Space Request Form / Change of Room Function

The University of Tennessee at Chattanooga

DIRECTIONS:

  • Complete Sections Aand F for all requests.
  • Complete Sections D for a request for new space and Sections C and D if renovation is also needed.
  • Complete Section E for change of function of space only.

  1. CONTACT INFORMATION:

Requesting Department: / Date of Request
Contact Name: / Contact Phone: / Contact Email:
  1. REQUEST FOR NEW SPACE:

  1. Why is new space needed? What are the implications if allocation of new space is not granted?
  1. Desired relationship/proximity to other departments:

Space will be used for: Instruction  Research  Office Storage 
Have you identified a suitable location for this new space that may be available? / Yes  No
Provide building name, room number(s). Attach drawings/floor plans. Contact Kelli Flood at 5335 for floor plans.
If space is currently occupied by another department, have you contacted current holder of the space provided? Yes  No  / Do they support the concept? Yes  No 
When is space needed?
Will the current space be vacated: Yes  No  If yes, explain the plans for the vacated space:
IF RENOVATION OF THE SPACE IS NEEDED, PLEASE COMPLETE SECTIONS C AND DBELOW. COMPLETE SECTION E IF ROOM FUNCTION WILL BE CHANGING.
  1. REQUEST FOR RENOVATION ESTIMATE OF SPACE

Provide building name and room number(s). Attach concept drawings/floor plans. Contact Kelli Flood at 5335 for floor plans.
Why is the renovation needed? What are the implications if the renovation is not approved?
Describe renovation needed in detail. Address special requirements.
Space will be used for: Instruction  Research/Lab Office Storage 
When does the work need to be completed?
Complete Section D regarding funding. Complete Section E if room function will be changing.
  1. FUNDING INFORMATION:

What is the source of funds for the renovation? Unit College Division VP  Grant Funds are needed 
How much is available to commit to the project?
Account to fund renovations:
______
  1. REQUEST TO CHANGE FUNCTION OF SPACE: if more than one room is involved, attach additional page(s)

Building ______
Room # ______
Current Space Use Code ______(for help with space use codes, please contact Kelli Flood at 5335)
Requested Space Use Change ______
Justification for change:
  1. AUTHORIZATION SIGNATURES
/ Signature approval must be obtained from the following prior to submitting to
The Facilities Planning Committeefor consideration.
(Signatures indicate agreement that the space request should be investigated, not approved.)
Current Space Assignee / Requesting Department
Department Head or Director: / Department Head or Director: / :
Dean: / Dean:
Vice Chancellor: / Vice Chancellor:

Forward by e-mail or fax this completed form with the proper signatures and attachments to Facilities, Planning & Management Space Management Coordinator, fax: 425-4749 mail code: 3553

FOR FACILITIES PLANNING COMMITTEE USE
This request was: Approved Denied Tabled by the Facilities Planning Committee on______
Facilities Planning Committee Chair:
______