Building Department
100 Hughes Road
Madison, Alabama 35758
Phone: 256-772-5644
FAX: 256-772-5601
http://www.madisonal.gov
PLUMBING PERMIT
Incomplete applications may not be processed.
CASH CARD Check #: ePermitting: www.buildportal.madisonal.gov
Building Permit#: Date:
Plumbing Permit#: Email Address:
Subdivision/Lot#: Street Address:
Property Owner’s Name: Contact#:
Plumbing Contractor: Contact#:
Company Address:
City of Madison License #: State Card License #:
Contract Price, if for a repair: $
Job Type: New Replacement
Type: Residential Commercial
Please choose:
New Single Family Home / per dwelling unit in Multi-Family structures
Commercial (including Hotels & Motels)
.005 multiplied by contract cost but not
less than $100.00
Water Heater replacement (residential & commercial)
Water / Sewer line replacement (residential & commercial)
New or Additional Water / Sewer line (residential or commercial)
Repair / replacement of interior water lines, valves, drain pipes or vent
piping.
Total contract price multiplied by .01
but not less than $25.00
Minimum permit fee for work not provided for herein.
I certify and acknowledge that I have read this application, that all information provided herein is true and correct, and all work performed as described
above and for which a permit is issued shall conform to all City Codes, Ordinances and State Laws and plans and specifications herewith submitted. By signing
this application, I am certifying that I will meet all requirements as a contractor under the laws of the State of Alabama, to include any exemptions as
provided by law and that I am authorized by the owner to execute this document as his or her agent. As a contractor, I certify and agree to protect all public
improvements and public utilities adjacent to or serving the property on which the proposed structure or structures described above are located, whether or
not the said improvements or utilities are the property of the City of Madison. I further agree to make or cause to have made repairs to, satisfactory to the
City of Madison, public improvements or utilities damaged as a result of actions, misuse, or lack of care on the part of any of my employees, agents,
subcontractors, or suppliers of materials of said public improvements or utilities.
Applicant Signature: Date:
Permit Specialist: Date
click to sign
signature
click to edit
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