Plumbing Permit Application
THIS IS AN PLUMBING PERMIT APPLICATION ONLY!

To become a permit, this application must be completed with the correct information. It is suggested that you call the Building Department to verify fee amounts. Failure to make proper payment will result in suspension of permit issuance.
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Email *
Property Owner/Customer *
Job Location *
Contractors Phone and Extension *
Contractor *
State License # *
City License # *
Description of Work *
Work Type *
Enter the number of fixtures to be connected below.
Water Closets (number)
Bathtubs (number)
Lavatory (number)
Kitchen Sink/Disposal (number)
Dishwasher (number)
Laundry Tray (number)
Clothes Washer (number)
Water Heater (number)
Urinal (number)
Drinking Fountain (number)
Shower (number)
Floor Sink/Drain (number)
Slop Sink (number)
Gas System (no outlet) (number)
Water Piping/Treating (number)
Water Interceptor (number)
Vacuum Breakers/Backflow (number)
Lawn Sprinkler System (number)
Sewers (number)
Cesspool (number)
Septic Tank & Pit (number)
Other Fixtures (number)
Contract Amount ($) *
Other Details (Optional)
I have completed this application with the correct information and I understand the procedures of this permitting system.  Enter your Signature Code supplied by the Building Department  below, then submit application.  Please print a copy of this application before submitting.  Signature Code: *
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