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Plumbing Permit ApplicationH:\CED\Data\Forms‐Templates\Self‐Help Handouts\Building\2019 Forms-Fillable\Plumbing.pdf    Updated 1/9/2019          Development Services Division  1055 S. Grady Way  Renton, WA 98057  (425) 430‐7200  www.rentonwa.gov  PLUMBING PERMIT  APPLICATION  This application must be filled out completely in order to be submitted for review.  We will not accept incomplete applications.  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 of half the plan review fee.  Once  issued, the permit is good for one (1) year from issue date.  A one–time extension of one (1) year can be requested at a cost of half the permit  fee.  Please follow our Electronic File Standards if plan review is required.   FOR OFFICE USE ONLY:  PERMIT NUMBER:  _______________________ PROJECT NUMBER:  _________ LAND USE NUMBER:  _____________  ASSOCIATED BUILDING PERMIT NUMBER (REQUIRED):__________________________________________________  This number is required if your work is associated with work being done under a Building Permit.  The Building Permit  could belong to someone else, but we still need the number to keep all associated permits tied together. You may  need  to contact the Building Permit owner.  Description of work:  _______________________________________________________________________________  1.LOCATION AND VALUATION INFORMATION  JOB ADDRESS:  _______________________________________ TENANT NAME:  __________________ LOT#:  ______   VALUE OF WORK: (Fair market value for time + materials) $______________ BOEING JOB # (If applicable):  _________   DESCRIPTION OF WORK TO BE PERFORMED: ____________________________________________________________ 2.OWNER INFORMATION PROPERTY OWNER NAME:  _____________________________________ PHONE:  ___________________________ ADDRESS:  _________________________________________ CITY:  ______________STATE:  ______ ZIP:  ________ 3.CONTACT INFORMATION CONTACT NAME:  _____________________________________________ PHONE: ___________________________  EMAIL:  ______________________________________________________ FAX:  _____________________________   4.CONTRACTOR INFORMATION DOING THE WORK AS THE BUILDING/HOME OWNER.  If yes, please fill out the Owner Affidavit and include it  with this form. Tenants cannot do work without written permission from the owner.   A LICENSED CONTRACTOR WILL BE DOING THE WORK.  Fill out the portion below (Required):   NAME:  ______________________________________________________ PHONE: __________________________  STATE OF WASHINGTON CONTACTOR’S LICENSE:  ____________________________________________________  CITY OF RENTON BUSINESS LICENSE:   ________________________________ UBI#: __________________________ PLUMBING PERMIT FEES Base Fee Single Family $52 Commercial /Multi-Family $75 Fixtures Quantity Fee Per Fixture Quantity Fee Per Fixture Bathtub $10 $15 Dishwasher $10 $15 Drinking Fountain $10 $15 Floor Drain $10 $15 Hose Bib $10 $15 Ice Maker $10 $15 Laundry Tray $10 $15 Other system not listed $10 $15 Shower $10 $15 Sink $10 $15 Sump/Trap $10 $15 Washer $10 $15 Water Closet $10 $15 Water Heater (Gas or Electric) $10 $15 Water Service- from meter to building $10 $15 Roof Drain / Rainwater System (per drain) $10 $15 Waste Interceptor N/A $15 Installation, alteration, or repair of water piping (Each fixture) $10 $15 Installation, alteration or repair of drainage or vent piping (Each fixture) $10 $15 Each Lawn Sprinkler system (includes backflow device) $10 $15 Each Vacuum breaker or backflow protection device on tank, vats, etc. $10 $15 Gas piping System (Up to 6 outlets) $20 $25 Medical gas piping System** (Up to 6 outlets) N/A $75 Re-inspection Fee $125 $125 ** Plan Review required. 40% of permit fee Additional 5% technology surcharge to calculated fee I certify that the information on this application furnished by me is true and correct and that the applicable requirements of the City of Renton 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 application. Any work done without the benefit of having a building permit issued is subject double the permit fee. Fees to be paid at permit intake. APPLICANT SIGNATURE: _________________________________________________ DATE:_______________________ APPLICANT NAME PRINTED: __________________________________________________________________________