DEPT. OF BUILDINGS, CODES & INSPECTIONS DIVISION
City of Tuskegee
No. __________________
APPLICATION FOR PLUMBING PERMIT Plan No. _________________
Zone _________________
1. Application is herby made for a PLUMBING PERMIT.
2. Class or Type of Building (Residence, Commercial, Educational, etc.): ____________________________________
a. Alteration ____________
3. Type of Plumbing (Choose One): b. Repair Work ____________
c. New Work ____________
4. Address: No. _______ Street _________________________________________________________________
5. Owner: __________________________________ Address:_________________________________________
6. Plumbing Contractor: ____________________________________ Address: ___________________________
6a. City, State, Zip Code: ______________________________________ Phone #: _________________________
I HEREBY AGREE to act under permit applied for in full accordance with all Laws and Plumbing Ordinances of the
City of Tuskegee, and in accordance with the attached Plans and Specifications, and I agree that no work will be done
contrary to the same, else the Permit issued hereunder to be void.
Date: ____________________________ , 2 ________ Signed: ____________________________________
________________________________________________________________________________________________________
Plans and Specifications: a. Water Closets / Urinals __________________________
NUMBER b. Lavatories ___________________________
OF c. Bathtubs / Showers ___________________________
FIXTURES: d. Sinks ___________________________
e. Water / Gas Lines ___________________________
f. Sewer Lines ___________________________
g. Wash Tubs ___________________________
Total Cost h. Slop Hoppers ___________________________
of Job $ ____________________ i. Dishwashers ____________________________
j. Grease Traps ____________________________
k. Garbage Disposals __________________________
l. Hot Water Heater ___________________________
TOTAL _____________________________
ACTION UPON APPLICATION BY BUILDING OFFICIAL
THE FOREGOING Application is approved and the same is hereby issued as PLUMBING PERMIT NUMBER
_____________ subject to inspections and approval as work progresses.
Date Issued: ___________________________ , 2 ______ Signed: ___________________________________
Building Official
REPORT OF INSPECTIONS
1. ________________________ Date _______________________ , 2 ________ Signed ____________________
2. ________________________ Date _______________________ , 2 ________ Signed ____________________
3. ________________________ Date _______________________ , 2 ________ Signed ____________________
REVISED 01.24.2008
