BOARD OR COMMISSION APPLICATION FORM
DATE: _____________________
Check one: New Appointment
Re-Appointment
NAME OF BOARD OR COMMISSION: _____________________________________________________________ NAME: ______________________________________________________________________________________ HOME ADDRESS: ________________________________________________ ZIP CODE: ____________HOME PHONE: ______ WORK PHONE _ ______ OCCUPATION: _______________________________________ EMAIL ADDRESS: __ HOW LONG HAVE YOU BEEN A RESIDENT OF THE CITY OF RICHMOND: _____________________________ PLACE OF EMPLOYMENT: _____________________________________________ REASONS FOR INTEREST IN APPOINTMENT:
____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ FRATERNAL AND/OR CIVIC ORGANIZATIONS:
____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ EDUCATION:
____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ REFERENCES (Minimum 5 – List Name, Address, Phone Number, and Email Address)
1._______________ _________
2._______________ ____________
3.________________________ ____
4.__________________________ ____________
5.______________________
To the best of my knowledge the information provided is true and correct:
_______________________________________________ ____________________________ Signature Date
Deliver or Mail to: City Clerk Or Email to: [email protected] 450 Civic Center Plaza
Richmond, CA 94804
For Office Use Only: New Appointment: Reappointment: 1st 2nd 3rd 11/03/2022
✔
Design Review Board
David Plotkin
94805
(
Architect
8 years
As an Architect with over 26 years in the Building Design & Construction field, I would like to volunteer my time & expertise to contribute to the positive growth of my home community of Richmond, CA. With an emphasis in public & non-profit work, I will provide value to the DRB in carefully balancing growth and equity for our diverse community.
Habitat for Humanity (past co-chair for the Building & Site Committee) Jewish Federation (past board member)
Jewish Community Center (past member of the Building & Site Committee) Bachelor of Architecture - University of Cincinnati - Department of Architecture, Art & Planning James Hatfield, 5 om
Michael Jensen,
Dawna Williams / Hamilton Families,
Michael Strong / Pankow Builders,
Samuel Chui / SF Public Works,
11/3/22