HomeMy WebLinkAboutDeferred Submittal form - FillableCITY OF PORT ORCHARD
Permit Center
IiiYiE Office located at 720 Prospect Street
Mailing address: 216 Prospect Street
1. Port Orchard, WA 98366
(360) 874-5533 • permitcenter@cityofportorchard.us
DEFERRED SUBMITTAL FORM
Please check with the City's Primary Contact (the Assigned Lead for this project) before submitting revisions using this form.
ALL REVISIONS MUST BE SUBMITTED TO THE PERMIT CENTER
1. PROJECT INFORMATION.
Permit Number:
Project Name:
Project Address:
Project Architect of Record:
Project Engineer of Record:
2. CONTACT INFORMATION.
Contact Name:
Mailing Address:
Phone Number:
Email Address:
3. ACKNOWLEGEMENT.
I have previously discussed the proposed deferred submittal items with the City's Assigned Lead on
this project. Prior approval is required, this is generally noted on the cover sheet of the approved
plans.
Select one: O Yes O No
Signature Date:
4. SUBMITTAL REQUIREMENTS. Electronic submittals are preferred. Contact the Permit Center for more
information. If paper copies are submitted, include one (1) copy of each item listed below.
❑ Electronic submittals must comply with formatting and resolution requirements.
Information is available on the City of Port Orchard Permit Center webpage, under Other Forms.
LII
Completed Deferred Submittal Form.
❑ Deferred Submittal Matrix (see attached example):
Note: A Word version is available from the Permit Center or on City's website. You may use your own
form, provided it contains the same type of information:
• Name/type of the submitted document.
• Page location that on previously submitted documents (approved plans).
• Identify new documents and/or pages that are part of this submittal.
• Description of each item.
Plans, calculations details:
❑ All sheets must be stamped by engineer or architect of record, truss calcs must be
stamped as reviewed and accepted by engineer of record.
❑ The title block on sheets must list the submittal date.
Drawings included with this submittal:
O Plans with details ❑ Calculations
Revised Submittal form (07/26/2021)
CITY OF PORT ORCHARD
.'*^ Permit Center
#' permitcenter@cityofportorchard.us
Project Name:
Form completed by:
Name
No.
Date Deferred Submittal will
be Submitted
Document
Description of Deferred Submittal
Be specific. Include type of plans, specs, etc
1.
Revised Submittal Matrix (07/26/2021) Page 1 of 1