DevSvcs-TE-1.1-20150227
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Innovative - Responsive - Professional
Supplemental
Plumbing Information
Building Services
Indicate the number of each type of fixture (including rough-ins) to remain in place, to be installed, to be relocated or replaced, or
to be removed under this permit. This form is to be used in combination with a Plumbing or Building Permit Application.
Existing,
(No change)
New,
Relocated,
or Replaced
Removed
Existing,
(No change)
New,
Relocated,
or Replaced
Removed
Back Water Valve
Bar Sink
Bathroom Sink
Bidet
Clothes Washer
Commercial Kitchen Sink
Dishwasher
Drinking Fountain
Engineered Laboratory System
Floor Drain
Floor Sink
Garage Drain
Grease Interceptor
Grease Trap
Grey Water System
Hose Bib
Ice Maker
Indirect Drain
Instant Hot Water Tap
Kitchen Sink
Laundry Sink
Laundry Tub
Medical Gas Outlet
Medical Gas System
Mop Sink
Oil or Sand Interceptor
Pool or Spa Drain
Pressure Reducing Valve
Rain Water Recovery System
Reclaimed Water System
Roof Drain - Interior
Roof Drain - Exterior
Service Sink
Sewage Ejector or Grinder Pump
Shower (Stand Alone)
Sovent System
Storm or Yard Drain
Sump Pump
Toilet (Water Closet)
Trap Primer
Tub or Tub/Shower Combo
Underslab or Footing Drain
Urinal
Utility Sink
Waste Interceptor
Waste & Vent Combined System
Water Heater (Electric)
Water Heater (Gas, replacement)*
Water Heater, Tankless (Electric)*
Water Service Line
Other
Describe Other:
*Fuel gas piping and new fuel gas fixtures require a
Mechanical Permit, and shall not be installed or
inspected under a Plumbing permit.
Project Address:
