Residential

Non-Residential

Permit Name/Tenant Name

Permit Address

Assessors Parcel No.

Describe the scope of work in detail

Building Owner Information

Building Owner Information

Name	Manager/Contact Person
Address	City
State(Select State) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Zip Code
Phoneext.	Faxext.
Email

Contractor Information

 *

Contractor Information

Name	Manager/Contact Person
Address	City
State(Select State) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Zip Code
Phoneext.	Faxext.
Email

 

Tear Off: Washington State Energy code insulation requirements apply to Non-Resident buildings.

Overlay: Engineer's Certification required for non-resident buildings.

Estimated Valuation: $

Number of roofing squares:

Square footage of structure:

Uses

Uses

Apartment/Condo	Carport	Church	Day Care
Industrial	Office	Parking Garage	Repair Garage
Residence	Residential Garage	Restaurant	Retail
School	School Portable	Theater	Utility Building
Warehouse	Other (please describe) If other, type text here.

Applicant

Applicant

Owner

Owner's Agent

Contractor

Contractor's Agent

If you are a homeowner doing your own work please check the box below:

By checking this box I understand that in accordance with RCW 18.27.110, the City of Kent must verify that the contractor is registered by the State of Washington prior to issuance of a building permit for work which is to be done by any contractor, unless the following exemption applies: Any person working on his or her own property, whether occupied by him or her or not, and any person working on his or her personal residence, whether owned by him or her or not but this exemption shall not apply to any person who performs the activities of a contractor on his or her own property for the purpose of selling, demolishing, or leasing the property.

 

(your initials) I certify that I have read this application and declare under penalty of perjury that the information contained herein is correct and complete. I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. I am either the owner of the property described on this permit application, the Washington State registered contractor responsible for the work, or I represent the owner or contractor as signified above and am acting with the owner’s/contractors full knowledge or consent.

NOTE: Application expires 180 days after Date Submitted

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

Page 1 / 1