HomeMy WebLinkAboutA_Demo_Permit_Application _Earlington_(House)_180307_v1DEMOLITION PERMIT APPLICATION
FOR OFFICE USE ONLY:
PERMIT NUMBER:_______________________PROJECT NUMBER:______________________LAND USE NUMBER:______________
This application must be fill out completely in order to be submitted for review. We will not accept incomplete applications. We require one
(1) Demolition permit application per structure. This application is good for one (1) year from the submittal date. A one –time extension of one
(1) year can be requested at a cost determined by the Building Official. Once issued, the permit is good for one(1) year from issue date. A one-
time extension can be requested at a cost determined by the Building Official. Please follow our Electronic File Standard when you are ready to
apply.
1. LOCATION AND VALUATION INFORMATION
JOB ADDRESS:________________________________________________________________________________LOT #____________________
VALUE OF WORK: (Fair market Value for Time + Materials) $______________________ BOEING JOB #(If applicable)
2. DEMOLITION TYPE (CHOOSE FROM BELOW):
Fees (Public Works disconnection/capping fees are separate) : Single Family: $125.25 Commercial/Multi-Family: $267.00
+ Add an Additional 5% Technology Surcharge to Calculated Fee
Square Footage of structure being demolished?__________________________ Each structure needs its own application.
Will the demolition involve a building greater than 4,000 square feet? YES / NO Circle One
Is any tree removal proposed for this demolition? YES / NO Circle One
RESIDENTIAL MULTI-FAMILY ACCESSORY STRUCTURE POOL
COMMERCIAL GARAGE/CARPORT INTERIOR (NON-STRUCTURAL) OTHER
3. BUILDING INFORMATION
WATER SUPPLY CONTACTS NUMBERS_
METER TO REMOVED, OR REMAIN IN PLACE? _________________________ DEVELOPMENT ENGINEERING (425) 430-7266
SANITYAR SEWER/ SEPTIC
SEWER TO BE CAPPED OR REMAIN IN PLACE? _________________________
SEPTIC SYSTEM? Y/N________ TO BE FILLED? Y/N_________ KING COUNTY PUBLIC HEALTH (206) 477-8050
ELECTRICITY
Electricity to be shut‐off and meter removed? Y/N_______ PUGET SOUND ENERGY (888) 225-5773
GAS
Gas to be shut‐off and meter removed ? Y/N________ PUGET SOUND ENERGY (888) 225-5773
Remove fuel or oil tanks? (Complete a RFA Tank Removal Permit Application) RENTON FIRE AUTHORITY 425-430-7000
FOUNDATION
Foundations destroyed and removed? ______________ All debris to be removed from site is to be restored to original condition.
CITY OF RENTON
DEVELOPMENT SERVICES
Building Division | 1055 South Grady Way, 6th Floor | Renton, WA 98057 | 425-430-7200 | Website: rentonwa.gov
4. CONTACT INFORMATION
CONTACT NAME:_______________________________________________________PHONE:______________________________
EMAIL:_____________________________________________________________FAX:___________________________________
5. OWNER INFORMATION
PROPERTY OWNER NAME:__________________________________________________________PHONE:___________________________
ADDRESS:_________________________________________________________________CITY:____________STATE:____________________
7. SUBMITTAL REQUIREMENTS
A copy of the an Asbestos Abatement Report performed by an approved asbestos remediation company.
A Site Plan showing structure being demolished, tree protection and erosion control measures taken to control any erosion or
debris that may leave the property during demolition.
This application does not give permission to remove any trees on the property. Trees are to be protected during demolition.
I certify that the information on this application furnished by me is true and correct and that the applicable requirements of the City of Ren‐
ton will be met. I understand that this application is valid for one (1) year from the application date. If a permit is not issued during this time
period, the application will become void. This application does not constitute a permit to work. Work is not to commence until the building
permit is posted on premises where work is to be performed. Certification is hereby rendered that no work is to be done except as described,
and that all work shall conform to applicable codes. Work in public rights-of-way and/or utility easements are not authorized under this ap‐
plication. Any work done without the benefit of having a building permit issued is subject double the permit fee as well as an investigation
fee. Fees to be paid at permit intake.
APPLICANT SIGNATURE______________________________________________________DATE__________________________
APPLICANT NAME PRINTED_________________________________________________________________________________
OTHER THINGS TO CONSIDER
Check to see if Puget Sound Clean Air Agency need notification prior to proceeding with demolition.
If structure to be demolished is over 4,000 sq. ft. - Environmental Checklist is required.
Construction debris is to be taken to an approved disposal facility. See King County Solid Waste for information. If you have ques‐
tions about disposing of asbestos, check with Puget Sound Clean Air Agency PCCCA regarding requirements.
The Lot is to be restored to original condition.
6. CONTRACTOR INFORMATION
I AM DOING THE WORK AS THE HOMEOWNER. If yes, please fill out the Owner Affidavit and include it with this document
I AM HIRING A LICENSE CONTRACTOR. Fill out the portion below:
NAME:_________________________________________________________PHONE:_____________________________________
STATE OF WASHINGTON CONTACTORS LICENSE:___________________________________________________________________
CITY OF RENTON BUSINESS LICENSE:_____________________________________________________________________________