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DECLARATION BY PERMIT APPLICANT

COMMUNITY DEVELOPMENT DEPARTMENT PERMIT CENTER SERVICES

345 NORTH EL DORADO STREET STOCKTON, CA 95202-1997

PH: (209) 937-8561 FAX: (209) 937-8893

Permit #

Date

APPLICATION FOR PERMIT

Project Location: Address:______________________________________________________________________________ Suite #:________________

Subdivision:_________________________________________ Lot #:_______________ Parcel # (APN):__________________________________________

Property Owner: Name:________________________________ Phone:_____________________ Email:______________________________________

Mailing Address:_______________________________________________ City:____________________________ State:_________ Zip:______________

Licensed Contractor: Name:_______________________________ Phone:__________________ Email:_____________________________________

Mailing Address:_______________________________________________ City:____________________________ State:_________ Zip:______________

Contractor State License #:_______________________________ City Business License #:______________________ Ex. Date:______________________

Architect/Engineer: Name:________________________________ Phone:___________________ Email:_____________________________________

Mailing Address:_______________________________________________ City:____________________________ State:_________ Zip:______________

Project Contact: Name:__________________________________ Phone:___________________ Email:______________________________________

Mailing Address:_______________________________________________ City:____________________________ State:_________ Zip:______________

Permit Holder: Property Owner* Contractor** To-be-determined (plan review requests only)

* Completed and signed owner/builder form required **”Authorized to Sign” form required if other than contractor applies

Plan Review Process: Standard Paper Submittal Electronic Plan Check

Applicant is: Property Owner Contractor Architect/Engineer Other: ________________________

BY MY SIGNATURE BELOW I CERTIFY TO EACH OF THE FOLLOWING STATEMENTS:

I have read this application and the information I have provided is correct. I agree to comply with all applicable City and County ordinances,

rules, regulations, and State laws relating to building construction, and with any and all conditions of this permit. I authorize representatives

of the City of Stockton to enter the above mentioned property for inspection purposes.

Applicant’s Signature____________________________________ Print Name_________________________________________ Date__________________

This section to be completed by City staff: DISCIPLINE ROUTING (check all those that apply)

□ Building □ Fire Prevention □ Planning □ Public Works/Engineering □ Municipal Utilities □ Other_____________________

Project Type: Commercial Residential Master Plan Production Home — Template #____________________

New Construction Addition Tenant Improvement Alteration Demolition Other:___________________________________

State Licensed Facility? _____Yes _____No If yes, OSHPD-III Certification Required? _____Yes _____No Flood Zone: ______________________

Construction Type:_________ Occupancy Type:_____________ Existing Use:____________________ Proposed Use:______________________

Is Building Sprinklered? _____Yes _____No Is Building Conditioned? _____Yes _____No # of Stories:________ # of Dwelling Units:_______

Area Determination:

1st Floor:_____________sf 2nd Floor:_____________sf 3rd Floor:_____________sf 4th Floor:_____________sf Total Bldg:_____________sf

Garage:______________sf Patio/Porch:_____________sf Deck/Balcony:_____________sf Other:_____________________ _____________sf

SCOPE OF WORK:

The applicant shall provide an estimated permit value at time of application. Permit valuations shall include total value of work, including materials and labor. Valuations shall be based on FAIR MARKET VALUE for labor and materials, even if performing the work yourself. Final building permit valuation shall be set by the building official. New construction will be based on City established per square foot cost.

VALUATION: $

Applicant RESIDENTIAL SUBMITTAL CHECKLIST City Staff

Yes No Items Yes No

Planning Division Approval:

Project complies with all setback requirements and has been approved by Planning to submit for building permit.

Project has received approval of any required planning permits and the building permit plans reflect all conditions from that process. (Design Review, Site Plan Review, etc)

Required Documentation:

One completed Application for Permit

Three (3) complete sets of construction drawings, signed by the designer. Minimum 18” x 24” size paper to include:

1. Site plan drawn to scale showing property lines, north arrow, easements, and all development.

2. Floor plans showing existing and proposed layouts.

3. Building elevations (north, south, east, and west views).

4. Foundation plan with representative details.

5. Roof plan with representative details.

6. Framing sections and other details necessary to construct the project.

Two (2) copies of truss layout and calculations, signed by the truss designer. (if applicable)

Two (2) copies of engineering calculations, signed by the architect/engineer-of-record (if applicable)

1. Engineering calculations will be required for any unusual design which deviates from substantial compliance

with conventional framing requirements for woodframe construction found in the California Residential Code.

2. All engineering plans and calculations shall be stamped and signed by a California licensed architect or

engineer.

Two (2) copies of energy code compliance calculations (if applicable)

Two (2) copies of FEMA Flood Elevation Certificate (if applicable)

Two (2) copies of City of Stockton 200-Year Flood Elevation Certificate (if applicable)

Plan check deposit

Applicant COMMERCIAL SUBMITTAL CHECKLIST City Staff

Yes No Items Yes No

Planning Division Approval:

Project complies with all setback requirements and has been approved by Planning to submit for building permit.

Project has received approval of any required planning permits and the building permit plans reflect all conditions from that process. (Design Review, Site Plan Review, etc)

Required Documentation:

One completed Application for Permit

Five (5) complete sets of construction drawings. Two of the sets must be signed by the architect or engineer. Minimum

18” x 24” size paper to include:

1. Cover sheet indicating scope of work, applicable codes, type of construction, occupancy, etc.

2. Site plan drawn to scale showing property lines, north arrow, easements, and all development. Site utility plan

showing all points of connection to city sewer, storm drain, and water.

3. Floor plans showing existing and proposed layouts, room usage, occupancy, etc.

4. Structural plans and representative details as required.

5. Plumbing and mechanical plans.

6. Electrical plans including a complete one-line diagram of the service.

7. Energy code compliance forms imprinted on full size plan sheets.

8. Accessibility compliance

Two (2) copies of truss layout and calculations, signed by the truss designer. (if applicable)

Two (2) copies of engineering calculations, signed by the architect/engineer-of-record (if applicable)

One completed Air Pollution Control District (APCD) Compliance form

One completed Hazardous Materials Disclosure form (OES form)

Two (2) copies of FEMA Flood Elevation Certificate (if applicable)

Two (2) copies of City of Stockton 200-Year Flood Elevation Certificate (if applicable)

One completed Accessibility For Existing Buildings Compliance form (if applicable)

Plan check deposit