Fillable APPLICATION FOR BUILDING PERMIT (City of Antioch)

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APPLICATION FOR BUILDING PERMIT (City of Antioch)

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COMMUNITY DEVELOPMENT
BUILDING DIVISION
200 H Street Phone (925) 779-7065
P.O. Box 5007 Fax (925) 779-7034
Antioch, CA 94531
APPLICATION FOR BUILDING PERMIT
JOB SITE ADDRESS ________________________________________________________________________
Applicant Name ___________________________________________________ Date ________________
Address __________________________________________________________ Phone _______________
Owner Name ______________________________________________________ Phone _______________
Contractor’s Name _________________________________________________ State Lic. ____________
Address __________________________________________________________ Phone _______________
Contact Email______________________________________________________
Contractors must provide a copy of Worker’s Compensation Certificate and Contractor’s State License pocket I.D.
Architect or Engineer _______________________________________________ State Lic. ____________
Address __________________________________________________________ Phone _______________
DESCRIPTION OF WORK
___________________________________________________________________________________________
Contract Price of Work $ _____________
TO BE COMPLETED BY BUILDING DEPT
Conditions/Remarks
FEES MAY BE DUE TO THESE AGENCIES PRIOR TO PERMIT ISSUANCE
ANTIOCH UNIFIED SCHOOL DISTRICT
510 G Street
Antioch, CA 94509
925-779-7500 x52302 Karen Shelp
karenshelp@antiochschools.net
DELTA DIABLO SANITATION DISTRICT
2500 Pittsburg-Antioch Hwy
Antioch, CA 94509
925-756-1900
Hours: Mon – Thurs 7am-5pm and Fri 7-11 am
AGENCIES BUILDERS MAY NEED TO CONTACT
Contra Costa Fire District
4005 Port Chicago Highway, Suite 250
Concord, CA 94520
925-941-3300
info@ccfpd.org
Contra Costa County Environmental Health
2120 Diamond Blvd., Suite 100
Concord, CA 94520
925-608-5500
UTILITY COMPANIES
Pacific Gas & Electric (PG&E)
1-877-743-7782
Republic Services
441 North Buchanan Circle
Pacheco, CA 94553
925-685-4711
Comcast Cable
1-800-945-2288
AT&T
1-800-750-2355
OTHER IMPORTANT INFORMATION
CALL BEFORE YOU DIG
Underground Services Assoc. 1-800-642-2444
CONSTRUCTION DEBRIS AND RECYCLING
http://ci.antioch.ca.us/Environment/CDROrdinance.htm
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APPLICATION FOR BUILDING PERMIT (City of Antioch)

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Completed 9 February 2021

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