Form 150 "Certificate of Occupancy" - Kansas

What Is Form 150?

This is a legal form that was released by the Kansas Department of Administration - a government authority operating within Kansas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2019;
  • The latest edition provided by the Kansas Department of Administration;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form 150 by clicking the link below or browse more documents and templates provided by the Kansas Department of Administration.

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Download Form 150 "Certificate of Occupancy" - Kansas

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Form150
June 2019
State of Kansas - Certificate of Occupancy
Department of Administration, OFPM-DCC
is hereby issued for this date Click or tap to enter a date
Agency:
Agency/Building number:
Name of building/location:
Agency Point of Contact:
Description of construction and square footages:
(i.e. new construction/renovation/addition)
The areas of the building listed above have been inspected for compliance with the codes
listed for the occupancy and the use for which the project is classified.
Reference the approved code footprint signed by OSFM on Click or tap to enter a date. for applicable codes, and
active/passive life safety requirements for this project.
Your Name Here
________________________
Construction & Compliance
Date of issuance
Enter Date.
This certificate of occupancy may be suspended or revoked wherever the certificate is issued in error, or on the basis of incorrect information supplied, or
where it is determined that the building or structure or portion thereof is in violation of any ordinance or regulation or any of the provisions of the code
listed. The suspension or revocation shall be in writing by the Department of Administration.
Form150
June 2019
State of Kansas - Certificate of Occupancy
Department of Administration, OFPM-DCC
is hereby issued for this date Click or tap to enter a date
Agency:
Agency/Building number:
Name of building/location:
Agency Point of Contact:
Description of construction and square footages:
(i.e. new construction/renovation/addition)
The areas of the building listed above have been inspected for compliance with the codes
listed for the occupancy and the use for which the project is classified.
Reference the approved code footprint signed by OSFM on Click or tap to enter a date. for applicable codes, and
active/passive life safety requirements for this project.
Your Name Here
________________________
Construction & Compliance
Date of issuance
Enter Date.
This certificate of occupancy may be suspended or revoked wherever the certificate is issued in error, or on the basis of incorrect information supplied, or
where it is determined that the building or structure or portion thereof is in violation of any ordinance or regulation or any of the provisions of the code
listed. The suspension or revocation shall be in writing by the Department of Administration.
Agency-Building
Agency and
No.:
Facility
Name:
Signature of OSFM / DCC Representative
(items
Description
Date Accepted
not applicable to this project noted as NA)
1. Code Footprint
For:
2. Fire Alarm Plans / Shop Drawings
For:
3. Automatic Sprinkler Plans / Shop
Drawings
For:
4. Fire Alarm System installed and
tested per NFPA.
For:
5. Automatic sprinkler system installed
and tested per NFPA.
For:
6. Emergency Lights tested.
For:
7. Back-up Power (generator, invertor,
battery, etc) tested.
For:
8. Fire Pump tested per NFPA.
For:
9. Standpipes tested per NFPA.
For:
10. Exit Paths verified to public way.
(Includes exit sign verification and
testing.)
For:
11. Elevator tested.
For:
12. Accessibility.
For:
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