HomeMy WebLinkAboutB20003319 Application Extension FormPermit Application Number: B20003319
Project Name:
4TH DIMENSION BUILDING
Current Application Expiration Date: 01/29/2022
Project Site Address:
4502 NE 4th St
Contact Name:
Phone: (________) ________-____________
E-mail Address:
Brief description of the reason for the extension and the estimated date of application issuance:
Are there associated Electrical, Mechanical or Plumbing Permits? If so, please list:
Applicant Signature:
Print:________________________________Sign:________________________________Date:_______________
Approved By (Initials):
City Staff Section
Approval Date:Fees Paid:Date Stamp:
1055 South Grady Way, Renton, WA 98057 | Phone: (425) 430 7200 x1 | Website: www.rentonwa.gov
BUILDING PERMIT APPLICATION
EXTENSION REQUEST FORM 1055 South Grady Way | Renton, WA 98057