BUILDING PLUMBING MECHANICAL
COMMERCIAL BUILDING APPLICATION o o o
ASSESSOR’S PARCEL NO.
OWNER’S NAME PHONE
OWNER’S MAILING ADDRESS SITE ADDRESS
LIST EXISTING BUILDINGS ON PROPERTY
BUILDER’S NAME PLIMUNG CONTRACTOR
BUILDER’S ADDRESS MECHNICAL CONTRACTOR
CITY: STATE: ZIP:
BUILDER’S PHONE CONT. LICENSE# EXPIRES
PROPOSED BUILDING & TYPE OF USE
MANUFACTURED HOME / / / / /
MAKE MODEL YEAR SERIAL NO. INSTALLERS LIC. NO. LENGTH & WIDTH
TYPE OF HEAT: oGAS oELEC. oOTHER ENERGY CODE PATH (circle one) CHPT. 4 CHPT. 5 CHPT. 6
EXISTING SQ. FTG: / / / / /
MAIN FLOOR SECOND FLOOR BASEMENT GARAGE CARPORT DECK
NEW SQ. FOOTAGE: / / / / /
MAIN FLOOR SECOND FLOOR BASEMENT GARAGE CARPORT DECK
BUILDING HEIGHT NO. OF STORIES: FIRE SPRINKLERS: oYES oNO NO. OF BEDROOMS NO. OF BATHROOMS
o NEW RESIDENCE o NEW BUSINESS o DECK/PORCH o REMODEL o ACC. BLDG. o MANUFACTURED
o ADDITION o TENANT IMPROVMENT o GARAGE/CARPORT o OTHER
I understand that applications for which no permit I issued within 180 days following the date of application shall expire by limitation, and plans
and other data submitted for review may thereafter may be returned to the applicant or destroyed by the building official. Sec. 106.4.4 U.B.C
OWNER/AGENT DATE
SUBDIVISION
SCHOOL DISTRICT
LOT
LOT SIZE
SECTION TOWN RANGE
OCCUPANCY GROUP
TYPE OF CONSTRUCTION
VALUATION…………………………….$
BUILDING PERMIT FEE………………….$
PLAN CHECK FEE……………………….$
KNOX BOX……………………………..$
MECHANICAL…………………………..$
PLUMBING…………………………...…$
STATE BUILDING CODE FEE……………$
ENERGY CODE FEE……………………..$
UTILITY’S, PARK & STREET FEES……..$
TOTAL FEES $
PAYMENT DATE PAYMENT $
BALANCE DUE$
BUILDING APPROVED MISCELLANEOUS APPROVAL PLANNING APPROVAL
CORRECTIONS REQUIRED
BLDG. SITE ELEVATION
ZONING
APPROVED AS REVISED
LOWEST FLOOR ELEV.
SEPA
APPROVED
SEPTIC/SEWER REQD.
SETBACKS FRONT
WATER SYS. APP.
REAR
SCHOOL DISTRICT
SIDE
CORNER
APPROVED
TO BE FILLED BY APPLICANT
