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FOR STAFF USE ONLY PERMIT # Signature: Date of Signature: Building Division 525 N 3rd Ave, Pasco, WA 99301 P: [PHONE REDACTED] www.pasco-wa.gov I [EMAIL REDACTED] Building Relocation Permit Application This application is to be completed and submitted with all required documentation to the Pasco Building Inspector before a permit to relocate or move a building will be issued. THIS PROCESS WILL TAKE A MINIMUM OF THREE BUSINESS DAYS. Providing false information is punishable with penalties up to five hundred dollars ($500). PMC Chapter 16.28 (Ord. 1810, 1976) REQUIRED for submittal: A map of the route with detail of all streets, cross streets, highways, alleys and properties over which the building is to be moved. Building Mover Information Moving Company Name: WA State Contractors License#: Contact Person: Phone: Email: Address: City: State/Zip: Current Location & Description of Building to be Moved Address moving FROM: Address: City/State/Zip: Type of Structure (Wood, Metal, Masonry etc.): Size of structure: (length) X (width) Loaded Height of Building ft. Destination Address & Route Information Address moving TO: Pasco, WA 99301 Parcel Number: Intended Use of Building (House, Office, Storage, Shop Date & Time of Day of Move: (date) (time) AM PM Notification of City Officials: The following City of Pasco officials must be notified and approve of the move date, time and route of travel. A moving permit will be denied without all signatures. If it is determined that Pasco Police and/or Public Works employees are necessary to assist with the move, the cost for their time and services must be paid by the mover and the receipt(s) attached to this application. Chief of Police: Date of Signature: Public Works Director/City Engineer: Date of Signature: Movers Certification: By my signature I hereby certify that; I have notified and received written approval from all affected power, cable television, telephone and railroad companies along the approved route of travel and; there are no unpaid assessments, liens or encumbrances against the title of property wherefrom the building is to be moved and; all information I have provided hereon is true and correct. SIGN SIGN SIGN SIGN