DEMOLITION PERMIT APPLICATION

SITE AND PROJECT DATA

Check which is applicable:

Commercial

Residential

Other

Valuation of Proposed Project:

Description of Work:

No. of Bldgs. on Site:

Parcel Number

Property Size

Plat/Development

Lot Number:

Property Owner's Phone Number

Property Owner's Email Address

Is the Applicant someone other than the property owner?

Yes

Applicant Phone Number

Applicant Email

ALL INSPECTION RESULTS SHALL BE EMAILED TO:

Contractor:

Contractor Phone Number

Contractor Email

Contractor's UBI or License #:

Lender/Issuer of Payment Bond:

Lender/Issuer Phone Number

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Sign Here

First Name

Last Name

Choose how to sign

Draw Type

I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. Any changes will be reported to the jurisdiction in which the permit is valid immediately. By leaving the contractor information section blank, I hereby certify further that contractors (general or subcontractors) will not be hired to perform any work in association with this permit. I also certify that if I do choose to hire a contractor (general or subcontractor) I will only hire those contractors that are licensed by the State of Washington.

Signer:

Owner

Agent

Contractor