SCOTTS VALLEY BUILDING PERMIT APPLICATION by vfe23766

VIEWS: 13 PAGES: 2

									                            SCOTTS VALLEY BUILDING PERMIT APPLICATION
                   City of Scotts Valley Building Departm ent, One Civic Center Drive, Scotts Valley, CA 95066
                                                 (831) 440-5640/FAX: (831) 438-2793



Construction Site Address: ________________________________APN ______________________
*******************************************************************************************************************
Property Owner: _____________________________________ Address: ______________________________________

City: ______________________ Zip: ___________ Phone: __________________________ FAX: __________________

Applicant/Contact: ___________________________________ Address: ______________________________________

City: ___________________ Zip: _________ Phone: ____________ FAX: _____________ Em ail: ______________

Contractor: _________________________________________ Address: ______________________________________

City: ______________________ Zip: ___________ Phone: __________________________ FAX: __________________

             NOTE: IF THE CONSTRUCTION SITE IS LOCATED WITHIN A HOMEOWNERS ASSOCIATION,
                                  WRITTEN APPROVAL FROM THEIR BOARD IS REQUIRED.
********************************************************************************************************************************************
Valuation of Construction: $______________________ 9 Residential                    9 Com m ercial

BUILDING:                   9   SFD / ___________ sq ft                             9   Swim m ing Pool
                            9   Addition _________ sq ft                            9   Interior Tenant Im provem ent (Com m ercial)
                            9   Interior Rem odel                                   9   Deck 9 New 9 Repair sam e 9 Expand
                            9   Garage 9Attached 9Detached                          9   W indows 9 Replacem ent 9 New
                            9   Exterior siding (lap board, vinyl, stucco)          9   Other ______________________________

M ECHANICAL:                9 Furnace       9 Gas Line   9 Air Conditioning 9 Exhaust Fan      9 Fireplace Insert
                            9 Pool Heater   9 Roof top HVAC (roof plan with approved screening required).
                            9 Other: ____________________________________________________________________

ELECTRICAL:                 9   Appliances (list): ____________________________________________________________
                            9   Equipm ent (list with ratings): __________________________________________________
                            9   Service Change (list AMPS): __________________________________________________
                            9   Switches/Receptacles (list num ber of each): ______________________________________
                            9   Lights (list num ber of each): ___________________________________________________
                            9   Sign                           9 Other: ____________________________________________

PLUM BING:                  9   Fixtures:     # New:_____       # Replace:_____       9 Sewer Connection 9 Pum p
                            9   Septic:       9 New             9 Replace               (Encroachm ent Perm it if in ROW )
                            9   W ater Heater 9Gas              9 Electric            9 W ater Treatm ent Equipm ent
                            9   New Gas Line                    9 Other: ___________________________________________

********************************************************************************************************************************************
Plan Check Deposit: ___________                Receipt Num ber: _________ Date Rcvd: _________ Rcvd. By: _________

Fire by:__________ Date: __________ Fee: $_________ / Public W orks by: _________ Date;______ Fee: $_______

Planning by: ______ Date: __________ Fee: $_________ Zoning: ________ AI: $_________ GP Maint: $___________
                                                                                               Construction
Building by: _____ Date: __________ Fee: $__________ Valuation: $___________ Occupancy: ______ Type:______

Building Standards Fee: $___________                             TOTAL FEES                      $________________
                                                                 LESS PLAN CHECK DEPOSIT PAID: - $________________
                                                                 TOTAL FEES DUE:                 $_________________



ID # ___________ BUILDING PERMIT # _____________                                              RECEIPT # _______________
                    IMPORTANT REGULATIONS YOU NEED TO KNOW

180-DAY (SIX MONTHS) BUILDING PERMIT LIMITATION:

-Activity on building permits in the application plan check process is required within 180 days (six
months) following the date of application or the building permit application shall be deemed expired.

-Inspections showing progress on issued building permits must occur within every 180 days (six
months) following the date of issuance, or the building permit shall be deemed expired.

-One six month extension is allowed if requested in writing prior to expiration.

-It is the responsibility of the applicant/owner if either of the above circumstances is about to occur to
contact the Building Department.


APPROVED CONSTRUCTION PLANS:

-All construction must be completed per the stamped approved plans. No changes can be made in
the field and all proposed changes must be shown on revised plans and approved in writing PRIOR
TO CONSTRUCTION. Failure to adhere to the approved plans may result in the demolition and
subsequent rebuilding of the project in conformance with approved plans.

-If modifications are necessary, they must be approved in writing PRIOR TO CONSTRUCTION.
Requests for changes may be considered by the appropriate Commission or City Department and
approved or denied based on the circumstances of the case.


REQUIRED SIGNATURE (SUBMITTING APPLICANT):

By my signature below, I hereby certify that I have read, understand and will comply with all
information and regulations in this application. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a building permit
does not presume to give authority to violate or cancel the provisions of any other State or local law
regulating construction or the performance of construction.

Property Owner:__________________________________________                     Date:________________

Authorized Agent: ________________________________________                    Date:________________
(requires signed Owner/Agent form)

Licensed Contractor: ______________________________________                   Date:________________

Contractor License Number:_________________________________                   Exp Date:____________




IS YOUR CITY OF SCOTTS VALLEY BUSINESS LICENSE CURRENT: _______

								
To top