======================================================================== [ASSOCIATION NAME] ARCHITECTURAL CHANGE REQUEST FORM (ARC / ACC) Free template from The HOA Guide — thehoaguide.com ======================================================================== Date of submission: __________ Application number (office use): __________ ------------------------------------------------------------------------ SECTION 1 — OWNER INFORMATION ------------------------------------------------------------------------ Owner name(s): __________ Phone: __________ Email: __________ Mailing address (if different from property): __________ ------------------------------------------------------------------------ SECTION 2 — PROPERTY INFORMATION ------------------------------------------------------------------------ Property address: __________ Unit / lot number: __________ Parcel or account number (if applicable): __________ ------------------------------------------------------------------------ SECTION 3 — PROPOSED CHANGE ------------------------------------------------------------------------ Type of modification (check all that apply): [ ] Fence or wall [ ] Paint / exterior color [ ] Roof / roofing material [ ] Landscaping / hardscaping [ ] Deck / patio / porch [ ] Solar panels [ ] Shed / outbuilding [ ] Windows / doors [ ] Driveway / walkway [ ] Lighting / fixtures [ ] Pool / spa / hot tub [ ] Satellite dish / antenna [ ] Awning / pergola [ ] Signage [ ] Other: __________ Detailed description of proposed change: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ Reason for the change: ________________________________________________________________ ________________________________________________________________ ------------------------------------------------------------------------ SECTION 4 — MATERIALS, COLORS, AND DIMENSIONS ------------------------------------------------------------------------ Materials to be used (brand, type, grade): ________________________________________________________________ ________________________________________________________________ Color(s) — include manufacturer name and color code: ________________________________________________________________ ________________________________________________________________ Dimensions (height, width, length, square footage as applicable): ________________________________________________________________ ________________________________________________________________ Attach the following (check each item included): [ ] Color samples or swatches [ ] Product specification sheets [ ] Photographs of current condition [ ] Photographs or renderings of proposed change ------------------------------------------------------------------------ SECTION 5 — SITE PLAN / SKETCH ------------------------------------------------------------------------ Attach or draw a site plan showing the location of the proposed change in relation to your property lines, structures, and any common areas. Include setback distances. [ ] Site plan / sketch is attached If drawing below, show property lines, existing structures, and location of proposed change with measurements: +---------------------------------------------------------------+ | | | | | | | | | | | | | | | | | | | | | | | | | | +---------------------------------------------------------------+ ------------------------------------------------------------------------ SECTION 6 — CONTRACTOR INFORMATION ------------------------------------------------------------------------ [ ] Owner will perform the work (no contractor) [ ] Licensed contractor will perform the work Contractor / company name: __________ Contractor license number: __________ Phone: __________ Email: __________ Insurance on file: [ ] Yes [ ] No ------------------------------------------------------------------------ SECTION 7 — PROJECT TIMELINE ------------------------------------------------------------------------ Estimated start date: __________ Estimated completion date: __________ Total estimated cost: $__________ Will the work generate noise, dust, or debris in common areas? [ ] Yes [ ] No If yes, describe your plan to minimize disruption: ________________________________________________________________ ________________________________________________________________ Will construction vehicles or equipment need access to common areas? [ ] Yes [ ] No ------------------------------------------------------------------------ SECTION 8 — NEIGHBOR NOTIFICATION ------------------------------------------------------------------------ List each neighbor whose property is adjacent to or directly affected by the proposed change. Indicate whether they were notified and whether they have concerns. Neighbor 1: Name: __________ Address: __________ Notified: [ ] Yes [ ] No Concerns raised: [ ] None [ ] Yes — see below Comments: __________ Neighbor 2: Name: __________ Address: __________ Notified: [ ] Yes [ ] No Concerns raised: [ ] None [ ] Yes — see below Comments: __________ Neighbor 3: Name: __________ Address: __________ Notified: [ ] Yes [ ] No Concerns raised: [ ] None [ ] Yes — see below Comments: __________ (Attach additional sheets if more neighbors are affected.) ------------------------------------------------------------------------ SECTION 9 — PERMITS AND COMPLIANCE ------------------------------------------------------------------------ Does this project require a municipal building permit? [ ] Yes — permit number: __________ [ ] No [ ] Unknown — I will verify before starting work Does this project comply with all applicable local, state, and federal regulations (building codes, zoning, ADA, etc.)? [ ] Yes [ ] Not yet determined ------------------------------------------------------------------------ SECTION 10 — OWNER ACKNOWLEDGMENT ------------------------------------------------------------------------ By signing below, I acknowledge and agree: 1. I have read the association's architectural guidelines and CC&Rs before submitting this request. 2. I will not begin work until I receive written approval from the architectural review committee. 3. Approval applies only to the specific change described above. Any material deviation requires a new or amended application. 4. I am responsible for obtaining all required municipal permits and complying with all applicable laws and building codes. 5. I am responsible for any damage to common areas or neighboring properties resulting from this project. 6. I will complete the work by the estimated completion date or request an extension in writing. 7. I understand that failure to obtain approval before starting work may result in fines, a requirement to undo the change, or both. Owner signature: __________________________________________ Printed name: __________ Date: __________ Co-owner signature (if applicable): ________________________ Printed name: __________ Date: __________ ======================================================================== COMMITTEE USE ONLY — DO NOT WRITE BELOW THIS LINE ======================================================================== Application received by: __________ Date received: __________ Application complete: [ ] Yes [ ] No — items needed: __________ Committee review date: __________ Decision: [ ] Approved as submitted [ ] Approved with conditions — see below [ ] Denied — see below [ ] Tabled — additional information requested Conditions of approval: ________________________________________________________________ ________________________________________________________________ Reason for denial (cite specific guideline or CC&R section): ________________________________________________________________ ________________________________________________________________ Signatures: Committee member: __________ Date: __________ Committee member: __________ Date: __________ Committee member: __________ Date: __________ Date owner notified of decision: __________ Method of notification: [ ] Mail [ ] Email [ ] Hand delivery ======================================================================== Free template from The HOA Guide — thehoaguide.com ========================================================================