Fillable BUILDING PERMIT SUBMITTAL FORM (City of Yorba Linda)

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BUILDING PERMIT SUBMITTAL FORM (City of Yorba Linda)

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City of Yorba Linda
4845 Casa Loma Avenue, Yorba Linda CA 92886
Building Division
Permit Counter 714-961-7120
Plan Check No: ______________
BUILDING PERMIT SUBMITTAL FORM
Applicant’s Name: ___________________________________ Phone:_________________________
Inspection Contact Name:______________________________ Phone:_________________________
Please fill in applicable information below and return this form to Building Division staff. Please provide any additional information you believe will assist the
Building Division in processing your application or ask for assistance.
Applicant to complete below (check appropriate box for applicant) Only Building Division to complete below
Job Site Address ________________________________________________
Suite No. _______________________________________________________
Tract____________________________________ Lot____________________
APN#__________________________________________________________
Owner’s Name_________________________________________________
Mailing Address________________________________________________
City, State, Zip_________________________________________________
Tel No _______________________________________________________
Type of permit(s) requested
(Be sure to fill in the work sheet for each permit discipline)
Occupancy __________Type of Construction___________
Proposed Work________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
Architect/Designer’s Name______________________________________
License No. __________________________________________________
Address______________________________________________________
City, State, Zip_________________________________________________
Tel No _______________________________________________________
Tenant Improvement: N/A
Type of Business__________________________________
Company Name___________________________________
Contact Person of Company_________________________
Tel No __________________________________________
Engineer’s Name ____________________________________________
License No._________________________________________________
Address_____________________________________________________
City, State, Zip________________________________________________
Tel No ______________________________________________________
Contractor’s Company Name___________________________________
Contractor License No. ________________________________________
Lic. Expiration date ____________________________________________
Contractor License Class _______________________________________
Square footage:
Dwelling: _________________
Attached Garage:___________ Porch: ________________
Addition: _____________ Alteration:___________________
Deck: _____________Attached Patio Cover: ___________
Reroof : ____________ (sq)
Detached Accessory structure:_______________________
Pool / Spa: _________________ / ___________________
Fence/Retaining wall : ____________________ (linear feet)
Tenant Improvement (existing/altered) _______ /_________
Office:_______________ Warehouse:_________________
Other: ________________________________________
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BUILDING PERMIT SUBMITTAL FORM (City of Yorba Linda)

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Completed 25 January 2021

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