Overtime Request Form - Santa Clara County Fire Department
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1Santa Clara County Fire Department
Overtime Request Form
Requests will only be accepted via email. Please email this form to
.
Permitee Name: ___________________________________ Phone Number: (______)_________-_________
Project Address: ____________________________________________________________________________
Overtime Plan Review
Fire Department Plan Check # for unincorporated only: (i.e. unincorporated 14-123) _________________________
The Fire Prevention Division will contact you within 2 business days with overtime status. If selected for overtime,
we will notify you upon completion with the plan review status (approved/not approved) and fee amount due.
Permits and/or comments will not be given until expedited plan check fees have been paid in full.
Please Note: Not all requests will be granted.
q I understand there is an overtime fee due upon completion (see below regarding fee rates).
Fire Prevention Staff use Only:
Date Received ______________________ Plan Due Date _______________ PC # _____________________________
Assigned Personnel: _______________ Expected Date of Review ___________ Hrs Worked: ______ Approved? Y N
Upon completion, assigned personnel will fill out italic portion above and return to staff with plans.
Overtime Inspection
Fire Department Plan Check #: (i.e. incorporated 14-1234 or unincorporated 14-123) _____________________
Requested Inspection Date: ________________________
Inspection Time: _____________________
(one date only)
The Fire Prevention Division will contact you within 2 business days with overtime status. If granted, we will
notify you with fee amount. Depending on location, additional travel time may be added to the fee amount.
Please Note: Not all requests will be granted.
q I understand there is an overtime fee due prior to inspection (see below regarding fee rates).
q A 24 battery test is required for this inspection.
Anticipated length of inspection. ______ hrs
Fire Prevention Staff Use Only:
Date Received _______________________________
PC # ______________________________________
Assigned Personnel: _____________________________________________
Paid?
Y
N
Estimated Hours of Overtime: ____________ Actual Hours of Overtime: _______________
Prior to inspection, staff will give this form to assigned personnel along with proof of payment. Upon
completion, assigned personnel will return to clerical staff actual hours worked if different than hours charged.
Overtime Fee Rates:
Project Location: (click one)
Incorporated: District cities/towns: $105
q Incorporated: Fire District (Cities & Towns)
•
q Unincorporated: County Fire Marshal Office
Unincorporated: County Fire Marshal Office: $215
•
_____________________________________
Acknowledge by typing name here
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