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Dawson County Fire Marshal’s Office (DCFMO) – Tenant Change Form Application to Occupy a Building/Space that has a Previously Issued Certificate of Occupancy Prior Business Name: New Business Name: Address: Suite # Phone Sublease/Sublet: (multiple businesses occupying the same suite, one has a valid C/O) This application is for a Name Change, Sublease, or Re-Issuance of FMO occupancy for Assembly, Storage or Industrial occupancies. Complete the application and provide the following items below so your tenant floor plans can be reviewed for inspection. DOCUMENTS REQUIRED TO REVIEW APPLICATION 1) Provide a current floor plan as presently configured/arranged (floor plan commonly found with lease documents) 2) Provide a Scope of Operations letter describing the businesses day-to-day operation Affidavit: OWNER I (PRINT) am notifying DCFMO that the, business, and/or owners’ is changing at the above listed location. I have made no changes in any way (gas lines, mechanical, plumbing and/or electrical work, moving of load bearing, or non-load bearing walls, or exits) to the address listed above. I also affirm that I will be conducting the same type of business that was previously approved by your office. I understand that if I wish to make any changes that influence the occupancy type, I must first submit plans to DCFMO and the Building Department obtain a commercial permit through the Building Department. I also understand that the DCFMO will schedule a fire inspection of my business prior to the completion of this process. The inspector may discover violations that will need to be corrected. I also understand that the inspector may find violations that will require plans to be submitted and a permit obtained to correct the violations. To the best of my knowledge, all the information that I have provided is true. A Dawson County Business licenses shall not be issued until the Fire Marshal inspects and approves the Tenant Change. FOR DCFMO Use Only: Occupancy Classification: Occupant Load: Date: (This process does not apply to CO’s issued prior to 1982 in accordance with O.C.G.A. 25 – 2 – 12 – C - 4) Public Notary Section Notary Stamp: Signature: Date of witness: Expiration: 1. Enter the application into Energov and create a Tenant Change Permit 2. Inform status of application and required action (if any) to the tenant 3. Schedule FMO Inspection 4. Enter Inspection Results (Energov). FIRE PREVENTION DIVISION