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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. |
