Identification of document / Specific Variance
Explanation of Variance / A Variance is written permission to build, install, process, or otherwise act in a manner not consistent with the provision of an applicable code but which provides, in the opinion of the issuing Administrator or Safety Codes Officer, an approximately equivalent or greater level of safety to persons and property.
Date of issue / March 29, 2001
Owner and/or contractor upon whom the variance is being issued / Mr. John Doe, President
ABC Construction
0000 Main Street
Anytown, Alberta
T6X 2P2
Reason for variance / Rational to be provided as to why the code, standard, or regulation does not or should not apply, including a quote from the Code, Standard, or Regulation to be varied.
Details of variance / A Variance is hereby granted in respect to the requirements of . . . (indicate what code, standard, and/or regulation including sections, etc that are being varied)
Describe the work that will be done under the variance.
Include any conditions if applicable.
Variance is specific and non-precedent setting / This variance is specific and sets no precedent.
Address and/or legal description of the property upon which the thing, process or activity which is the subject-matter of the variance is located / ABC Society
000 Centre Street
Anytown, Alberta
T6X 2P2
Lot 0, Block 0, Plan TR9999
Authority under which the Variance is being issued / This Variance is issued under the authority of the Safety Codes Act, Chapter S-0.5; and (indicate the code and sentence, etc allowing for the issuance of an alternative, if applicable)
Advisement of Offence / Non-compliance with the requirements of this Variance is an offence under the Safety Codes Act.
Identification of Safety Codes Officer / Signature of Safety Codes Officer
Samuel Brown
(Indicate discipline) Safety Codes Officer
Certification number S0000099
Designation number D00099
Accredited organization employing
Safety Codes Officer / Municipal District of Anytown Box 999
Anytown, Alberta, T9T Y3Y
Accreditation Order number / Phone: / (780) 444-9999
Fax: / (780) 999-4444
0000099
Submission of a copy of Variance to
an Administrator / A copy of this Variance will be submitted to:
(Indicate discipline) Technical Administrator
c/o Safety Codes Council
Suite 1000
10665 Jasper Avenue
Edmonton, Alberta, T5J 3S9