Contractor Cement Limit Pathway compliance form

Use this form for compliance with the cement limit pathway. The structural engineer or responsible applicant must complete and submit this form to the building department for plan check to review. 

Form instructions

1. Complete the form by providing the date, company information, and signature.
2. Make sure you provide information for all concrete mix designs used on the project. Indicate if different units of measure are used.
3. You must include a batch receipt provided by the ready-mix supplier as proof of concrete and cement received and poured.
   1. Quantity of cement poured, in pounds per cubic yard (lbs/cyd), must be equal to or less than the amount as specified in original permit to build.

How to submit this form

Submit this form with your building permit application via the online building permit portal. If you have any questions about submittal, please call the Building & Safety hotline at 415-473-6550.