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APPLICATION FOR UCC BUILDING PERMIT

APPLICATION FOR UCC BUILDING PERMITSite InformationPolitical SubdivisionandCountynames are Name (name of company, mall, institution, university, etc.): BUILDING and/or Tenant NameStreet NumberandNameCityStateZip CodePolitical SubdivisionCountyApplication TypeAccessibility OnlyReviewAdditionAlteration or RenovationNew BuildingNew Structure/FacilityPartial OccupancyPhased ApprovalPlan Revision/Deferred SubmissionUncertified (Existing) BuildingUse/OccupancyClassification:Chec k box toleft of applicable allthat Adult CareR-3R-4S-1S-2 USingle Family Dwelling/Townhouse (must be state-owned)Mandatory DocumentsCheck each block below indicating that all of the following will be submitted with this APPLICATION .

APPLICATION FOR UCC BUILDING PERMIT Site Information Political Subdivision and County names are required. Facility Name (name of …

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