Fillable Change of Information (City of Des Moines)

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Change of Information (City of Des Moines)

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The Change of Information (City of Des Moines) form is 1 page long and contains:

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8 check-boxes
36 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Des Moines

BROWSE CITY OF DES MOINES (WA) FORMS

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Building Department

21630 11th Avenue South, Suite D

Des Moines, WA 98198

(206)870-7576 fax:(206)870-6544

www.desmoineswa.gov

Change of Information

Project Name:

Project Address:

Name:

Address: City: State:

Zip:

Phone:

Fax:

Name:

Address: City: State: Zip:

Phone: Fax:

Email:

WA Contractor License #:

Des Moines Business License #:

Print name of Owner of Record

Owner of Record signature

Date:

Scope of

Change:

Office use only:

Associated Permit Number:

PLEASE NOTE: CHANGES IN OWNERSHIP ARE NOT ACCEPTED ON THIS FORM

Please note: Changes in personnel, project contacts, or addresses listed on original application or original documents for an active

project will not be accepted unless noted on this completed and signed Change of Information form. Detailed information regarding

such will be required each time a change occurs. Incomplete forms may not be accepted.

Received By:

Date:

Change approved by:

Change denied by:

Reason (if any) for denial:

Date entered into system: Person inputting new data:

Former:

Contractor Architect/Designer

Engineer Project Contact

Company Name:

New: