SUPPLEMENTAL MATERIAL - Laserfiche WebLink

EFFECTIVE DATE: March 5, 2025 BUILDING PERMIT QUESTIONNAIRE This questionnaire needs to be completed and included with the plan check package submitted to the Building and Safety Division when filing for a building permit online for the project described below. Its purpose is to ensure the plans are checked in a timely manner and the project is built according to the approved plans. We appreciate your cooperation and if you have any questions, please contact the Planning Division at (925) 931-5600 / [email protected]. 1. Applicant's Name and Address: Guy Houston, California Gold Advocacy Group, 6300 Village Parkway, Suite 200, Dublin, CA 94568 2. P24-0732, Project Address: 4212 First Street 3. Description of the project for which a permit is being requested: Install new monument, wall, and canopy signage as part of a gas station rebranding for Gulf Gas Station 4. Do you certify that the plans submitted for issuance of building permits conform in every respect to the approved plans and to all conditions of approval? _YES NO 5. If the answer to question No. 6 is `NO,' please list every item on the building permit plans which differs from the approved plans or conditions of approval. Use the reverse side or attach additional sheets if necessary. All changes to the approved plans should be clouded with delta numbers (0). I hereby attest the above is true and correct. I understand that failure to correctly answer these questions may result in a delay of issuance of building permits and if changes are discovered after the permit is issued, I am responsible for revising the project to conform to the plans approved through the Planning Division. Date Signature Phone Number Email