Do I need a notary for the wireless facilities supplemental application?

No. The form has no notary block; the applicant signs and dates a certification under penalty of perjury.

What materials must accompany the application?

The form calls for six copies of a site plan, current color site photographs, underlying permit information, and, for eligible facilities requests, radio frequency and structural reports.

How do I submit the application?

Submit it as part of the Plan Check submittal to the Building Safety Division at 9770 Culver Blvd., 2nd Floor, Culver City, CA 90232.

Culver City, CA · Los Angeles County

No notary required

Supplemental Application for Wireless Eligible Facilities Requests and Emergency Generators

This supplemental application is for applicants seeking a building permit for an eligible facilities request or emergency generator on private property.

What this form is

Applicants must complete this form with a building permit application for an eligible facilities request or qualifying emergency generator on private property. It requests project and contact details, information supporting the application type, and supporting materials such as site plans, photographs, permit history, and, for eligible facilities requests, engineering reports. The form also includes an applicant certification.

Who needs it

Applicants submitting a building permit application for an eligible facilities request or qualifying emergency generator on private property must also complete this form.

How to submit it

Submit it as part of the Plan Check submittal to the Building Safety Division, 9770 Culver Blvd., 2nd Floor, Culver City, CA 90232.

About notarization

This document is signed without a notary; the applicant certifies under penalty of perjury that the information is true, accurate, and complete.

How to submit this form

1
Download The Application
Download the supplemental application PDF.
2
Complete The Form
Provide contact and project information, select the application type, and complete the applicable project details.
3
Gather Required Attachments
Prepare the site plans, photographs, permit information, and any engineering reports required for your application type.
4
Submit To The City
Include the completed application in your Plan Check submittal to the Building Safety Division.

Frequently asked questions

Do I need a notary for the wireless facilities supplemental application?: No. The form has no notary block; the applicant signs and dates a certification under penalty of perjury.
Who must complete this supplemental application?: Applicants seeking a building permit for an eligible facilities request or qualifying emergency generator on private property must also complete this application.
What materials must accompany the application?: The form calls for six copies of a site plan, current color site photographs, underlying permit information, and, for eligible facilities requests, radio frequency and structural reports.
How do I submit the application?: Submit it as part of the Plan Check submittal to the Building Safety Division at 9770 Culver Blvd., 2nd Floor, Culver City, CA 90232.

Need something notarized?

This Supplemental Application for Wireless Eligible Facilities Requests and Emergency Generators doesn’t need a notary — but if you have another Culver City form that does, a commissioned online notary can help.