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200 S. Anaheim Blvd., Suite 145 Anaheim, California 92805 (714)765-5153 Phone (714)765-4607 Fax www.anaheim.net/building OCT 2013 B811 CITY OF ANAHEIM PLANNING DEPARTMENT BUILDING DIVISION DUPLICATION OF BUILDING PLANS AUTHORIZATION FORM Pursuant to Health and Safety Code Section 19851, the original or current owner of the subject building (or if a common interest development, the Board of Directors or similar governing body established to manage the building) and certified, licensed or registered professional or his or her successor who signed the original document must authorize the duplication of issued building permit construction plans maintained by the Planning Department, Building Division. Plan Duplication Request for: (Type or Print Property Address or Tract Number) I DECLARE THAT I AM: (Check One) The original or current owner of the property described above; The certified, licensed or registered professional or his or her successor who signed the original documents on the above described property; or The authorized representative of the Board of Directors or other governing body of the association established to manage the above described building, and have the authority to sign on behalf of the governing body. AUTHORIZATION OR REFUSAL I, authorize the City of Anaheim to duplicate the building plans described above pursuant to the plan duplication request. Further, a facsimile of my signature may be used for the limited purpose set forth herein. I, refuse authorization for the City of Anaheim to duplicate the building plans described above pursuant to the plan duplication request. Further, a facsimile of my signature may be used for the limited purpose set forth herein. Signature: Date: Please mail within ten (10) days of receipt to: NAME MAILING ADDRESS