CITY OF LITTLE ROCK
DEPARTMENT
OF PLANNING & DEVELOPMENT
BUILDING
CODES DIVISION APPLICATION FOR:
723
WEST MARKHAM, 2ND FL LAWN SPRINKLER
LITTLE ROCK, AR 72201 (RPZA IRRIGATION PERMIT)
PHONE (501) 371-4841 OR (501) 371-4842 OR (501) 371-4840
FAX: (501) 371-4546 EMAIL: permits@littlerock.gov
OFFICIAL USE ONLY
PERMIT NO. 2019
DATE ISSUED
ISSUED BY
INSPECTIONS
APPLICANT (Please Check)
WILL CALL READY
INSPECTOR'S COMMENTS
MANUFACTURE
MODEL NUMBE
RPZ SIZE SERIAL NUMBE
PROJECT ADDRESS: PROJECT NO.:
OWNER/TENANT:
ADDRESS: TELEPHONE:
PLUMBING CONTRACTOR:
ADDRESS:
LI CENSE NO.:
T ELEPHONE/FAX:
IRRIGATION CONTRACTOR:
ADDRESS:
CLASS OF WORK: NEW REPLACEMENT
T ELEPHONE:
QTY COST QTY COST
1. RPZ IRRIGATION SYSTEM
(REQUIRING ADDITIONAL METER)
26.95 3. INSPECTIONS (REQUIRED) 21.55
2. RPZ REPLACEMENT
26.95
4. DATA PROCESSING FEE (REQUIRED)
LOCATION OF RPZ ASSEMBLY ON PREMISES METER LOCATION
LOCATED WITHIN 10 FT. OF WATER METER
STREET ALLEY
REMOTE LOCATION (SPECIFY):
NOTICE: SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, GAS, PLUMBI
NG AND HVACR WORK.
I hereby certify that the data submitted on or with this application is true and correct. Any deviation from information contained herein,
unless approved by the Building Official will render this permit null and void.
SIGNATURE OF CONTRACTOR, OWNER OR AGENT DATE
REV 1/19
$5 res
$7 comm
