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PRINTED: 06/03/2022 DEPARTMENT OF HEALTH AND HUMAN SERVICESFORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES OMB NO. 09380391STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTIONS(X1) PROVIDER/SUPPLIER/CIA
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Gather all necessary information such as the building address, owner information, and intended use of the building.
02
Fill out all sections of the building permit application form accurately and completely.
03
Provide any additional documentation required, such as site plans or architectural drawings.
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Submit the completed application and any supporting documents to the relevant building department or authority.
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Pay any required fees and wait for approval before beginning any construction or renovation work.

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Property owners looking to construct, remodel, or renovate a building at the specified location.
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Developers or contractors assigned to build the structure according to the approved plans.
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Architects or engineers involved in the design and planning of the building project.
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Building 01 - main is the main structure of the property.
The property owner is required to file building 01 - main.
Building 01 - main should be filled out with accurate information about the property's main structure.
The purpose of building 01 - main is to provide detailed information about the main structure of the property.
Information such as the construction materials used, square footage, number of floors, and any renovations must be reported on building 01 - main.
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