PLAN CHECK SUBMITTAL FORM If you are human, leave this field blank. CONTACT INFORMATION First Name * Last Name * Firm Name * Fax Number Phone Number * Email Address * How would you like to be contacted? (check any/all) * Phone Fax Email PROJECT NAME AND/OR REF. NO. * CONSTRUCTION TYPE PROJECT ADDRESS MALL / SUBDIVISION NAME Project City * VALUATION PROJECT STATE * AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY SIZE (SQ. FT.) PROJECT ZIP CODE * OCCUPANT LOAD NO. OF EMPLOYEES CONSTRUCTION DATE PROJECTED OPENING DATE Services Requested Make Applications For Plan Check Requirements Processing Time Estimate Cost of Plan Check Fees Address for Submittal Fees Estimate Building Permit Cost Business License (specify) (specify) (specify) SCOPE OF WORK(select one) Options Tenant Improvement Shell T.I. T.I. to existing lease space Addition to Existing New Ground Up Construction Rough Graded Lease Pad Shell Tenant Improvement FIRE PREVENTION and USAGE Information Is This a Green Project? YES NO Is Building Fully Sprinklered? YES NO Will There Be Alterations To Existing Sprinklers? YES NO Is Fire System Fully Alarmed? YES NO Will There Be Alterations To Fire Alarms? YES NO Previous Use? New- No Previous Use Retail Restaurant Previous Use Current Tenant Name Outdoor Dining Area? YES NO No. of Outdoor Seats Number of seats (if food use) How Many Exits Are Available? Alcohol Served? N/A Existing ABC Permit Need ABC permit N/A ABC Permit To Be Processed By Others Please Process My ABC Permit How did you hear about Fast Trak Permit Service? Website Referral Newsletter Phone Book Other ARCHITECT Information OWNER Information ARCHITECT FIRM NAME OWNER NAME ARCHITECT CONTACT NAME OWNER CONTACT ARCHITECT TELEPHONE OWNER TELEPHONE ARCHITECT ADDRESS OWNER ADDRESS ARCHITECT CITY OWNER CITY ARCHITECT STATE AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY OWNER STATE AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY ARCHITECT ZIP CODE OWNER ZIP CODE ADDITIONAL COMMENTS: Please use this section to clarify, in detail, if any exterior alterations, change of use, or structural calculations applicable. If CUP or Design Review has been reviewed, please provide case number(s) Submit
