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City of Anaheim PLANNING DEPARTMENT Building Division APPLICATION FOR TEMPORARY USE AND OCCUPANCY (TCO) JOB ADDRESS: BUILDING PERMIT NUMBER: Request is hereby made for the temporary use and occupancy on subject project only for the time specified. I hereby acknowledge that as a condition for consideration and granting approval of a TCO, that this TCO will become null & void upon the listed expiration date, and therefore, I acknowledge and understand that upon the voiding of the TCO, legal occupancy or use of said premises and/or portions thereof will no longer be permitted. Any extension of time to this TCO request will be granted subject to review and approval by the Building Official. There will be an additional fee of $407.69 for any request to extend the time of this TCO. I understand that the fee is non-refundable if this application is denied. I am fully aware of Section 109.1 of the California Building Code which indicates, in part, that no building or structures shall be used or occupied until the Building Official or authorized representative has issued a Certificate of Use and Occupancy. REASON FOR REQUEST: Type of Occupancy: Full Occupancy Stocking & Training Only Portion of the Building (refer to handout for requirements) What is preventing a final sign-off? How long will the TCO be needed? The party signing below hereby agrees to hold the City of Anaheim, its officers and employees free and harmless from any incidence or occurrence which may occur as a result of this release. Signature of Applicant Date Telephone Email Address