Town of Uniontown

Building Permit Application


Home / Permit Requirements/ Building Dept

Permit#______________

Property Owner Name:_________________________________________________________

Site Location/Physical Address: __________________________________________________

Mailing Address: ______________________________________________________________

Home Phone: _______________________________ Work/Cell: ________________________

Contractor Co. Name:___________________________________________________________

Contact Name:_________________________________________________________________

Address: _____________________________________________________________________

Contractor Phone:______________________________________________________________

WA State Contractors License # __________________________________________________

Describe Project:_______________________________________________________________ _____________________________________________________________________________

Intended Use of Building: _______________________________________________________

Fair Market Value of Work (labor & materials):______________________________________

FOR OFFICIAL USE - DO NOT WRITE BELOW THIS LINE

    Permit Fee:    ______________

    State Council Fee: __________

    Total Amount Due:__________

Paid by: Check #________ or Cash________

Permit Review and Approved by Planning & Zoning Chair:: __________________________________

Permit Approved By Building Inspector:_____________________________________