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<br />EFFECTIVE DATE: March 5, 2025 <br /> <br />BUILDING PERMIT QUESTIONNAIRE <br />This questionnaire needs to be completed and included with the plan check package submitted to the <br />Building and Safety Division when filing for a building permit online for the project described below. Its <br />purpose is to ensure the plans are checked in a timely manner and the project is built according to the <br />approved plans. We appreciate your cooperation and if you have any questions, please contact the Planning <br />Division at (925) 931-5600 / pod@cityofpleasantonca.gov. <br /> <br />1. Applicant’s Name and Address: <br /> <br /> Guy Houston, California Gold Advocacy Group, 6300 Village Parkway, Suite 200, Dublin, CA 94568 <br /> <br />2. P24-0732, Project Address: 4212 First Street <br /> <br />3. Description of the project for which a permit is being requested: <br /> <br />Install new monument, wall, and canopy signage as part of a gas station rebranding for Gulf <br />Gas Station <br /> <br />4. Do you certify that the plans submitted for issuance of building permits conform in every respect to <br />the approved plans and to all conditions of approval? ___YES ___NO <br /> <br />5. If the answer to question No. 6 is ‘NO,’ please list every item on the building permit plans which <br />differs from the approved plans or conditions of approval. Use the reverse side or attach additional <br />sheets if necessary. All changes to the approved plans should be clouded with delta numbers (∆). <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />I hereby attest the above is true and correct. I understand that failure to correctly answer these questions <br />may result in a delay of issuance of building permits and if changes are discovered after the permit is issued, <br />I am responsible for revising the project to conform to the plans approved through the Planning Division. <br /> <br /> <br />_____________________ _________________________________ <br />Date Signature <br /> <br /> _________________________________ <br /> Phone Number <br /> <br /> _________________________________ <br /> Email <br /> <br /> <br />Page 37 of 399