Application for a Plumbing Permit

PLUMBING PERMIT

APPLICATION FOR CONTRACTORS ONLY.

THIS IS THE APPLICATION ONLY. YOU WILL BE CONTACTED WHEN APPROVED FOR CREDIT CARD PAYMENT. CREDIT CARD FEES WILL BE ADDED TO YOUR TOTAL.

Job address:

Property owner or business name:

Job description:

Job description (cont.)

RESIDENTIAL NEW CONSTRUCTION - FLAT FEE*

PLEASE TYPE THE NUMBER AND FEE AMOUNT

SINGLE FAMILY (ITEMIZE BELOW) - $180.00 per unit

MULTI-FAMILY (EACH DWELLING UNIT - ITEMIZE BELOW) - $160.00 per unit

* RESIDENTIAL FLAT FEE INCLUDES APPLICATION FEE, 1 UNDERGROUND, 1 ROUGH, 1 FINAL INSPECTION

APPLICATION FEE (INCLUDES ONE INSPECTION) - $50.00

ADDITIONAL INSPECTIONS - $50.00 each

WATER HEATER - $5.00 each

FIXTURES, WATER CONNECTED APPLIANCES - $5.00 each

DRAINS - $5.00 each

WATER DISTRIBUTION SYSTEM - $5.00 each

STACKS (SOIL, WASTE, VENT, ROOF CONDUCTOR) - $5.00 each

SEWERS (SANITARY, STORM) - $5.00 each

MONITORING MANHOLE - $5.00 each

SEWER SUMP/EJECTOR - $5.00 each

BACKFLOW PREVENTER - $5.00 each

LAWN SPRINKLER SYSTEM - $5.00 each

MEDICAL GAS PIPING - $5.00 per opening

INVESTIGATION/ADMINISTRATION FEE (HOURLY - 1 HOUR MINIMUM) - $75.00 per hour

TOTAL FEES:

IF INSPECTION CANNOT BE COMPLETED UPON REQUESTED (LOCKED OUT, NOT READY, NO ADDRESS POSTED, ETC.), A REINSPECTION FEE WILL BE CHARGED. IF ANY WORK IS STARTED BEFORE THE PERMIT IS OBTAINED, AN ADMINISTRATIVE/INVESTIGATION FEE SHALL BE PAID BEFORE THE PERMIT IS ISSUED.

CONTRACTOR INFORMATION

Name:

Phone number:

Address:

E-mail Address:

Contractor license number:

Contractor license expiration date:

Federal Employer ID # or exemption reason:

Worker comp. insurance carrier or exemption reason:

MESC employer # or exemption reason:

“Section 23a of the state construction code act of 1972, 1972 PA 230, MCL125.1523A, prohibits a person from conspiring to circumvent the licensing requirements of this state relating to persons who are to perform work on residential building or residential structure. Violators of Section 23a are subject to civil fines.”

I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to make this application as his authorized agent, and we agree to conform to all applicable laws of the State of Michigan. All information submitted on this application is accurate to the best of my knowledge.

The applicant is agreeing that the electronic signature on this document be accepted as original.

Electronic signature:

Date:

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