City of City of Ojai Ojai Community Development Development Department Department Community

BUILDING APPEAL APPLICATION Applicant(s) Name: Address: Telephone/Fax/E-mail: ATTACH ADDITIONAL INFORMATION IF NEEDED TO DESCRIBE THE APPEAL IN DETAIL. 1. Reason for Appeal: 1.

2. Statement of Grounds for Appeal: 2.

3. If this appeal involves an application or permit application for construction, please provide the 3. following information: a. Address of Construction Project: ___________________________________________________ Owner’s Name Name and and Mailing Address: ________________________________________________ b. Owner's ________________________________________________ ________________________________________________ ________________________________________________ 4. Reference the specific section of the code your interpretation involves: ________________________ Please circle OMC Other: Other: _____________________ Please circlethe theapplicable applicableCode: Code:CBC CBCCEC CEC CMC CMC CPC CPC OMC 5. 5. Do you have any information materials or references of support, please list each item attached: Item 1: __________________________________________________________________________ Item 2: __________________________________________________________________________ Item 3: __________________________________________________________________________ I hereby certify under penalty of perjury that the information I have provided is true and accurate.

Signature of Property Owner

Date

Page of 11 Page 11 of 4 0 1 SSouth o u t h VVentura e n t u r a SStreet t r e e t • Ojai, O j a i , Ca C a 93023 93023 401 ((805) 8 0 5 ) 6646-5581 4 6 - 5 5 8 1  •f a x : ( (805) 8 0 5 ) 6 653-2236 5 3 - 2 2 3 6  • www.ojaicity.org w w w . o j a i c i t y . o r g fax: Rev. 08/17/15 Ver. 1