Fillable Owner of property Property Address Approximate cost of (City of Spring Hill)

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Owner of property Property Address Approximate cost of (City of Spring Hill)

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-Planning Department
Y:\City Hall\Community Development\FORMS\PERMIT APPS & HANDOUTS\Plumbing Permit.doc Revised 1.9.20
Plumbing Permit
Community Development/Planning Dept.
401 N. Madison St., Spring Hill, KS 66083
(913) 592-3657 ● (913) 592-5040 FAX
planning@springhillks.gov ● www.springhillks.gov
Owner of property
Property Address
County: Johnson Miami Use of building Zoning
Approximate cost of project (labor and materials) $
Contractor License Information
Company Name
Plumbing Contractor Name
Contractor Address City State Zip
Phone E-mail
Johnson or Miami County License #
New plumbing fixture or drainage system (description of work):
Repair or alteration to existing plumbing system (description of work):
NOTE: Please call before you dig by contacting the Kansas One-Call System at 811 or (800) 344-
7233 to locate all local utility lines. Dig Safe # ______________________________________________________
I affirm that the information provided is true and correct and I agree to conform to all regulations of the City of
Spring Hill covering this type of work. I state that the work done is performed by the licensed contractor as stated
above. I understand failure to comply with these provisions may result in the revocation of this permit and or
contractor license.
Applicant Signature
Applicant Name (print) Date
PLUMBING PERMIT
This plumbing permit for the above-described work is hereby approved, subject to all provisions outlined herein, and all work
is performed to the current adopted edition of the International Plumbing Code.
Approved By
Date
Permit No.
Permit Fee $ 50.00
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Owner of property Property Address Approximate cost of (City of Spring Hill)

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Completed 16 July 2020

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