Project Space Request Form

Completion of this form is REQUIRED to request new or additional space or to make any alterations to existing space with DPA/DCS/Capitol Complex managed buildings.

New space         Existing Space  

AGENCY:           Agency Name          

                        Division/Work Unit  


                        Current Location     (Building Name and Address) 
                                                  
 
                        
                         Agency Contact   
    

                         Title                    


                          E-mail                     
                             
                          Telephone           
  

                          Date                      

PROJECT JUSTIFICATION:  Reason for Request (Examples include: adding staff, programs, etc.; new finishes such as paint, carpeting, etc.; relocating walls to provide new office configuration, additional storage space, etc.)

    

PROJECT IMPACTS:

                 Estimated Square Footage:                                        
                 Consult with Capitol Complex representative to determine impacts on Capitol Complex
                 buildings.


                 Will the work impact structural systems?                    Yes   No
                 Will the work impact mechanical systems?                   Yes   No
                 Will the work impact electrical systems?                     Yes   No
                 Will the work impact fire protection systems?              Yes   No
                 Will the work impact existing partition systems?           Yes   No
                     and/or access to exits?
                 Are there other known building code considerations?     Yes   No  

BUDGET:
                 What is the agency’s budget for the work? $                
 
                 What is the funding source?                                      
 


SCHEDULE   
                  When does the agency want to begin design work?      
 
                  When does the agency want to begin construction?     
 
                  When does the agency want the project completed?    
 


ADDITIONAL COMMENTS/CONCERNS

 

SPACE GUIDELINES

For planning purposes refer to the Space Standards section under Real Estate on the State Buildings and Real Estate Programs website.