Santa Clara County Planning Office
70 W. Hedding Street, 7th Floor, East Wing
San Jose, CA 95110
www.sccplanning.org
BUILDING SITE APPROVAL VERIFICATION FORM
Is this property an approved building site? DATE:___________
PLANNING OFFICE USE ONLY
Property is not approved building site. Reasons:________________________________________________
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Property is an approved building site. (Such as: PM for Subdivision; Numbered Lot on Numbered Tract; BSA
File # w/Building Permit) Reasons: _______________________________________________________
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Property is exempt from Building Site Approval. Reasons (Such as: Parcel is Zoned R1; Zoned AR, located
east of Hwy. 101 and is not located in the Anderson/Coyote watershed; SFR at Stanford):______________
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Additional Notes: ________________________________________________________________________
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Submittal Reviewed By: DATE: ___________
Planner Name: ______________________ _________________________________
Second Reviewer: ________________________ _________________________________
Phone: ____________________________ Email: ____________________________
Signature
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Print
Signature
Note: Building Site Approval (BSA) Verification is only used to determine BSA status.