KITTITAS COUNTY FIRE MARSHALS OFFICE
411 N. Ruby St., Suite 2, Ellensburg, WA 98926
Office (509) 962-7657 Fax (509) 962-7682
FIRE MARSHAL NEW CONSTRUCTION APPLICATION
Permit Information
Suppression System
Type I Range Hood
Haz-Mat Facility
Permit Number:
Detection System
Industrial Oven
Spray Booth/Room
#
Hydrant System
Tenant Improvement
Dip Tank
Tank Installation*
Membrane Structure
Other: (Please Specify)
Associated Permit:
Permit Description:
Is this an Enforcement
Action? Yes * No
Total Bid Amt $_________
Materials $_____________
Installation $___________
Valuation $_____________
Applicant Information
Owner of Record:
Phone:( )
Cell:( )
Mailing Address: City: State: Zip:
Agent/Contractor:
Phone:( )
Cell:( )
Contact Address: City: State: Zip:
Project Location
Physical Address:
City:
Assessor’s Map Number: ___ ___ - ___ ___ - ___ ___ ___ ___ ___ - ___ ___ ___ ___
When Submitting Construction Documents, A Minimum Of (3) Sets Are Required
(Exception: Residential Sprinkler Submittal Shall Comply With Policy #04-01)
I hereby state that the above information is correct. I agree to comply with all permit requirements
related to this project. I further agree to, and hereby grant to the Kittitas County Fire Marshal’s Office
the right to enter onto the premises as described for this permit application, for the purpose of making
such inspections and tests as may be required.
A Non-Refundable $150.00 Deposit Is Required For Fire Marshal Plan Review Services
*A Plan Review Is Not Required For Liquid Petroleum Gas (LPG) Tank Installation
Owner / Licensed Contractor / Authorized Agent on Commercial Structures
Signature: ____________________________ Print Name: __________________________________
Title: ________________________________ Job #: _________________Date: _________________
*All enforcement actions are subject to double permit fees.