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Plumbing Permit Application
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Steps
1.
Job Location Information
This section is complete
This section is incomplete
2.
Plumber Information
This section is complete
This section is incomplete
3.
Item Information
This section is complete
This section is incomplete
4.
Additional Item Information
This section is complete
This section is incomplete
5.
Certification of License
This section is complete
This section is incomplete
Job Location Information
Job Location
*
Owner Name
*
Owner's Address1
*
City
*
State
*
Zip
*
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Plumber Information
Plumber's Name
*
Plumber's Trade Name
*
Plumber's Address
*
Address2
City
*
State
*
Zip
Phone
*
Cell
Email
*
City License #
*
State License #
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Item Information
Application Type
*
-- Select One --
Residential
Commercial
Apartment
Single Fixture Only
Description of Work
*
List Fixtures
($5 per fixture)
Total Installation Fixture Count
Commercial Dishwasher
($20 per item)
Water Heaters
New Gas Water Heater
New Electric Water Heater
Replace Gas Water Heater
Replace Electric Water Heater
($15 per water heater)
Water Heater Additional information
Water/Sanitary/Storm
Sanitary Sewer
Storm Sewer
Water service Supply
($20 per system)
Water/Sewer/Storm Additional Information
Gas Piping
Natural gas piping (1-4 outlets - $20)
LP/Propane gas piping (1-4 outlets - $20)
LP Tank ($20 per tank)
Number of gas outlets and LP Tanks
($4 per outlet over 4)
Furnace
New gas furnace
New oil furnace
Replacement gas furnace
Replacement oil furnace
($20 per furnace)
Number of furnaces
Boiler
New gas boiler
New electric boiler
New oil boiler
Replacement gas boiler
Replacement electric boiler
Replacement oil boiler
($20 per boiler)
Number of boilers
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Additional Item Information
Interceptor
Oil interceptor
Grease interceptor
Sand interceptor
($40 per interceptor)
Number of interceptors
Pumps
Sewer Ejector/Grinder pump ($40 each)
New Sump Pump ($10 each)
Replacement Sump Pump ($10 each)
New Water Pump ($25 each)
Replacement Water Pump ($25 each)
Number of Pumps
Heaters
Gas Space Heater
Oil Space Heater
Gas Unit Heater
Oil Unit Heater
($10 per heater)
Number of Heater
All Storage Tanks
Residential Storage Tank
Commercial Storage Tank
Removal Storage Tank
($20 per tank)
Number of Storage Tanks
Others Not Listed
($10 per other item)
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Certification of License
If in the opinion of the Plumbing Inspector, drawings and specifications are required for this application, I shall furnish such drawings and specifications.
It is the responsibility of the license holder to give 24 hour advance notice to the Planning and Code Administration Department when work is ready for testing and inspections. Failure to schedule inspections for any period of six months following the issuance of this permit will be cause for the permit to become void.
I acknowledge that I have read this application and affirm that the information supplied by myself is correct; and that the owner/tenant of the referenced property has authorized me to do work described herein. I agree to comply with all City Ordinances and State Law regulating plumbing work.
Certification
*
I certify that I am properly registered and licensed
I do not certify that I am properly registered and licensed
License Holder Name
*
Credit Card Information
*
Call License Holder ($10 service processing fee)
Email License Holder
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Receive an email copy of this form.
Email address
This field is not part of the form submission.
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