Patterson, CA · Stanislaus County
Backflow Permit Application
This application collects project, property, owner, contractor, and applicant details for a backflow permit requested from the City of Patterson.
What this form is
Use this application to request a City of Patterson backflow permit and provide details about the work, job address, property owner, contractor, and applicant. The form also includes contractor licensing and workers’ compensation declarations, an owner-builder declaration, and signature fields. It says a plan check fee may be required and lists plan and supporting-document requirements for residential and commercial projects.
Who needs it
Property owners, contractors, or applicants seeking a City of Patterson backflow permit should complete the application and applicable declarations.
How to submit it
The form lists the City of Patterson at 1 Plaza, P.O. Box 667, Patterson, CA 95363, and [email protected]. It does not specify a submission method.
About notarization
No notary is required; the contractor and owner-builder declarations are made under penalty of perjury and require signatures, and the signer signs and dates the application.
How to submit this form
- 1
Download The Application
Download the Backflow Permit Application PDF.
- 2
Complete The Application
Provide the project, work address, property owner, contractor, applicant, and contact details requested on the form.
- 3
Gather Plans And Supporting Documents
For residential and commercial projects, the form requests three sets of plans, two sets of supporting documents, and an electronic set.
- 4
Submit To The City
The form lists the City of Patterson address and [email protected]; it does not state a submission method.
Frequently asked questions
- What is the Patterson Backflow Permit Application for?
- It collects project and property details and applicant, owner, and contractor information for a backflow permit request to the City of Patterson.
- Who should complete the application?
- The form is for an applicant seeking a backflow permit. It includes fields for the property owner and contractor, along with applicable contractor or owner-builder declarations.
- Do I need a notary for the Backflow Permit Application?
- No. The contractor and owner-builder declarations are made under penalty of perjury and require signatures, but the form does not require a notary.
- How do I submit the Backflow Permit Application?
- The form lists the City at 1 Plaza, P.O. Box 667, Patterson, CA 95363, and [email protected]. It does not specify how to submit the application.