RESIDENTIAL ONLY

PLUMBING PERMIT APPLICATION
(PLUMBING PERMIT TO BE SECURED 24 HOURS BEFORE WORK STARTS)


Name of Plumber (Print or Type)  ______________________________________________________  Date ____________________

Signature & Licence Number of Plumber ____________________________________________________________________________

Mailing Address:  ________________________________________________________________________________________________

Telephone:  ____________________________________________   Fax Number: ___________________________________________

Builder/Contractor _____________________________________	Property Owner____________________________________

The following abstract of specification of plumbing with description and plan is submitted for approval:

JOB SITE INFORMATION

Road Number  _______________________	Lot Number ______________________________________________

Road Name    _______________________	Nearest Town ____________________________________________

911 Number   _______________________	Kent County or Sussex County ____________________________

Directions to job site, be specific:  ___________________________________________________________

_________________________________________________________________________________________________


DESCRIPTION OF PLAN

Number of Stories  ___________ 

				FIXTURES		SOIL OR WASTE PIPE	VENT PIPE
				How Many		Size	  Material	Size	Material


BATH - 		Water Closet
		Lavatory
		Bathtub
		Shower
		Bidet


KITCHEN -	Kitchen Sink
		Dishwasher
		Ice Maker


UTILITIES -	Washer
		Utility Sinks
		O/S Hose Bib
		O/S Shower
		Water Conditioner
		Water Heater
		Bar Sink


OTHER - 	



FOR OFFICIAL USE ONLY

Types of Inspections Requested:
(48 Hour Notice Required)		

1.	UG	
						PERMIT ISSUED ______________  NO:  ________________	
2.	RI					
						________________________________________________
3.	F					  		Plumbing Inspector

DOC. # 35-05-20/07/02/07