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H:\CED\Data\Forms‐Templates\Self‐Help Handouts\Building\2019 Forms-Fillable\Plumbing.pdf Updated 1/9/2019
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<br />Development Services Division
<br />1055 S. Grady Way
<br />Renton, WA 98057
<br />(425) 430‐7200
<br />www.rentonwa.gov
<br />PLUMBING PERMIT
<br />APPLICATION
<br />This application must be filled out completely in order to be submitted for review. We will not accept incomplete applications. This application is
<br />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
<br />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
<br />fee. Please follow our Electronic File Standards if plan review is required.
<br /> FOR OFFICE USE ONLY: PERMIT NUMBER: _______________________ PROJECT NUMBER: _________ LAND USE NUMBER: _____________
<br />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
<br />could belong to someone else, but we still need the number to keep all associated permits tied together. You may
<br />need to contact the Building Permit owner.
<br />Description of work: _______________________________________________________________________________
<br />1.LOCATION AND VALUATION INFORMATION
<br /> JOB ADDRESS: _______________________________________ TENANT NAME: __________________ LOT#: ______
<br />VALUE OF WORK: (Fair market value for time + materials) $______________ BOEING JOB # (If applicable): _________
<br />DESCRIPTION OF WORK TO BE PERFORMED: ____________________________________________________________
<br />2.OWNER INFORMATION
<br />PROPERTY OWNER NAME: _____________________________________ PHONE: ___________________________
<br />ADDRESS: _________________________________________ CITY: ______________STATE: ______ ZIP: ________
<br />3.CONTACT INFORMATION
<br />CONTACT NAME: _____________________________________________ PHONE: ___________________________
<br />EMAIL: ______________________________________________________ FAX: _____________________________
<br />4.CONTRACTOR INFORMATION
<br />DOING THE WORK AS THE BUILDING/HOME OWNER. If yes, please fill out the Owner Affidavit and include it
<br />with this form. Tenants cannot do work without written permission from the owner.
<br /> A LICENSED CONTRACTOR WILL BE DOING THE WORK. Fill out the portion below (Required):
<br /> NAME: ______________________________________________________ PHONE: __________________________
<br />STATE OF WASHINGTON CONTACTOR’S LICENSE: ____________________________________________________
<br /> CITY OF RENTON BUSINESS LICENSE: ________________________________ UBI#: __________________________
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