PLUMBING/ IRRIGATION CONTRACTOR INFORMATION
Complete all additional information for Plumbing Irrigation Permit noted.
Irrigation Plumbing Permit: Total Cost of Plumbing Project $_______________
Plumbing Contractor Name: _______________________________________ Phone #: _________________
Address: ____________________________________________ City: ___________________________
State: ___________ Zip Code: ____________ Email: _______________________________________
NC PLUMBING License #: ___________________ Classification: ____________________________
Irrigation Contractor (if applicable): ______________________________ Phone #: ________________
Address: ____________________________________________ City: ___________________________
State: _________________ Zip Code: ______________ Email: _______________________________
Irrigation License #: ___________________
The following documents are required prior to permit issuance:
[ ] Cost of plumbing project provided
[ ] All plan reviewers have signed off on approvals
[ ] Fee paid at pick-up
SIGNATURES
I/We hereby certify that all information in this application is correct and all work will comply with the
State Plumbing Code and all other applicable State and local laws and ordinances and regulations. The
Inspection Department shall be notified of any changes in the approved plans and specifications for the
project permitted herein.
II/We further certify that I/We have full legal right to request such action and that the statements or
information made in any paper or plans submitted herewith are true and correct to the best of my
knowledge. I/We understand this application, related material and all attachments become official
records of the Town of Clayton, North Carolina, and will not be returned.
_______________________________________ _______________________________
Applicant’s Signature Date
_______________________________________ _______________________________
Owner’s Signature Date
Staff Approval:
_______________________________________ _______________________________
Inspector’s Approval Date
______________________________________ _______________________________
CO Final Date
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
