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CITY OF RANCHO MIRAGE
DEVELOPMENT SERVICES
BUILDING AND SAFETY DIVISION
69-825 Highway 111, Rancho Mirage, CA 92270
General: 760.202.9253 Inspections: Building@r
(For City Use Only)
Building Permit No.: ___
Planning □ Public Works □
General: 760.202.9253 Inspections: Building@ranchomirageca.gov
BUILDING PERMIT APPLICATION
PROJECT INFORMATION
| Site Address: ________ | Rancho Mirage, California 92270 | |
|---|---|---|
| Residential OR Commercial Description of Work | Est. Project Cost: $______ | |
| New Construction (including ADUs) ✿ Living Area (inc. A/C.) Sq. Ft.: ________ | HVAC Installation/Replacement Electrical Upgrade/New Panel/Sub Panel Water Heater Installation/Replacement Re-Roofing Pool/Spa Window Replacement, Enlarging opening? Yes/No PV Solar/Battery, Upgrading Existing: Yes/No System Size: ________ Battery: ________ | |
| Add. /Expansion Existing Structure, Sq. Ft. ________ | Re-Roofing Pool/Spa Window Replacement, Enlarging opening? Yes/No PV Solar/Battery, Upgrading Existing: Yes/No System Size: ________ Battery: ________ | |
| Conversion (e.g. Garage to living), Sq. Ft. ________ | Window Replacement, Enlarging opening? Yes/No PV Solar/Battery, Upgrading Existing: Yes/No System Size: ________ Battery: ________ | |
| Demolition, Sq. Ft. ________ | Window Replacement, Enlarging opening? Yes/No PV Solar/Battery, Upgrading Existing: Yes/No System Size: ________ Battery: ________ | |
| Other: ________ | System Size: ________ | |
 Note: Covered projects require the CALGREEN minimum 65% diversion of C&D material. No. Mods: ________ No. Inverters: ________ | ||
| a separate C&D Waste Management Plan must be submitted and approved prior to permit issuance. | ||
☐Residential OR ☐ Commercial
Site Address: _______________________________________________ Rancho Mirage, California 92270
Description of Work
INFORMATION
☐New Construction (including ADUs)
☐HVAC Installation/Replacement
Living Area (inc. A/C.) Sq. Ft.: _______________
Garage/Mech./Porch/Patio Sq. Ft.: ___________
☐Electrical Upgrade/New Panel/Sub Panel
☐Add. /Expansion Existing Structure, Sq. Ft. __________
☐Water Heater Installation/Replacement
☐Conversion (e.g. Garage to living), Sq. Ft. ____________
☐Re-Roofing
☐Add. /Expansion Existing Structure, Sq. Ft. __________
☐Demolition, Sq. Ft. ____________
☐Pool/Spa
☐Conversion (e.g. Garage to living), Sq. Ft. ____________
☐Other: ________________________________________
☐Window Replacement, Enlarging opening? Yes/No
☐Demolition, Sq. Ft. ____________
__________________________________________________________
☐PV Solar/Battery, Upgrading Existing: Yes/No
opening?
Yes/No
☐Other: ________________________________________
System Size: _______ Battery: ___________
Note: Covered projects require the CALGREEN minimum 65% diversion of C&D material. No. Mods: ________ No. Inverters: ________
System Size: _______ Battery: ___________
a separate C&D Waste Management Plan must be submitted and approved prior to permit issuance.
a separate C&D Waste Management Plan must be submitted and approved prior to permit issuance.
OWNER INFORMATION
ARCHITECT/DESIGNER INFORMATION
| Name: | |
|---|---|
| Telephone No.: | |
| Email Address: | |
| Mailing Address: |
Name: ______________________________________
Telephone No.: ________________________________
Lic. No. _____________Bus Lic. No. _______________
Name: ______________________________________
Telephone No.: ________________________________
Email Address: ________________________________
Email Address: ________________________________
Mailing Address: ______________________________
_____________________________________________
Mailing Address: ______________________________
_____________________________________________
_____________________________________________
Name: ___
Lic. No. ___Bus Lic. No. ___
Telephone No.: ___
Telephone No.:
Email Address: ___
Mailing Address: ___
Mailing Address:
___
CERTIFICATION
TRANSPARENCY NOTICE: Some or all of the content contained in this application and its attachments may be subject to disclosure pursuant to the California Public Records Act (Government Code section 6250, et seq.)
Application is hereby made to the Building Official for a permit subject to the conditions and restrictions set forth.
1. Each person upon whose behalf this application is made and each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application agrees to and shall indemnify and hold harmless the City of Rancho Mirage, its officers, agents and employees.
Any permit issued as a result of this application becomes null and void if work is not commenced within ONE HUNDRED EIGHTY
DAYS from the date of issuance of such permit.
I certify that I have read this application and state that the above information is correct. I agree to comply with all City and State laws relating to the building construction and hereby authorize representatives of the City to enter upon the above-mentioned property for inspection purposes. I also understand that utilities will not be released until such times as all laws, codes and special conditions are completed and accepted by the City. By signing this application, I attest that the property owner has granted consent to apply for the permit and that the associated plans can be released to the property owner at any time.
Date: __/____/____ Name:
SIGN
___
Date: ____/____/______ Name: __________________________________
_____________________________________________________________