Building Use Permit Application

BUILDING USE PERMIT APPLICATION

WHEREAS: Applicant Name: , Business/Organization: ; and

WHEREAS: Property Owner: , Site Address: ; and

WHEREAS: Applicant requests authorization for the temporary or modified use of the described building or premises for the purpose set forth below and agrees to comply with all applicable codes, conditions of approval, and permit requirements.

APPLICANT INFORMATION

Individual Corporation Limited Liability Company (LLC) Other:

PROPERTY & BUILDING INFORMATION

SCOPE OF USE / WORK

Proposed Use Start Date: End Date:

SAFETY, ACCESS, AND SERVICES

Will the use include temporary structures, tents, stages, or cooking operations? Yes No

Will fire protection or alarm system modifications be required? Yes No

PLANS & ATTACHMENTS

Check all attachments submitted with this application:

Site plan / vicinity map Floor plans / layout Electrical/lighting plans Fire safety / suppression plans

Certificate of insurance naming the jurisdiction as additional insured Owner authorization letter

FEES AND PAYMENT TERMS

Payment Schedule: Full payment of permit fees is due upon permit issuance unless an approved payment plan is executed. Applicant is responsible for all plan review, inspection, and recovery fees incurred.

Late Fee and Collections: Any invoice not paid within thirty (30) days of invoice date shall accrue a late fee of 1.5% per month (18% per annum) on the outstanding balance and may be referred for collections. Applicant agrees to pay reasonable costs of collection, including attorneys' fees.

TERM, TERMINATION, NOTICE

Authorized Term Start Date: Authorized Term End Date:

Notice Period for Termination: Either the jurisdiction or the permit holder may terminate authorization upon written notice delivered at least days prior to the intended termination date, provided that immediate termination may occur where public safety or code violations are observed.

CONFIDENTIALITY; INSPECTION; INDEMNITY

Confidentiality: Applicant acknowledges that information submitted may be considered public record under applicable law. To the extent any confidential or proprietary information is identified and accepted as confidential by the jurisdiction, such information will be treated consistent with applicable public records law and only used for review and enforcement of permit conditions.

Inspection and Compliance: Applicant authorizes representatives of the jurisdiction to enter the premises at reasonable times to inspect for compliance with applicable codes, permit conditions, and approved plans. Failure to allow inspection or to comply with conditions may result in suspension or revocation of the permit.

Indemnity and Insurance: Applicant agrees to defend, indemnify, and hold harmless the jurisdiction, its officers, employees, and agents from any claims, liabilities, damages, losses, or expenses, including reasonable attorneys' fees, arising out of or in connection with Applicant's use of the premises or performance under this permit. Applicant shall procure and maintain at its expense commercial general liability insurance with limits no less than $1,000,000 per occurrence and shall provide a certificate of insurance naming the jurisdiction as additional insured where required.

GOVERNING LAW; ENTIRE AGREEMENT

Governing Law: This application and any permit issued hereunder shall be governed by and construed in accordance with the laws and municipal codes of the jurisdiction where the property is located. Venue for any action arising from or related to this application shall be the appropriate state or local court in that jurisdiction.

Entire Agreement: Submission of this application together with the approved permit, conditions, and attachments constitutes the entire understanding between Applicant and the jurisdiction with respect to the subject matter and supersedes all prior discussions and agreements. Any modification must be in writing and signed by an authorized representative of the jurisdiction.

CERTIFICATION

By signing below, Applicant certifies that the information provided in this application is true and correct to the best of Applicant's knowledge, that Applicant has authority to request the proposed use, that Applicant will comply with all conditions of approval, applicable building and fire codes, and permit requirements, and that Applicant will reimburse the jurisdiction for all fees and costs in accordance with the payment terms above.

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