HomeMy WebLinkAboutOriginals _ Affidavit for Copy _ Owner Consent _ ArchEng Consent _ Updated 10-06-2021
951-674-3124
130 S. Main Street
Lake Elsinore, CA 92530
Affidavit for Copy of Plans
I am requesting copies of plans for a structure located at ,
and currently on file with the City of Lake Elsinore.
Requestor ’s name:
Requestor ’s address:
Requestor ’s phone number:
Requestor’s email:
I acknowledge and agree to the following conditions per Health and Safety Code Section 19850 and
19851, regarding the use of the copies:
1. The copy of the plans shall only be used for the maintenance, operations, and use of the
building.
2. Drawings are instruments of professional service and are incomplete without the interpretation
of the certified, license, or registered professional of record,
3. That subdivision (a) of Section 5536.25 of the California Building and Professional Code states
that a licensed architect who signs plans, specifications, reports, or documents shall not be
responsible for damage caused by subsequent changes to, or use of, those plans, specifications,
reports, or documents where the subsequent changes or uses, including changes or uses made
by state or local government agencies, are not authorized or approved by the licensed architect
who originally signed the plans, specifications, reports, or documents, provided that the
architectural service rendered by the architect who signed the plans, specifications, reports, or
documents was not also a proximate cause of the damage.
Signature: Date:
I am the property owner (must sign below).
I declare under the penalty of perjury under the laws of the state of California that the forgoing is true
and correct.
Signature: Date:
I am not the property owner. Property owner signed consent is attached.
951-674-3124
130 S. Main Street
Lake Elsinore, CA 92530
PERMISSION TO COPY
(Certified, Licensed, or Registered Professional)
The city of Lake Elsinore has received a request (see attached affidavit) to provide copies of plans,
documents, or calculations for a structure at the subject address that where prepared, stamped and /
or signed by :
Subject address: , Lake Elsinore, California.
Project Architect:
Name:
Firm:
Plan Information:
Client/Developer:
Project Name:
Project/Job Number:
Per Health and Safety Code Section 19851, we are requesting your permission to provide a copy
to the requestor. The requestor has agreed to use the document in accordance with the terms of
the enclosed affidavit. A copy of Health and Safety Code Section 19851 has been included for
your reference.
Please sign below, indicating your permission for the City of Lake Elsinore to provide a copy of
the requested plans to the requestor. If request is denied, please provide reason. We must have
your response within 30 days of receipt of this request. If you are unable to respond to this request
within 30 days due to illness, travel, or other extenuating circumstances, please contact the City of
Lake Elsinore City Clerk’s Department at (951) 674-3124, extension 269.
Please be aware that under Health and Safety Code Section 19851, Section F-1, if we do not hear
from you within 30 days, or in special circumstances 60 days, the City may release a copy of the
plans to the requestor.
Permission Granted Permission denied (please provide reason for denial)
Name: Date:
Signature:
Please return this form to the City of Lake Elsinore Clerk’s Department, 130 South Main Street, Lake Elsinore,
California, 92530, fax (951) 245-5322, or by email at lreyes@lake-elsinore.org as soon as possible.
951-674-3124
130 S. Main Street
Lake Elsinore, CA 92530
OWNER CONSENT FOR COPY OF PLANS
Please provide copies of plans for the structure at
(Address)
to .
(Requestor’s name)
Owner of Structure (s)
I, the undersigned, attest that I am the owner of the structure at the above address, and I hereby consent to
the City of Lake Elsinore to provide copies of the plans to the person noted above.
Governing Body for common Interest Development
I, the undersigned, attest that: (1) I am a representative of the board of directors or governing body of the
association established to manage the common interest development of which the structure at the above
address is part; (2) I have the authority to sign this Owner Consent for Copies on behalf of such board of
directors or governing body; and (3) the board of directors or governing body consents to the City of Lake
Elsinore providing copies of the plans to the person noted above.
Owner’s Name:
Owner’s Address:
Owner’s Number:
Owner’s E-mail:
Owner’s Signature: Date:
Title: (representative of association)
Please retune this form along with the signed Affidavit.