Construction Permit Application - City Of Oxnard Development Services printable pdf download

APN _______________

ERMIT

ITY OF

XNARD

____-___________

Development Services - Building and Engineering

CONSTRUCTION PERMIT APPLICATION

Signatures Not Completed in the Presence of Department Staff Must be Notarized

IDENTIFY YOUR BUILDING PROJECT

Property Location or Address: _________________________________________________________________

This permit is to be issued in the name of the (_) Licensed Contractor or (_) the Property Owner as the

permit holder of record who will be responsible and liable for the construction.

Property Owner Information: Name __________________________________ Tel No_____________________

Mailing Address____________________________________________________________________________

Licensed Design Professional (Architect or engineer in charge of the project) Information:

Name _________________________________ License No._______________ Tel No____________________

Mailing Address____________________________________________________________________________

Description and valuation of work to be performed:_________________________________________________

IDENTIFY WHO WILL PERFORM THE WORK (Complete either 2a or 2b)

2a – CALIFORNIA LICENSED CONTRACTOR’S DECLARATION

I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with

Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.

Contractor Name and Address: ________________________________________________________________

License Class and No. _____________________ Contractor Signature ________________________________

2b – OWNER-BUILDER’S DECLARATION

I hereby affirm under penalty of perjury that I am exempt from the Contractors’ State License Law for the

reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5,

Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish,

or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement

that he or she is licensed pursuant to the provisions of the Contractors’ State License Law (Chapter 9

(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is

exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant

for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).):

(_) I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of

or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and

Professions Code: The Contractors’ State License Law does not apply to an owner of property who, through

employees’ or personal effort, builds or improves the property, provided that the improvements are not intended

or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner-

Builder will have the burden of proving that it was not built or

improved for the purpose of sale.).

(_) I, as owner of the property, am exclusively contracting with licensed Contractors to construct the

project (Section 7044, Business and Professions Code: The Contractors’ State License Law does not apply to

an owner of property who builds or improves thereon, and who contracts for the projects with a licensed

Contractor pursuant to the Contractors’ State License Law.).

(_) I am exempt from licensure under the Contractors’ State License Law for the following reason:

_________________________________________________________________________________________

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CALBO Jan 1, 2009 Permit Application Template

Construction Permit Application - Signatures.doc

Construction Permit Application - City Of Oxnard Development Services

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