Fillable Application for BUILDING PERMIT (City of DuPont)

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Application for BUILDING PERMIT (City of DuPont)

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The Application for BUILDING PERMIT (City of DuPont) form is 1 page long and contains:

  • 1 signature
  • 16 check-boxes
  • 33 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of DuPont

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Application for BUILDING PERMIT
BUILDING SERVICES DIVISION
1700 Civic Drive DuPont, WA 98327
P: (253) 912-5216 F: (253) 964-1455
www.dupontwa.gov
PERMIT NUMBER:
□ SFR □ Duplex □ Multi Family/No.Units □ Commercial: Type of Use:
(i.e. Business, Food Service, Government, Repair Garage, Retail,etc)
□ Other □ Detached Garage □ Deck
□ New □ Addition □ Remodel □ Tenant Improvement □ Repair □ Demolition
Project Address:
Parcel Number:
Owner of Building:
Project Name (commercial) :
Mailing Address:
Phone Number: ( )
(if different from Project Address)
Applicant (if contractor, fill out next section):
Address:
Contact Person:
Email:
City:
State: Zip:
Phone Number: ( )
Contractor:
Address:
City:
State: Zip:
State Contractor Number:
City Business License:
Project Contact Person:
Phone Number: ( )
Value of Work (required):
Description of Work:
Square Footage: 1
st
Floor 2
nd
Floor Garage Other ( ) TOTAL:
0
SCHEDULE OF FEES (OFFICE USE)
Valuation $
Permit Fee $
(City of DuPont Fee Table)
Plan Review Fee $
(75% of permit fee)
BCC Fee (Residential) $ 6.50
BCC Fee (Commercial) $ 25.00
SUBTOTAL $
Paid: Rec’t# Amt.$
Balance TOTAL $
I certify that I am the: □ Owner □ Contractor □ Agent
I hereby certify that I have read and examined this application and state
that the above information is correct. I agree to comply with all City
Ordinances and State Laws, whether specified herein or not.
***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.
Applicant / Authorized Agent Signature Date
Printed Name
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Application for BUILDING PERMIT (City of DuPont)

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Completed 21 January 2021

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