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

## COMPLETE ALL ITEMS:

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

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

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

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

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

COST OF CONSTRUCTION: ___ REGISTRATION CERTIFICATE: ___

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: ___ ___

ZONING APPOVAL ___

M.U.A. LETTER [WATER & SEWER] ___

O.C. BOARD OF HEALTH [WELL WATER & SEPTIC CERTIFICATE OF COMPLIANCE ___

O.C. BOARD OF HEALTH RETAIL FOOD HANDLERS LICENSE & COPY OF

SATISFACTORY CERTIFICATE

MUNICIPAL FOOD HANDLING LICENSE – ISSUED BY THE TOWNSHIP CLERK

STATE HEALTH DEPARTMENT WHOLESALE FOOD HANDLERS LICENSE

OPEN PERMITS [___]

_____  _____

OPEN VIOLATIONS [_____]

_____  _____

D.E.P. [IF REQUIRED]

___ ___

FINAL INSPECTION DATES: [ALL INSPECTIONS]

FINAL INSPECTION DATES: [ALL INSPECTIONS]

BUILDING ___ ELECTRIC ___ FIRE ___ PLUMBING ___

TREE REMOVAL RELEASE DATE – ZONING / FINAL TREE REMOVAL DATE – ENGINEERING ___

PINELANDS APPROVAL ___

DUMP RECEIPTS

___

ENGINEERING

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

OCEAN COUNTY SOILS

PRELIMINARY ___ CONDITIONAL EXP. DATE ___ FINAL COMPLIANCE DATE ___

➢ DEVELOPMENT FEES

PRELIMINARY ___ FINAL ___ COAH ROUND 3 ___

## CERTIFICATES – IF REQUIRED

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

ELEVATOR ___ KITCHEN HOOD & SUPPRESSION SYSTEM ___ FIRE SPRINKLER ___

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

STATE OF NJ MOTELS, HOTELS & MULTIPLE DWELLINGS REGISTRATION CERTIFICATION

☐ ☐ ☐ ☐

APPROVED ___ TCO/NUMBER OF DAYS ___ DENIED ___

DENIED FOR: ___

PENDING: ___

___

REJECTED: ___ REASON: ___