CDA - Building Permit Extension/Renewal Request

Nevada County Building Department

950 Maidu Avenue | Suite 170 | P.O. Box 599002 | Nevada City, CA 95959 | buildingdept@nevadacountyca.gov | nevadacountyca.gov/1114/Building-Department | (530) 265-1222
Permit Extension/Renewal Request
1st Extension2nd ExtensionRenewal (half processing fee, half plan check/inspection fee)
Permit #*
Permit #
Assessor Parcel Number (APN) #
9 Digit Number
Name of Permit Applicant*

First NameLast Name
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Project address same as mailing address
Project Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Permit Type*
Permit Type
FinancialWaiting on professionalOther
If other, please explain*
If other, please explain
When do you expect to take action? (i.e. resubmit plans, schedule inspection, complete project)*
When do you expect to take action? (i.e. resubmit plans, schedule inspection, complete project)
Permits and applications are limited to two extensions. After one year of inactivity, additional permit fees will be charged. If permit or permit application is expired during code cycle change, applicant will reapply for new permit with current codes. Renewal fees for permit applications are based on half the plan check fees and half the permit processing fees. Renewal fees for permits are based on half the inspection fees and half the permit processing fee.
Signature
Applicant Signature
Date*

MonthDayYear
Expiration Date

MonthDayYear
New Expiration Date

MonthDayYear
YesNo
YesNo
Processing Fee
Processing Fee
Processed By
Processed By
Yes
Date

MonthDayYear
Should be Empty:

Nevada County Building Department

Permit Extension/Renewal Request

Signature