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MECHANICAL/PLUMBING PERMIT APPLICATION
APPLICATION NO.________________________
SECTION I - RESIDENTIAL (NON-COMMERCIAL / INDUSTRIAL) – Fill out completely. Be
sure to also complete Section IV (signature) to complete permit application form. Fees must
be submitted at time of application.
APPLICANT
Name: __________________________________________________________________
Mailing Address: _____________________________________________________________
Site Address
(if different): ____________________________________________________
Government Lot #___________
Parcel # ___________ Assessor’s Tax Account # _____________
(Trust Land Only)
Home #: ( ) Work #: ( ) Fax #: ( )
CONTRACTOR INFORMATION
CONTRACTOR NAME / COMPANY: ___________________________________________
Registration No. (Required) ________________________________________________
Registration Expiration Date (Required) _____ / _____ / _____
Mailing Address: _________________________________________________________
Street Address (If Different): _______________________________________________
Work #: ( ) Fax # ( )
3. Describe the work you are seeking an application for:
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SECTION IICOMMERCIAL / INDUSTRIAL (Non-Residential) Fill out completely. Be sure
to include all required submittal attachments and to also complete Section IV (signature) to complete
permit application form. Construction plans are required for commercial HVAC and plumbing
application. Please list each occupancy classification and describe what work is being proposed for
each area.
REQUIRED INFORMATION FOR COMMERCIAL / INDUSTRIAL APPLICATIONS:
SITE PLAN:
Site Plans must show the building in relationship to the property and all accessory building and utilities. List
distances to streets, property lines and between buildings. Show the location of all equipment and piping
outside the building.
MECHANICAL AND/OR PLUMBING DIAGRAMS AND PLANS:
Plans must be no smaller than 8.5x11 and includes a scaled floor plan that shows the location and size of
fixtures, equipment, sized fuel gas piping, ducts, shut-offs, return air, exhaust fans, supply and drainage piping,
valves, cleanouts, floor drains, vent risers, grease traps, commercial range hoods, extinguishing systems, duct
and shaft construction, and roof termination.
COMMERCIAL ATTACHMENTS
Site Plan Attached
Plumbing Piping Diagrams and Plans Attached
Mechanical Diagrams and Plans Attached
Uniform Building Code Occupance (1997 U.B.C. Section 301 and Table 3-A for classifications)
SECTION III - FEES
Commercial fees will be determined through plan review
MECHANICAL PERMITS FEE
Mechanical Permit Fee 23.50
FURNACE
<100,000Btu
>100,000Btu
14.80
x____ =$_____
18.20
x____ =$_____
Dryers 9.50 x____ =$_____
Wood/Gas Stoves 9.50 x____ =$_____
Range Hoods 9.50 x____ =$_____
Water Tanks 9.50 x____ =$_____
Misc. (please write in): 9.50 x____ =$_____
Fuel Piping
1-4 fixtures
5 + fixtures
5.00
x____ =$_____
1.00
x____ =$_____
Total Mechanical Fees $_____________________
PLUMBING PERMITS FEES
Plumbing Permit fee 20.00
Fixtures 7.00 x____ =$_____
Total Plumbing Fees $_____________________
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SECTION IV – SIGNATURE BLOCK
Application is hereby made for a permit to authorize the activities described herein. I certify that I am familiar
with the information contained in this application, and that to the best of my knowledge and belief, such
information is true, complete, and accurate. If further certify that I possess the authority to undertake the
proposed activities. I hereby grant to the officials of the Swinomish Indian Tribal Community the right to enter
the above-described location to inspect the proposed or completed work.
___________________________________________________________ Date: ___________
Signature of Applicant or Designated Agent (REQUIRED)
FEES MUST BE SUBMITTED AT TIME OF APPLICATION
The Uniform Building Codes require the Swinomish Indian Tribal Community to make the following inspections.
It shall be the duty of the permit applicant to cause the work to remain accessible, on test and exposed for
inspection purposes. Neither the Tribal Building Official nor the Jurisdiction shall be liable for expense entailed
in the removal or replacement of any material required to allow inspection. It shall be the duty of the person
doing the work . . . “to notify the Building Official that such work is ready for inspection (and) to provide access
to (a ladder when necessary) and means for inspection of such work” (Sec. 305 U.B.C.).
The following is a brief description of WHEN inspections are required.
PLUMBING
After rough-in of piping, installed and on test (before covering), and final.
MECHANICAL
After rough-in (installed and on test) before covering metal chimneys, before concealment of ducts, and
final.
WHEN SUBMITTING PERMIT APPLICATIONS VIA MAIL SEND APPLICATIONS TO:
Swinomish Indian Tribal Community
Office of Planning and Community Development
Attn: Permit Administrator
11430 Moorage Way
La Conner, WA 98257
NOTE: Failure to send permit applications to the Permit Administrator may result in delay or loss of
your permit application.
CALL 466-7310 FOR INSPECTIONS
When you call for an inspection, please have the following information ready:
Name of the permit holder
Permit number
Site address – (brief description of how to get there)
Type of inspection