Fillable BUILDING PERMIT APPLICATION

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BUILDING PERMIT APPLICATION

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Country of origin: OTHERS
File type: PDF

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Case Number: BLD
PLN
BUILDING PERMIT APPLICATION
Application Date:
Project Address: City:
Zip:
Assessor’s Parcel Number:
APPLICANT:
Owner Architect/Designer Engineer Contractor
OWNER:
Name:
Address:
City/State/Zip:
Phone:
Email:
ARCHITECT/DESIGNER:
Name:
Company Name:
Address:
City/State/Zip:
Phone: CA License #:
Email:
ENGINEER:
Name:
Company Name:
Address:
City/State/Zip:
Phone: CA License #:
Email:
CONTRACTOR:
Name:
Company Name:
Address:
City/State/Zip:
Phone: CSLB Class/#:
Email:
PROJECT INFO: Type: One/Two Family Residential Multi-Unit Residential Commercial/Industrial Mixed-Use Conversion Other:
Permit For: Building Electrical Mechanical Plumbing Re-Roof Solar PV Other:
Valuation: $
Description of Work:
Existing Use:
Proposed Use:
Occupancy Group(s):
# of Units:
Type of Construction: # of Stories:
Signature of Applicant/Owner: Print Name: Date:
*OFFICE USE ONLY*
FIRE SAFETY:
Building Safety Score:
Fire Sprinklers Required: Y N Fire Sprinklers Exempted By:
PLANNING REVIEW
:
Zoning:
Design Review Area: Y N
For Plan Check Only: Date:
For Permit Issuance: Date:
F
ees
Required:
Planning Permit Required:
Grading Permit Required:
Floor Area Habitable (sq. ft.) Non-Habitable (sq. ft.)
New:
Existing:
:
Planning Notes:
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BUILDING PERMIT APPLICATION

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Completed 23 June 2021

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