COMMERCIAL USE ONLY – INITIAL EVERY ITEM ON SHEET – DATE STAMP

COMPLETE ALL ITEMS:

PERMIT NUMBER: ___ BLOCK: ___ LOT: ___ ADDRESS: ___

PERMIT NUMBER
BLOCK
LOT
ADDRESS

BUSINESS NAME: ___ CONSTRUCTION COST: ___ REGISTRATION NUMBER: ___

BUSINESS NAME
CONSTRUCTION COST
REGISTRATION NUMBER

C.O. APPLICATION NAME/RESPONSIBLE PERSON IN CHARGE: ___

C.O. APPLICATION NAME/RESPONSIBLE PERSON IN CHARGE

ADDRESS: PHONE NUMBER: (W) ___ (C) ___

ADDRESS
PHONE NUMBER: (W

USE GROUP: ___ LIVE LOAD: ___ OCCUPANCY LOAD: ___ CONSTRUCTION CLASS: ___

USE GROUP
LIVE LOAD
OCCUPANCY LOAD
CONSTRUCTION CLASS

COST OF CONSTRUCTION: ___ REGISTRATION CERTIFICATE: ___

COST OF CONSTRUCTION
REGISTRATION CERTIFICATE

CERTIFICATE FEE : _____[10% OF ALL PERMITS, LESS DCA FEES] FIRE DISTRICT: _____

CERTIFICATE FEE
10% OF ALL PERMITS, LESS DCA FEES] FIRE DISTRICT

REQUIRED PRIOR AND FINAL APPROVALS [WHERE APPLICABLE] PRIOR FINAL

  • LETTER FROM THE PROPERTY OWNER APPROVING OCCUPANCY: ___ ___
PRIOR [1]
FINAL [1]
  • ZONING APPOVAL ___
PRIOR [2]
FINAL [2]
  • M.U.A. LETTER [WATER & SEWER] ___
PRIOR [3]
FINAL [3]
  • O.C. BOARD OF HEALTH [WELL WATER & SEPTIC CERTIFICATE OF COMPLIANCE ___
PRIOR [4]
FINAL [4]
  • O.C. BOARD OF HEALTH RETAIL FOOD HANDLERS LICENSE & COPY OF SATISFACTORY CERTIFICATE
[1]
[1]
  • MUNICIPAL FOOD HANDLING LICENSE – ISSUED BY THE TOWNSHIP CLERK
[2]
[2]
[3]
[3]
  • STATE HEALTH DEPARTMENT WHOLESALE FOOD HANDLERS LICENSE
  • OPEN PERMITS [___]
[4]
[4]

_____ _____

  • OPEN VIOLATIONS [_____]
[5]
[5]
OPEN VIOLATIONS

_____ _____

  • D.E.P. [IF REQUIRED]

___ ___

[6]
[6]

FINAL INSPECTION DATES: [ALL INSPECTIONS]

  • FINAL INSPECTION DATES: [ALL INSPECTIONS] BUILDING ___ ELECTRIC ___ FIRE ___ PLUMBING ___
[7]
FIRE
PLUMBING
BUILDING
ELECTRIC
  • TREE REMOVAL RELEASE DATE – ZONING / FINAL TREE REMOVAL DATE – ENGINEERING ___
TREE REMOVAL RELEASE DATE – ZONING / FINAL TREE REMOVAL DATE – ENGINEERING [1]
[1]
  • PINELANDS APPROVAL ___
TREE REMOVAL RELEASE DATE – ZONING / FINAL TREE REMOVAL DATE – ENGINEERING [2]
[2]
  • DUMP RECEIPTS
  • ENGINEERING

___

[3]

PRELIMINARY ENGINEERING: ___ AS-BUILT: ___ FINAL ENGINEERING: ___ BOND: ___

PRELIMINARY ENGINEERING
AS-BUILT
FINAL ENGINEERING
BOND
  • OCEAN COUNTY SOILS PRELIMINARY ___________ CONDITIONAL EXP. DATE
PRELIMINARY
CONDITIONAL EXP. DATE
FINAL COMPLIANCE DATE
  • DEVELOPMENT FEES PRELIMINARY __________ FINAL __________ COAH ROUND 3 __________ CERTIFICATES – IF REQUIRED FIRE ALARM _____
FINAL
COAH ROUND 3
PRELIMINARY
HAZAQRDOUS MATERIALS LIST
FIRE ALARM
  • ➢ DEVELOPMENT FEES

PRELIMINARY ___ FINAL ___ COAH ROUND 3 ___

CERTIFICATES – IF REQUIRED

FIRE ALARM ___ HAZAQRDOUS MATERIALS LIST ___ D.E.P. AIR QUALITY ___

D.E.P. AIR QUALITY

ELEVATOR ___ KITCHEN HOOD & SUPPRESSION SYSTEM ___ FIRE SPRINKLER ___

KITCHEN HOOD & SUPPRESSION SYSTEM
ELEVATOR
FIRE SPRINKLER

EMERGENCY GENERATOR ___ BACKFLOW PREVENTOR PLUMBING/FIRE ___ PEST CONTROL ___

EMERGENCY GENERATOR
BACKFLOW PREVENTOR PLUMBING/FIRE
PEST CONTROL
STATE OF NJ MOTELS, HOTELS & MULTIPLE DWELLINGS REGISTRATION CERTIFICATION

☐ ☐ ☐ ☐

APPROVED ___ TCO/NUMBER OF DAYS ___ DENIED ___

APPROVED
TCO/NUMBER OF DAYS
DENIED
DENIED FOR

PENDING: ___

PENDING [1]

___

PENDING [2]

REJECTED: ___ REASON: ___

REJECTED
REASON

REVISED 12/19/2016