Form Center

Plumbing Permit Application

2. Contractor*

4. Address*

5. City/State*

6. Zip Code*

8. Contact Person*

9. Contact No. *

11. Reply Email Address*

    choi game cau caEnter the email address you would like us to respond to

15. JOB INFORMATION

17. Job Address*

19. Property Owner*

21. Improvement Cost*

22. Building Type*

    1. Commercial

    1. Residential

24. Attach Document

    Attach document you would like to submit with this application.

25. Attach Document

    choi game cau caAttach document you would like to submit with this application.

27. FIXTURES

29. Fixture
    -- Select One --3-Compartment SinkBackflow DeviceBasinBeauty BasinBidetBuilding SewerDishwasherDrinking FountainElectric Water HeaterFloor DrainFloor SinkGarbage DisposalGas Water HeaterInterceptorPedicure SinkService SinkSewer EjectorShowerSinkTubUrinalWashing Machine ConnectionWater ClosetWater ServiceWhirlpool

30. Quantity

31. Work Type
    -- Select One --New AddReplaceMove

33. Fixture
    -- Select One --3-Compartment SinkBackflow DeviceBasinBeauty BasinBidetBuilding SewerDishwasherDrinking FountainElectric Water HeaterFloor DrainFloor SinkGarbage DisposalGas Water HeaterInterceptorPedicure SinkService SinkSewer EjectorShowerSinkTubUrinalWashing Machine ConnectionWater ClosetWater ServiceWhirlpool

34. Quantity

35. Work Type
    -- Select One --NewAddReplaceMove

37. Fixture
    -- Select One --3-Compartment SinkBackflow DeviceBasinBeauty BasinBidetBuilding SewerDishwasherDrinking FountainElectric Water HeaterFloor DrainFloor SinkGarbage DisposalInterceptorPedicure SinkService SinkSewer EjectorShowerSinkTubUrinalWashing Machine ConnectionWater ClosetWater ServiceWhirlpool

38. Quantity

39. Work Type
    -- Select One --NewAddReplaceMove

41. Fixture
    -- Select One --3-Compartment SinkBackflow DeviceBasinBeauty BasinBidetBuilding SewerDishwasherDrinking FountainElectric Water HeaterFloor DrainFloor SinkGarbage DisposalGas Water HeaterInterceptorPedicure SinkService SinkSewer EjectorShowerSinkTubUrinalWashing Machine ConnectionWater ClosetWater ServiceWhirlpool

42. Quantity

43. Work Type
    -- Select One --NewAddReplaceMove

45. Fixture
    -- Select One --3-Compartment SinkBackflow DeviceBasinBeauty BasinBidetBuilding SewerDishwasherDrinking FountainElectric Water HeaterFloor DrainFloor SinkGarbage DisposalGas Water HeaterInterceptorPedicure SinkService SinkSewer EjectorShowerSinkTubUrinalWashing Machine ConnectionWater ClosetWater ServiceWhirlpool

46. Quantity

47. Work Type
    -- Select One --NewAddReplaceMove

49. Fixture
    -- Select One --3-Compartment SinkBackflow DeviceBasinBeauty BasinBidetBuilding SewerDishwasherDrinking FountainElectric Water HeaterFloor DrainFloor SinkGarbage DisposalGas Water HeaterInterceptorPedicure SinkService SinkSewer EjectorShowerSinkTubUrinalWashing Machine ConnectionWater ClosetWater ServiceWhirlpool

50. Quantity

51. Work Type
    -- Select One --NewAddReplaceMove

53. Fixture
    -- Select One --3-Compartment SinkBackflow DeviceBasinBeauty BasinBidetBuilding SewerDishwasherDrinking FountainElectric Water HeaterFloor DrainFloor SinkGarbage DisposalGas Water HeaterInterceptorPedicure SinkService SinkSewer EjectorShowerSinkTubUrinalWashing Machine ConnectionWater ClosetWater ServiceWhirlpool

54. Quantity

55. Work Type
    -- Select One --NewAddReplaceMove

57. Fixture
    -- Select One --3-Compartment SinkBackflow DeviceBasinBeauty BasinBidetBuilding SewerDishwasherDrinking FountainElectric Water HeaterFloor DrainFloor SinkGarbage DisposalGas Water HeaterInterceptorPedicure SinkService SinkSewer EjectorShowerSinkTubUrinalWashing Machine ConnectionWater ClosetWater ServiceWhirlpool

58. Quantity

59. Work Type
    -- Select One --NewAddReplaceMove

61. Fixture
    -- Select One --3-Compartment SinkBackflow DeviceBasinBeauty BasinBidetBuilding SewerDishwasherDrinking FountainElectric Water HeaterFloor DrainFloor SinkGarbage DisposalGas Water HeaterInterceptorPedicure SinkService SinkSewer EjectorShowerSinkTubUrinalWashing Machine ConnectionWater ClosetWater ServiceWhirlpool

62. Quantity

63. Work Type
    -- Select One --NewAddReplaceMove

65. Fixture
    -- Select One --3-Compartment SinkBackflow DeviceBasinBeauty BasinBuilding SewerDishwasherDrinking FountainElectric Water HeaterFloor DrainFloor SinkGarbage DisposalGas Water HeaterInterceptorPedicure SinkService SinkSewer EjectorShowerSinkTubUrinalWashing Machine ConnectionWater ClosetWater ServiceWhirlpool

66. Quantity

67. Work Type
    -- Select One --NewAddReplaceMove

69. Fixture
    -- Select One --3-Compartment SinkBackflow DeviceBasinBeauty BasinBidetBuilding SewerDishwasherDrinking FountainElectric Water HeaterFloor DrainFloor SinkGarbage DisposalGas Water HeaterInterceptorPedicure SinkService SinkSewer EjectorShowerSinkTubUrinalWashing Machine ConnectionWater ClosetWater ServiceWhirlpool

70. Quantity

71. Work Type
    -- Select One --NewAddReplaceMove

73. Fixture
    -- Select One --3-Compartment SinkBackflow DeviceBasinBeauty BasinBidetBuilding SewerDishwasherDrinking FountainElectric Water HeaterFloor DrainFloor SinkGarbage DisposalGas Water HeaterInterceptorPedicure SinkService SinkSewer EjectorShowerSinkTubUrinalWashing Machine ConnectionWater ClosetWater ServiceWhirlpool

74. Quantity

75. Work Type
    -- Select One --NewAddReplaceMove

77. Fixture
    -- Select One --3-Compartment SinkBackflow DeviceBasinBeauty BasinBidetBuilding SewerDishwasherDrinking FountainElectric Water HeaterFloor DrainFloor SinkGarbage DisposalGas Water HeaterInterceptorPedicure SinkService SinkSewer EjectorShowerSinkTubUrinalWashing Machine ConnectionWater ClosetWater ServiceWhirlpool

78. Quantity

79. Work Type
    -- Select One --NewAddReplaceMove

81. Fixture
    -- Select One --3-Compartment SinkBackflow DeviceBasinBeauty BasinBidetBuilding SewerDishwasherDrinking FountainElectric Water HeaterFloor DrainFloor SinkGarbage DisposalGas Water HeaterInterceptorPedicure SinkService SinkSewer EjectorShowerSinkTubUrinalWashing Machine ConnectionWater ClosetWater ServiceWhirlpool

82. Quantity

83. Work Type
    -- Select One --NewAddReplaceMove

85. Fixture
    -- Select One --3-Compartment SinkBackflow DeviceBasinBeauty BasinBidetBuilding SewerDishwasherDrinking FountainElectric Water HeaterFloor DrainFloor SinkGarbage DisposalGas Water HeaterInterceptorPedicure SinkService SinkSewer EjectorShowerSinkTubWashing Machine ConnectionWater ClosetWater ServiceWhirlpool

86. Quantity

87. Work Type
    -- Select One --NewAddReplaceMove

89. Other

91. Description of Work*

93. I hereby certify that all the information in this application is correct and all work will comply with the State Building Code and all other State and local laws, ordinances and regulations. The Inspections Division will be notified of any changes in the approved plans and specifications for the project permitted herein. I further understand that this is NOT an authorization to begin work. Work may only commence after approval and issuance of the permit.

95. Signature of Applicant*

96. Date
    Date

Leave This Blank:


98. 1. Receive an email copy of this form.
99. Email address

    choi game cau caThis field is not part of the form submission.

100. Submit Submit and Print

* indicates a required field