Attachment 4 - BOA Application.Redlined1 of 6
TOWN OF LOS GATOS
BOARD, COMMISSION, COMMITTEE APPLICATION
Contact: Clerk Department
110 East Main Street, Los Gatos, CA 95030
(408) 354-6834 or Clerk@LosGatosCA.gov
General eligibility requirements: A resident of the incorporated limits of the Town of Los
Gatos. Other requirements may apply to specific Boards, Commissions, or Committees.
If you would like to apply for more than one Board, Commission, or Committee, place a
number next to the Board, Commission, or Committee, in order of your preference, for
which you would like to apply. A separate application is required to be submitted for
each Board, Commission, or Committee you are applying for. Only applications for
current openings will be considered at this time. Applications for future openings will be
kept on file for one year. Qualified applicants will be notified for an interview with Town
Council.
__ Arts and Culture Commission
__ Building Board of Appeals
__ Community Health and Senior Services Commission
__ Complete Streets and Transportation Commission
__ Finance Commission
__ General Plan Committee
__ Historic Preservation Committee
__ Library Board
__ Parks Commission
__ Personnel Board
__ Planning Commission
IMPORTANT NOTICES
Please note that all information provided on the application becomes a public record after it is
officially filed. All appointed applicants are required to file the Fair Political Practices Commission
(FPPC) Statements of Economic Interest (Form 700) annually, which are also a public record.
Applicants appointed to the Planning Commission are also required to complete Ethics Training AB
1234 every two years.
ATTACHMENT 4
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BUILDING BOARD OF APPEALS APPLICATION
Contact: Clerk Department
110 East Main Street, Los Gatos, CA 95030
(408) 354-6888 or Clerk@LosGatosCA.gov
Note: Only the text that shows in the boxes is visible.
Please do not go beyond the borders of the boxes.
FIRST NAME: LAST NAME:
STREET ADDRESS: ZIP CODE:
PHONE: ❑Cell ❑Home ❑Work EMAIL:
EMERGENCY CONTACT: PHONE: ❑Cell ❑Home ❑Work
EMPLOYER: JOB TITLE:
HOW LONG HAVE YOU LIVED IN LOS GATOS?
*If appointed your name, phone number, and email address will be made available to the public.
Please list what experience,
education, or volunteer positions that
you have held.
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Why are you interested in serving on
Building Board of Appeals?
Have you ever attended, or listened to
audio of a Building Board of Appeals
meeting? If yes, please provide a
summary of your observation. If not,
why not?
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How would you define the role of a
Building Board of Appeals member?
How will you demonstrate impartiality in
your role as a Board Member with your
personal beliefs with regards to building
policies?
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The Board is expected to demonstrate
knowledge of the Town Code and its
Building policies. What experience or
training do you have that would be useful
on the Board?
The Board of Appeals consists of three (3) members who are qualified by experience and training to pass
upon matters pertaining to building construction and building service equipment and who are not employees
of the Town of Los Gatos.
• Are you able to read and understand architectural drawings? Yes No
• Are you familiar with state and local regulations concerning
access for persons with disabilities? Yes No
• Does your work and personal schedule allow you the ability
to attend evening and/or Saturday meetings? Yes No
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All applicants are required to be interviewed to be considered for appointment as a
Board Member.
Applicants will be contacted via email with the interview date and time.
Signature: Date:
IN COMPLIANCE WITH THE AMERICANS WITH DISABILITIES ACT, IF YOU NEED SPECIAL ASSISTANCE TO PARTICIPATE
IN THE INTERVIEW PROCESS, PLEASE CONTACT THE CLERK DEPARTMENT AT (408) 354-6834.
NOTIFICATION 48 HOURS BEFORE THE MEETING WILL ENABLE THE TOWN TO MAKE REASONABLE
ARRANGEMENTS TO ENSURE ACCESSIBILITY [28 CFR §35.102-35.104]
Submit Via Email