Demolition Permit Application - City Of Auburn

DEMOLITION

Form last

updated on

May 2015

PERMIT APPLICATION

Physical Address:

Mailing Address:

Webpage & Email:

Phone and Fax:

Auburn City Hall Annex, 2

Floor

25 West Main Street

Phone: 253-931-3090

1 East Main Street

Auburn, WA 98001-4998

permitcenter@auburnwa.gov

Fax: 253-804-3114

PROJECT INFORMATION

Permit Number #

Type of Structure(s) to be Demolished:

 Commercial

 Multi-Family

 Single Family Residence

Parent Permit #

 Accessory Building

 Mobile/Manufactured Home

Job site address: ____________________________________________________ Zip ____________

Received:

Subdivision Name: _____________________________ Lot # ______ Parcel # __________________

For Commercial – Complex Name: _________________________________ Sq. Ftg.______________

For Multifamily – Building Name:_______________________________________ # of Units________

For Mobile/Manufactured Homes –  Demo  Remove Park Name: ______________ Space #______

Scope of Work: ________________________________________________________________________________________________

______________________________________________________________________________________________________________

Upon completion, will there be any remaining impervious surfaces (e.g. foundation, paved driveway, outbuildings?) Yes

No

OWNER

CONTRACTOR

Name:__________________________________________________

Company Name: ________________________________________

 Check this box if this is the primary contact

Contact Person:_________________________________________

Contact Person: ________________________________________

Address:_______________________________________________

Address: ______________________________________________

City: ________________________ State: ______ Zip: ________

City: _______________________ State: ______ Zip: _________

Phone: _______________ E-mail: __________________________

Phone: ________________ E-mail: ________________________

Auburn Business Lic# _________ Contractor’s Lic#__________

WATER SUPPLY

Is the property served by City of Auburn Water?  Yes

 No

If no, provide the name of Purveyor _____________________________

The meter will:  be Removed

 Remain and be Protected

 N/A – on Private Well

SEWER & SEPTIC SYSTEMS

Is the property served by City of Auburn Sewer?  Yes

 No

If no, provide the name of Purveyor: ____________________________

Sewer Cut & Capped?  Yes

 No

If yes, provide the sewer permit number: ___________________________________________

Septic Tank to be Removed?  Yes

 No

Septic Tank to be Drained and Filled?  Yes

 No

Demolition Permit Application - City Of Auburn - 2015

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