City of Sumner
Single Family
Building Permit Application
(Please fill out ALL fields unless otherwise noted)
Site/Project Address (if available):
Parcel #:
Owner:
Phone:
Email:
Owner Address:
City:
State:
Zip:
Surveyor/Engineer/Contractor:
Phone:
Contractor License Number:
Address:
Email:
City:
State:
Zip:
Contact Person:
Phone:
Fax:
Contact Address:
Email:
City:
State:
Zip:
Description of Project:
Total construction valuation of the project (if no added square footage): $______________________
Supporting Materials Required:
Office Applicant - (please check off all applicable “applicant” boxes)
This Application Form and Checklist
Site Plan (1:40 scale)
Full property lines, building envelope with building setbacks include any existing structures
Environmental constraints (wetlands, river, etc) delineated if any
Streets in relationship to the proposed building including sidewalks, curb, alley, driveway
Location of easements (if any)
Utility connections from main line to the building (water, sewer, and storm)
Separated Pedestrian connection to sidewalk
Existing and proposed contour lines
Floor Plans & Elevations (To scale ¼” = 1 foot & Dimensioned)
Proposed use of the spaces and storage arrangements (i.e. bedroom, kitchen, etc)
Design Review Conditions incorporated into elevations (Consult Planning Department for applicability)
Washington Energy Code Compliance Form
Structural Design and Calculations
Geotechnical Report (Consult Building Official)
PDF Copy of all submitted documents
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.
**B
Y 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.
______________________________________________________ ____________________________________________ DATE: _____/_____/______
SI
GNATURE OF OWNER / AUTHORIZED AGENT PRINTED NAME
Community Development
cd@sumnerwa.gov
(25
3)299-5530
www.sumnerwa.gov
File Number: __________________________
Other Questions:
Is this an ADU (Accessory Dwelling Unit)? Yes No
*If yes, please consult with planning staff for Design Review requirements
Is this a new home that is part of a new subdivision? Yes No
*If no, an engineered drainage plan is required
Print Form
Email Form
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signature
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