Lifornia 90012 Phone (916) 440-8300 Phone (213) 897-0166 www.oshpd.ca.gov/fdd FAX (916) 324-9188 FAX (213) 897-0168 Application for AB 2632 Project Building Permit Name of Facility: Phone: OSHPD # Address: A Fax: Sub # Zip: Facility ID # City: County: Name of Legal Owner: E-mail: Address: Phone: Fax: City: State: Zip: Type of Project: Name of Facility Representative: Phone: Fax: City: State: Type of Facility: E-mail: Address: Annual Permit ( G Project) (Submit.
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How to fill out the Ab 2632 Form online
The Ab 2632 form is necessary for obtaining a project building permit for various healthcare facilities. This guide will walk you through each essential step in filling out the form online, ensuring you complete it accurately and efficiently.
Follow the steps to fill out the Ab 2632 form online effectively.
- Click ‘Get Form’ button to obtain the Ab 2632 form and open it in your browser's online editor.
- Enter the facility name as registered on the facility license, along with the complete address, including city, county, zip code, phone number, and fax number.
- Fill in the legal owner's name, email address, phone number, and address details.
- Provide the facility representative’s name, with their contact information including email, phone, and address.
- Briefly describe the scope of the project in no more than 45 characters.
- If applicable, enter the applicant job number and the OSHPD number, if known. Otherwise, leave it blank.
- Select the type of project by checking the appropriate box for ‘Annual Permit’ or ‘S Project’.
- Indicate the type of facility being addressed.
- In the description section, detail the work to be performed and explain how it complies with the Health and Safety Code, attaching additional pages if needed.
- Enter the estimated construction cost or contract amount.
- Identify the responsible individual for the construction work, including their contact details and specify whether they are the owner or contractor.
- Fill out the special conditions section if required, or leave blank for OSHPD use.
- Complete the licensed contractor declaration, including the license class, number, and signature.
- Complete the workers compensation declaration, including policy details and attach necessary documents if applicable.
- If you are an owner-builder, fill out the appropriate declaration.
- If applicable, complete the construction lending agency details.
- Finalize by filling in the name and contact information of the individual submitting the application, and mark their role as the legal owner or agent.
- After ensuring all fields are accurately completed, save changes, and decide to download, print, or share the completed form.
Complete your Ab 2632 form online today and ensure a smooth application process.
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