Building Division - Forms

Email your application forms to:  

AGENCY APPROVAL FORM  - Agency Acknowledgement and Verification Signatures (i.e., Fire District, Water Supplier, Environmental Management, Air Quality Management, Police Department, Engineering Department, Planning Division, Building Division) required prior to final and issuance of a Certificate of Occupancy.  

CONSTRUCTION PERMIT FORMS LISTED BY PART NUMBER:  The forms listed below allow you to pick the forms that are specific to your construction needs.  

Construction Permit Application: Part 1

Owner Builder Declaration (Residential only) (Read: What is an Owner-Builder?)

Water-Conserving Plumbing Fixtures per SB 407PART 4:  (required if doing a remodel where plumbing is involved).   

Re-roof and cool roof verification form: PART 5A (Residential only, Commercial must have CA State form)   

Re-roof shortened Prescriptive Residential Alteration formPART 5B (cool roof only)   

Application Approval Signature of Other AgenciesPART 6

Asbestos Notification at Demolition of Building: PART 7A

Bond and Insurance Verification for Demolition PermitPART 7B

Lead Paint Notification Renovation Pre-1978PART 8

LPG, HVAC, Setback Supplement form: PART 9 (Provide a site plan drawing locating the item(s) that will be permitted).   

Window Fenestration InformationPART 10A

Window Fenestration Prescriptive Residential Alterations California short formPART 10B

Domestic Water Heater DWH Information: PART 11A

Domestic Water Heater T-24 California VersionPART 11B

PART 12   

    A:  Waste Management for Commercial Projects   

    B:  Waste Management for Residential Projects   

   Section C. Materials Waste Management Plan   

   Section D. Materials Waste Management Company   

   Section E. Waste Stream Reduction Alternative (low rise residential)   

    C:  Waste Management Supplement Anticipated Tables   

    D:  Waste Management Supplement Actual Tables   

Special Inspection and Testing Agreement: PART 13

Grading application and informationPART 14

Encroachment application and informationPART 15

PV Solar Expedited Checklist (updated 3/22/2021; read carefully)

Water and Sewer application informationPART 17

Single Family Dwelling submittal checklistPART 19




 Development Services Department,  Building Division 
 City Hall, Second Floor
 3101 Center Street
 Placerville, CA 95667
 For general inquiries or to request an appointment: (530) 642-5240
 To request an inspection 24 hours a day: (530) 642-5241