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OCCUPANCY USE INSPECTION COMPLIANCE



Date ___________________________                                                                                 Fee $50.00

Name of Applicant ___________________________________________________________________

Trade Name of Business ______________________________________________________________

Address of Business _________________________________________________________________

Directions __________________________________________________________________________
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Fire                                                           In Compliance                     Non-Compliant               Not Applicable

Inspector: _________________________________________________ Date: _____________________

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Electrical                                                 In Compliance                      Non-Compliant               Not Applicable

Inspector: _________________________________________________ Date: _____________________

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Handicap Accessibility                        In Compliance                      Non-Compliant                Not Applicable

Inspector: _________________________________________________ Date: _____________________

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Non-Compliance Reason _______________________________________________________________
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