Natural Gas
Water Service
Sewer Connection
Telecommunications

5. FINAL INSPECTION COORDINATION

Requested Inspection Date:

Preferred Time:

Inspector Assigned:

Inspector Contact:

Pre-inspection walkthrough completed

All trade inspections approved

Site cleanup completed

Property ready for occupancy

6. DEFICIENCY RESOLUTION TRACKING

Outstanding Deficiencies:

Correction Deadline:

Follow-up Inspection Date:

7. CERTIFICATE TRACKING & RENEWAL MANAGEMENT

CO Certificate Number:

Issue Date:

Expiration Date (if applicable):

Renewal Required:

Temporary Certificate of Occupancy

Final Certificate of Occupancy

8. CERTIFICATION & APPROVAL

CONTRACTOR CERTIFICATION: I certify that all work has been completed in accordance with approved plans and specifications, applicable building codes, and industry standards. The building is ready for occupancy.

INSPECTOR VERIFICATION: I have inspected the above-described building and certify that it complies with applicable codes and regulations for the intended use and occupancy.

Contractor Signature
Print Name: ________________
Date: ____________________

Building Inspector
Print Name: ________________
Date: ____________________

Property Owner
Print Name: ________________
Date: ____________________