2. City of Ellisville

   1 Weis Avenue
   

   Ellisville, Missouri, 63011

   Phone: 636-227-9660  *  Fax: 636-227-9486

   
   

   OCCUPANCY PERMIT FOR COMMERCIAL, RETAIL, OFFICE, BUSINESS, ASSEMBLY, OR INDUSTRIAL USE

3. 
5. Date:*
   Date:

6.  

7. Permit #:

9. PERMIT FEE IS BASED ON THE SQ. FOOTAGE OF TOTAL LIVING SPACE. $1 PER 100 SQ. FEE WITH A MINIMUM OF $25

   ATTACH SITE PLAN OF PROPERTY OR FLOOR PLAN, IF APPLICABLE.

11. New Occupant Information (Business Name):*
12. Phone:*
14. Address of Building:*
15. Zoning:
17. City:*
18. State:*
19. Zip:*

23. Building Information:

25. Name of Property Owner:*
26. Phone: *
28. Address of Property Owner:*
30. City: *
31. State:*
32. Zip:*
34. DESCRIPTION OF BUSINESS OPERATION: (ie., warehouse, office, retail: (is there sales tax charged?), manufacturer, etc. or any combination of square footage of any combination.)*
36. Date of Proposed Occupancy:*
    Date of Proposed Occupancy:
37. MO State Sales Tax No.:*
38. No. of Floors*
39. Sq. Ft. per Floor*
41. No. of Employees:*
42. Full-time Employees:*
43. Part-time Employees:*
45. Type of Construction:*
46. No. of Assigned Parking Spaces:*
47. Loading Spaces:*
49. Screening/Planting:
50. Live Loads on Floors:
52. Does your business include the storage, use, or manufacture of fammable or combustible liquids?*

    1. Yes
    2. No
53. (If yes, provide MSDS Sheets.) Specify type and amount of flammable and combustible liquids:
55. Upload MSDS Sheets:
57. Does your business include the storage of combustible material (such as paper products, plastic, wood, etc.)?*

    1. Yes
    2. No
58. If yes, Specify type and amount:
60. Does your business include the storage, use, or manufacture of corrosive or hazardous materials?*

    1. Yes
    2. No
61. (If yes, provide MSDS Sheets.) Specify type and amount of corrosive or hazardous materials:
63. Upload MSDS Sheets
65. Are any alterations to the present structure planned, such as walls, partitions, shelving, etc.?
67. Estimated Cost of Renovations:

69. The undersigned herewith applies for an Occupancy Permit for the above-described premises in accordance with the terms of Chapter 505.030, Ellisville Municipal Code, Ordinance No. 3035-7, 7-20-2011.

73. APPLICANT INFORMATION:

75. Name:*
77. Address:*
79. City:*
80. State:*
81. Zip:*
83. Phone:*
84. Cell Phone:*
86. Email:*
88. Signature:*
89. Relationship to Building/Applicant:*

93. NOTE: All businesses in the City of Ellisville Must register with St. Louis County at 314-889-2220 for personal property business account.

95. Name:
96. Phone:
98. Full Mailing Address:

100. If additional lines are needed, please attach a separate sheet.

102. Ver.: 01/07/2020

Leave This Blank:


104. 1. Receive an email copy of this form.
105. Email address

     This field is not part of the form submission.

106. Submit

* indicates a required field