Form 00705-Temporary Certificate Of Occupancy Form
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1
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3Temporary Certificate of Occupancy
Permit Application
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE WITHOUT A
CERTIFICATE OF OCCUPANCY (CofO) OR A TEMPORARY CERTIFICATE OF OCCUPANCY (TCO)
Permit Number: __________________ Project Address: ____________________________________________
Owner’s Name: _____________________________________________________________________________
Address: ___________________________________________________________________________________
City: __________________________________________ State: ___________ Zip Code: _________________
Phone: _________________________________ Email: ____________________________________________
Contact Person: ____________________________________________________________________________
Address: __________________________________________________________________________________
City: __________________________________________ State: ___________ Zip Code: _________________
Phone: _________________________________ Email: ____________________________________________
PLEASE READ AND SIGN THE STATEMENT BELOW
I accept responsibility for compliance with all terms and conditions of this TCO agreement. I am aware that
utilities will be disconnected if the terms and conditions of this TCO are not met.
Owner or Owner’s Representative Signature: ______________________________________________________
Print Name: _________________________________ Date: _________________________________________
----------------------------------------------------------FOR STAFF USE ONLY------------------------------------------------------------
Summary of Conditions/Stipulations for Temporary Occupancy
(To be completed by Inspections Field Supervisor)
Expiration Date: ______________ Initials: _____________________ Insp. # _______ Date: _______________
Occupancy Type: _______________ Construction Type: _____________________________________________
Fire Sprinklers Required?
Yes
No
Electrical Clearance Required?
Yes
No
Fire Alarm Required?
Yes
No
Gas Clearance Required?
Yes
No
Specific Conditions (Print Legibly):
__________________________________________________________________________________________
__________________________________________________________________________________________
Inspections Required:
Plumbing
Mechanical
Electrical
Structural
Civil/Site
Fire
Elevator
TCO No: __________________ Fee: ______________ Date: _______ Accepted By: ____________________
A Temporary Certificate of Occupancy (TCO) may be requested for limited occupancy of a structure. Such
Certificate will be valid after the application has been approved, fees paid and all inspectors have signed
in the appropriate section of the TCO form. All conditions and stipulations shall be in writing and signed by the
owner’s representative. The TCO is subject to Section 111.3 of the Phoenix Building Construction Code
Administrative Provisions and Section 507.K.4 and 507.K.5 of the Phoenix Zoning Ordinance.
Page 1 of 3
This publication can be made available in alternate formats (Braille, large print, or digital media) upon request.
Contact Planning & Development at (602) 262-7811 voice or (602) 534-5500 TTY.
S:\Certificate of Occupancy, Temporary, Application
TRT/DOC/00705
WEB\dsd_trt_pdf_00705
Rev.8/14
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Parent category: Financial