Construction Demolition Permit

CONSTRUCTION DEMOLITION PERMIT

Permit Number:     Date Issued:

WHEREAS

WHEREAS, the applicant seeks authorization to demolish or remove a structure located at the property described below in accordance with applicable building codes, environmental laws, and local ordinances; and

WHEREAS, the permitting authority has the statutory power to issue demolition permits subject to conditions that protect public health, safety, utilities, and cultural resources; and

WHEREAS, issuance of this permit constitutes limited authorization to proceed only upon the express conditions, inspections, fees, and approvals set forth in this document.

APPLICANT INFORMATION

PROPERTY / PROJECT INFORMATION

Parcel / APN:     Existing Structure Type:

Year Built:     Stories:     Estimated Demolition Cost: $

CONTRACTOR / DEMOLITION OPERATOR

SCOPE OF WORK

HAZARDOUS MATERIALS / ASBESTOS ABATEMENT

Asbestos survey completed: Yes     Abatement required: Yes

UTILITIES / DISCONNECTS

Applicant certifies that the following have been notified and disconnected where applicable:

Gas     Electric     Water     Sewer     Other:

INSPECTIONS AND APPROVALS

Required inspections (check all that apply): Pre-demolition condition survey     During demolition progress     Final site inspection

PAYMENT TERMS

Permit Fee: $     Payment Method:

Payment Schedule / Due Date:

Late Fee / Interest for unpaid amounts:

BOND OR SECURITY

Bond required: Yes     Bond Amount: $

TERM AND TERMINATION

Authorized start date:     Anticipated completion date:

Permit term may be revoked or suspended for failure to comply with conditions, failure to pay fees, or where public health or safety is at risk. Notice period for voluntary termination by applicant:

CONDITIONS AND LEGAL REQUIREMENTS

Compliance with Codes: All demolition work must comply with applicable building codes, public safety regulations, environmental statutes, and local ordinances. The permit holder is responsible for securing any additional permits required by other agencies or authorities with jurisdiction.

Indemnification: The applicant agrees to indemnify, defend, and hold harmless the permitting authority, its officers, employees, and agents from and against any claims, liabilities, fines, penalties, costs and expenses (including reasonable attorney fees) arising out of or related to the performance of demolition work, except to the extent caused by the gross negligence or willful misconduct of the permitting authority.

Insurance: Prior to commencing work, the contractor must maintain general liability and other insurance as required by the permitting authority and name the permitting authority as an additional insured where required. Proof of insurance must be submitted with this application.

Site Restoration: Upon completion of demolition, the site must be secured, graded, and restored or stabilized as required. Debris, hazardous materials, and waste must be removed and disposed of in accordance with applicable law.

Right of Entry; Inspections; Revocation: Authorized representatives of the permitting authority may enter the site at reasonable times to inspect work. The permitting authority may suspend or revoke this permit for material noncompliance or for false statements in this application.

CONFIDENTIALITY

Records and documents submitted in connection with this permit are subject to public records laws. To the extent the applicant designates any portion as confidential, the permitting authority will handle such designations in accordance with applicable law; however, the permitting authority does not guarantee nondisclosure beyond applicable legal protections.

GOVERNING LAW

This permit and any dispute arising under it shall be governed by the laws of the state in which the property is located, without regard to conflicts of law principles.

ENTIRE AGREEMENT

This permit, together with any approved plans, supporting documents, and conditions imposed by the permitting authority, constitutes the entire agreement between the parties with respect to the authorized demolition work and supersedes all prior representations or agreements, whether written or oral.

APPLICANT CERTIFICATION

By signing below, the applicant certifies under penalty of perjury that the information provided is true and correct, that the applicant is authorized to undertake the work described, and that the applicant will comply with all conditions, laws, and regulations applicable to the demolition work.

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