Form Center

2. 

3. Community and Economic Development Department

   Building Safety Division 

   1010 Tenth Street, Suite 3100 Modesto, CA 95354

5. Request for refund of permit fees

   Refunds may be issued for the following:

    

   1. Simple Permits (Reroofs, HVACs, Water Heaters, Residential Solar) 80% max refund
      1. Permit has been issued and the applicant requests a refund for the permit fees due to the project being cancelled.
      2. It has been less than 1 year since the permit has been issued.
      3. Only the portion of the permit that has not been acted upon will be refunded.
      4. Plan check or building permit fees may be refunded only if a plan check or building inspection has not been performed. This includes inactive inspections.
      5. General Plan Maintenance Fee refunded in it’s entirety

    

   2. Other Permits (projects with plans) unused fees refund
      1. Permit has been issued and the applicant requests a refund for the permit fees due to the project being cancelled.
      2. It has been less than 2 years since the permit has been issued.
      3. Only the portion of the permit that has not been acted upon will be refunded.

    

   3. It is discovered that the permit fee was miscalculated, and applicant was charged too much.

    

   4. Any other division error that may require a refund.

    

   5.  Wrong jurisdiction

    

    

7. Applicant's First Name*
8. Applicant's Last Name*
9. Applicant's Email Address*
11. Applicant's Mailing Address*
13. Mailing City*
14. Mailing State*
    -- Select One --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
15. Mailing Zip Code*
17. Project Address
19. Permit Number
21. Reason for refund:
23. Certification*

    1. I certify that the information listed herein is true and accurate.
Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

* indicates a required field