PLUMBING PERMIT (PLB) APPLICATION
Planning & Building Services Department
Building Division
200 S. Willow St.
P.O. Box
1727
Jackson, WY
83001
phone: (307) 733-7030
www.tetoncountywy.gov
Fees
Paid
For Office Use Only
Check # Credit Card Cash
PLB
To schedule an inspection, please call (307) 732-5745.
Physical Address: _____________________________________________________________________________________________
Subdivision & Lot:_______________________________________________ PIDN:_________________________________________
OWNER: A copy of the Warranty Deed or Contract of Sale must accompany this application.
Name: Phone:
Mailing Address: City, State:
Email: ZIP:
APPLICANT/AGENT: If the applicant is other than owner, a notarized Teton County Planning & Development Letter of Authorization
must accompany this application. Only the owner or his/her authorized agent may sign the application, correction list or
per
mit.
Name: Phone:
Mailing Address: City, State:
Email: ZIP:
CONTRACTOR: Contractors are required to be licensed in the Town of Jackson. A property owner may act as the general contractor
for his/her primary residence only.
Name: Phone:
Mailing Address: C ity, State:
Email: ZIP:
License No.
TYPE OF WORK: If there is already a permit include the permit number here:___________________________________________
New Single-family residence (IRC)
Multi-Family Residential Addition/Remodel (IMC)
New multi-family residential (IMC)
Single Family Residential Addition, Remodel (IRC)
Commercial Addition Remodel (IMC)
