PROJECT ADDRESS: PERMIT #

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Residential Building/Mechanical/Plumbing Permit Checklist Community Development 6000 Main St. SW Lakewood, WA 98499 Phone (253) 512-2261 permits@cityoflakewood.us PROJECT ADDRESS: PERMIT # Plans shall be of sufficient clarity to indicate the location, nature, and extent of the work proposed, and conform to the provisions of the adopted International Codes and City ordinances. Drawings in pen or pencil, or plan sheets that are cut, pasted, taped or that have been altered by any means (pen, pencil, marking pen, etc.) will not be accepted for plan check. Any revisions (or additional information) to the original submittal MUST be accompanied by a building revision form. See the chart below for number of copies required for revisions. Submittal Requirements The number indicates the number of copies for submittal (if applicable). New Single Family Residence Mechanical & Plumbing Addition or ADU Remodel (Interior work only) Carport/Patio cover/garage Retaining wall/deck Office Use Only Residential Building Permit Application 1 1 1 1 1 Mechanical Permit Application (if applicable) 1 Plumbing Permit Application (if applicable) 1 Site Plan (see Sample Site Plan) Minimum 11 x 17 2 2 2 2 Architectural/Construction drawings 2 2 2 2 2 2 Engineered drawings and calculations ( if applicable) 2 2 2 2 2 2 Energy Code Compliance forms (or show on plans) 1 1 1 1 a Lakewood Water District water availability letter 1 1 1 Geotechnical Report (for slopes equal to or greater than 15%) 2 2 2 2 2 Pierce County utilities sewer permit 1 1 Health Department approval of septic system 1 1 1 b Plan check fee due upon submittal Zoning Certification Fee Documentation necessary to verify legal lot status f 1 Manufactured truss packet and layout sheet 1 1 1 Tree Removal Permit (lots greater than 17,000 GSF) 1 1 1 Disposal Authorization (written authorization from Lemay Refuse) h Lakewood Water District Cross Connection Control Program form 1 1 1 1 1 a. Include energy forms if windows, skylights and/or exterior doors are being replaced (www. energy.wsu.edu). b. A Health Department Septic remodel permit is required if you are adding additional bedrooms. c. Provide a copy of your Lakewood Water District disconnect documentation if applicable d. Provide a copy of your Pierce County Utilities sewer capping permit if applicable e. Provide a copy of your septic tank decommissioning if applicable. f. Refer to LMC 18A.50.115.A.2. These documents may include recorded deeds, subdivision records, or recorded boundary line adjustments or possibly chain of title report. This requirement may be waived by CDD if the Planning Department can verify legal lot status. g. REMEMBER TO SCHEDULE ELECTRICAL DISCONNECT PRIOR TO DEMOLITION h. Contact: Lemay Refuse Attention: Larry Meany Office: (253) 875-5869 Email: LARRYM@WASTECONNECTIONS.COM

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Residential Building Permit Application Community Development 6000 Main St. SW Lakewood, WA 98499 Phone (253) 512-2261 permits@cityoflakewood.us Office use Permit #: Date rec d: _ Please refer to the residential permit checklist for additional submittal requirements. PROJECT ADDRESS: Parcel #: APPLICANT: Address (City, State, Zip): OWNER: Address (City, State, Zip): LENDING AGENCY: Address (City, State, Zip): CONTRACTOR*: Phone: E-Mail Address: Phone: E-Mail Address: Phone: E-Mail Address: Phone: Address (City, State, Zip): License #: Exp. Date: *Contractor must have a valid City of Lakewood business license prior todoing work in thecity PROJECT DESCRIPTION: 1 ST Floor (sq. ft.) 2 nd Floor: 3 rd Floor: Basement: Plumbing sinks (kitchen/utility) water closet (toilet) tub/shower lavatories (bath sink) dishwasher Garage: Carport: Project Valuation: Deck: Property is served by: Retaining Wall (linear ft.) Sewer Mechanical clothes furnace < 100,000 btu washer furnace > 100,000 btu laundry gas hot water tank drains hose range/stove bibs oven (separate) hot water tank other Septic heat pump air-conditioner gas heater/stove gas fireplace/insert I hereby certify that the information provided is correct and that the construction on the above described property, the occupancy, and use will be in accordance with the laws, rules, and regulations of the State of Washington and the Lakewood Municipal Code. I agree to hold harmless the City of Lakewood as to any claim incurred as a result of this work. Print Name: Signature: Owner Agent Specify Date:

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SAMPLE USE ONLY

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