Re-Roof Permit Application

Please Select One:(Required)

Residential Roof

Commercial Roof

Will the old roofing material be removed?(Required)

Yes

If Commercial, is the area of roofing more than 10,000 sq. ft.?

Yes

If "No", what type of roofing material is on the existing roof?

If "No", is there already more than 1 layer of roofing attached?

Yes

Site Address:(Required)

Parcel Number (Optional):

PROPERTY OWNER

Name:(Required)

First Last

Address:(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone:(Required)

Email:(Required)

Signature:(Required)

Contractor

Please Select if Contractor

Business Name:(Required)

Address:(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone:(Required)

Email:(Required)

License Number:(Required)

Signature:(Required)

IF YOU ARE THE OWNER AND ACTING AS YOUR OWN CONTRACTOR, PLEASE COMPLETE THE FOLLOWING DECLARATION:

Signature:

I acknowledge that I am applying for a construction permit thru the Union Gap Community Development Department. I also acknowledge that I am not a licensed contractor, specialty or general, or that I am not acting a s a contractor and wish to be exempt from the requirements of the Washington State Contractor’s act, per RCW 18.27.090, and will abide by all provisions and conditions of the exemption as stated. I agree that if I use the assistance of any person(s) to provide labor and/or assistance, I will retain only contractors registered and currently licensed as required under the laws of the State of Washington. I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct.

Date:

Phone

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