Inspection Course

General Inspection Methodology and Procedures

Appeal for Modification of Fire Code

City of ______________________________________________________________________________________
Address all Communications to Department of Building Codes.
Meeting Date: ________________________________________________________________________________
Petition must be on file at the office of the Board of Appeals: ______________________________
one week before meeting date.
Approvals on proposed construction are null and void unless permit is obtained within 6 months.					
Address of Job:  No. _______________ Street __________________________________________________
Legal Description: Lot________________ Block_________________Tract____________________________
Between Cross Streets: _________________________ and _________________________________________
Owner’s Name: ________________________________________________________________________________
Petitioner’s Name: ___________________________________________________________________________
Petitioner is:  Owner: ________ Contractor: ________ Architect: ________ Engineer: ___________
Address of Petitioner:  No. _______________ Street ___________________________________________
Phone No. of Petitioner: ____ ____ ______ City: __________________ P.O. Zone _________________
Status of Job:  Not Started: __________ Under Construction: __________ Finished: _____________
Permit No.: __________________ Plan Check No.(if permit has not been issued) _________________
Specific ordinance modification desired: _____________________________________________________
			(Additional sheets or data may be attached)
Date: __________ Owner Signature: ____________________________________________________________

(It is understood that only those points specifically mentioned are affected by action taken on this appeal.)

			Plot on Reverse Side Required for Yard Modification

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INDEXGeneral Inspection Methodology & Procedures

FPT 102 - Fire Prevention and Inspection // Instructor: Kevin M. Kolb        Slide #12