FOR USE BY REGISTERED CONTRACTORS ONLY BUILDING DIVISION TECHNICAL BULLETIN FX-1 FAXMIT CONSTRUCTION PERMIT REGISTRATION FORM The City of Novato will accept applications and issue permits to preregistered licensed contractors for minor work via facsimile (FAX). Payment must be made by MasterCard or Visa credit card faxed with a completed application. Currently, this unique service is limited to the following projects: PLUMBING ELECTRICAL MECHANICAL BUILDING Water Heater Replacements Repair Gas or Water Line Waste Line Repair Add Gas Line to New Domestic Appliance, i.e., Cooktop Service Upgrade Up to 200 AMP Maximum Minor Electrical, i.e., Adding Single Branch Circuit Replace Furnace/Heater Add or Replace A/C Unit (Excluding New Rooftop Mounts) Add Residential Ventilation Fan, i.e. Bathroom Fan Boiler Fireplace Insert Re-roofing and Resheathing Installing Skylight(s) (Include Dimensioned Detail, Framing, and Manufacturer s Description) Tube Lights Exterior Siding Repair Replacement Windows [Same size only.] To quality for this service, it is necessary to register with the City the names and signatures of persons authorized to obtain permits for your company. All legal requirements must be complied with, such as contractor s license and workers compensation declaration. Your City Business License must be current. The Finance Department does not accept faxed business license applications at this time. Please follow the steps noted below: 1. Complete a FAXMIT Permit Registration Form (p. 2 of 6) and a FAXMIT Permit Worksheet (p. 4 of 6). All sections and declarations must be completed and signed. Illegible and incomplete credit card application form cannot be processed. Mail the completed original registration form (p. 2 of 6) to: City of Novato, Building Division, 922 Machin Avenue, Novato, CA 94945. Make copies of the FAXMIT construction permit worksheets for your information and future submittals. You will be notified as soon as the information is verified. 2. Once registered, you may fax your FAXMIT permit worksheets pp. 4 & 5 of 6 (and 6 if reroof) along with credit card payment information to the City of Novato at (415) 899-8216 and your FAXMIT permit and Inspection Card will be faxed to you. Do not commence work until you have received your approved FAXMIT permit. 3. To pay for permits by MasterCard or Visa, indicate credit card and authorized signatures on the registration form (p. 2 of 6). A COPY OF THE PERMIT SHALL BE MAINTAINED ON THE JOB SITE DURING CONSTRUCTION. If you have any questions regarding this process or need additional forms or permit information, please visit our website at www.novato.org/building or contact the Building Division at (415) 899-8989. If you wish to schedule an inspection following your approval, please call the automated Inspection Request Line at (415) 899-8240 before 6:00 AM of the day the inspection is needed. July 2015 City of Novato Building Inspection Division Technical Bulletin FX-1 Page 1 of 5
Community Development Department Building Division FAXMIT Permit Registration Form Company Name Street Address City/Zip Phone Number FAX Number Contractor s State License No./Class/Expiration Date Email Address: Visa MasterCard Credit Card No. Name on Card Expiration Date The following employees have my permission to apply for construction permits and to use the above credit card to obtain construction permits in the name of my company. Authorized Cardholder s Name (Type or Print) The undersigned gives the City of Novato permission to accept a facsimile of any of the above signatures on a FAXMIT application in lieu of an in-person signature. I hereby certify that I will comply with all declarations and agreements on the FAXMIT permit worksheet application. Contractor s Name Date Mail this form to: City of Novato, 922 Machin Avenue, Novato, CA 94945-5054 OFFICE USE ONLY: Approved by Date File No. July 2015 City of Novato Building Inspection Division Technical Bulletin FX-1 Page 2 of 5
FAXMIT Permit Worksheet (Declarations) PLEASE PRINT OR TYPE CITY OF NOVATO Page 5 must be completed as part of this worksheet. Project Address: 922 Machin Avenue Novato, CA 94945-5054 Phone: (415) 899-8989 Fax: (415) 899-8216 Fax: (415) 899-8216 LIABILITY DECLARATIONS To obtain this permit, the undersigned hereby files this application and agrees, certifies, and declares: Notice has been given to me that this permit may be used only in compliance with the Novato Municipal Code and all other applicable ordinances and laws. This permit does not allow occupancy of the construction for which this permit is issued until it has been approved in writing by the City of Novato for occupancy after final inspection. This permit does not allow additional work to be performed. Separate permits are required for any plumbing, electrical, heating, air conditioning work, and the handling of hazardous materials. I agree to comply with all City and County ordinances and State laws relating to building construction and hereby authorize representatives of the City of Novato permission to enter the job premises at any reasonable time to inspect any work installed under this permit and remove any nonconforming construction at my expense. LICENSED CONTRACTOR S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Exp. Date Date: Contractor: CSLB License: Contractor Address: CSLB License Class: City: State: Zip Code: Contractor Email: City of Novato Contractor Phone: ( ) Business License: Contractor Fax: ( ) WORKERS COMPENSATION DECLARATION I hearby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self-insure for workers compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers compensation insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers compensation insurance carrier and policy number is: Carrier Exp.Date Policy# I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the workers compensation laws of California and agree that if I should become subject to the workers compensation provision of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date Applicant WARNING: Failure to secure workers compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000) in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest, and attorney s fees. OFFICE USE ONLY DATE: PROCESSED BY: RECEIPT NO.: PERMIT NO: July 2015 City of Novato Building Inspection Division Technical Bulletin FX-1 Page 3 of 5
FAXMIT Permit Worksheet (Fees) Effective: February 27, 2012 Completed applicable Energy Code Forms** must be included with completed FAXMIT Permit Worksheet. Project Address: Job Description: Valuation Flat Fee Item Only $ Valuation Non-Flat Fee Item(s)$ Total Job Valuation $ Owner Name: Address: City: State: Zip: Phone No.: ( ) Flat Fee* Permits Residential Only Owner Email: Flat Fee* Water Heater [50 gallon or less]** Furnace Replacement** Furnace and A/C Replacement** Window or Sliding Door Replacements (1-8)** Window or Sliding Door Replacements (9 + )** $ 39.90 $ 93.23 $ 93.23 $ 93.73 $127.61 *Flat fee permits include surcharges, plan storage, seismic and green building fees. Valuation Based Permits [Not Flat Fee] [Residential and Commercial] Job Valuation Fee Plan Storage Total Due PLUMBING: Water Heater** [over 50 gallons] Repair Gas or Water Line Add Gas Line to New Appliance [i.e. Cooktop] Waste Line Repair ELECTRICAL: Service Upgrade to 200 AMP or Less Minor Electrical; i.e., Single Circuit MECHANICAL: Replace Furnace** [Commercial] Replace Furnace and A/C** [Commercial] Add A/C Unit** Add Ventilation [ex.: Bathroom Fan] Boiler Fireplace Insert BUILDING: Re-roof & Resheathing**[Supplemental Worksheet required] Tube Lights Exterior Siding Repair or Replacement Less than $2,000 $2,001 to $3,000 $3,001 to $4,000 $4,001 to $5,000 $5,001 to $6,000 $6,001 to $7,000 $7,001 to $8,000 $8,001 to $9,000 $ 9,001 to $10,000 $10,001 to $11,000 $11,001 to $12,000 $12,001 to $13,000 $13,001 to $14,000 $14,001 to $15,000 Valuations above $15,001 call (415) 899-8989 for fee. $ 90.54 $ 107.48 $ 124.42 $ 141.36 $ 158.30 $ 175.24 $ 192.18 $ 209.12 $ 226.06 $ 243.00 $ 259.94 $ 276.88 $ 293.82 $ 310.76 $ 94.44 $ 111.38 $ 128.32 $ 145.26 $ 162.20 $ 179.14 $ 196.08 $ 213.02 $ 229.96 $ 246.90 $ 263.84 $ 280.78 $ 297.72 $ 314.66 PAYMENT METHOD: CHECK (Authorization Form Attached) or CREDIT CARD (Credit Card on Registration Form) AMOUNT $ [Required] Applicant : Fax No.: ( ) [Required] Date: APN: - - (Completed By City) Permit No.: - July 2015 City of Novato Building Inspection Division Technical Bulletin FX-1 Page 4 of 5
Building Inspection Division Job Address Cool Roof Required (Energy Code) City of Novato Supplemental Application for Reroofing Permit To schedule an inspection, call the automated Inspection Request Line by 6 AM for same day inspection: 415-899-8240. Address located in Wildland Urban Interface Fire Area ( WUI ) Community Development Department Permit Number YES NO ( Staff initial only) YES NO ( Staff initial only) Type of Occupancy: Commercial Residential Single-family Apt./Condo. Work may require closure of public sidewalk and/or public street parking areas for protection of workers, pedestrians and/or to stage equipment and materials. YES NO Type of Roofing to be installed (must be compatible with roof structure/diaphragm): Built-up Tar & Gravel Metal Shingle New Venting ( WUI requirement) Composition Shingle Concrete, Slate or Tile Gutter Covers (WUI requirement) New Skylight(s) New Sheathing: Specify Materials Radiant Barrier required when sheathing is installed (Green Building requirement). Wood Shake (fire retardant) Other (describe) Type of Existing Roofing (please specify): Complete Tear Off: Yes No Number of roofs on existing building? Fire Rating of New Roof: Class A Class B Note: Class C not approved in Novato. Note: This permit is void if work is not commenced, abandoned or approved within a 180-day period from the date the permit is issued. I hereby acknowledge that I have read this application and state that the above is correct and agree to comply with all City Ordinances and State laws regulating building construction. Structural integrity of existing roof frame is assumed to be sound and not validated by this approval. An in-progress inspection is required (with no more than 30% of new roof covering applied) and a final inspection when the job is complete. It is the responsibility of the applicant to secure an in-progress inspection and final approval. Refer to 2013 California Residential Code, Chapter 9 and the 2013 California Building Code, Chapter 15, for technical requirements. Resheathing, repair of framing, addition of skylights, or alteration of existing framing requires separate inspections and may require plans. Failure to obtain final inspection within 180 days shall make this permit null and void. Additional fees shall be required for a new permit. of Applicant July 2015 City of Novato Building Inspection Division Technical Bulletin FX-1 Page 5 of 5 Date Gutter Covers included in Final Inspection Final for Cool Roof Residential Reroof CF-6R-ENV-01