Plumbing Permit Application - Department Of Development - Cityof Columbus
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1Date ___________________________________ Applications # _________________________________
C ity of C olumbus | Depar tment of Development | BuildingSer vic es Division | 757C a rolyn Ave nue , C olum bus, O hio43224
PLUMBING PERMIT APPLICATION
FOR 4 OR MORE FAMILY RESIDENTIAL AND COMMERCIAL
TYPE OR PRINT ALL INFORMATION
ð
4 (OR MORE) FAMILY RESIDENTIAL - # OF DWELLING UNITS =
¨ COMMERCIAL
¨ MULTIPLE PERMIT APPLICATIONS SUBMITTED
APPLICATION #
OF
Assessment of single application fee will only be made to applications
Please indicate the total number of applications being
submitted for the same address at the same time
submitted for the same address at the same time
TYPE OF PERMIT ¨ New Construction
Bldg Permit #
¨ Alter Existing
¨ Addition to Building
ADDRESS OF JOB _________________________________ City _________________________ Zip Code _________________
Working In Unit(s) # ________________________
TAX DISTRICT/PARCEL # __________________________________
Tenant Name(s)__________________________________ Telephone ( ____ ) _____________________________________
CONTRACTOR _____________________________________ Telephone ( ____ ) ______________FAX ( ____ ) ____________
Street Address ___________________________________City/State _____________________Zip Code _______________
License # _______________________________________Email ________________________________________________
________________________________________________________________________________________________________
SIGNATURE OF LICENSED CONTRACTOR OR AUTHORIZED SIGNER
PRINT OR TYPE NAME
PROPERTY OWNER OF RECORD _____________________________________________________________________________
Telephone ( ____ ) _________________________________ FAX ( ____ ) ___________________________________________
Street Address __________________________________ City/State _____________________Zip Code ________________
________________________________________________________
______________________________________________
SIGNATURE OF OWNER
PRINT OR TYPE NAME
__________________________ _____________________________________________________________________________
SOFT #
AUTHORIZED SIGNATURE OF ACCOUNT
New Construction / Addition: Total Square Foot of the space indicate on the building permit
* Alterations: coverage area (Square footage of
*
area when work is to be done.)
* All square footage is to be rounded to the next higher 1,000
Fee based on total area
Cost base
TYPE
Sq Ft AREA
MULTIPLIER
BASE FEE
Sub total
÷ 1000
Total square
Up to 5000
=
X $ 140.00
footage or
New
coverage
construction,
6,000 to
÷ 1000
=
X $ 70.00
+ $ 65.00
=
additions,
area
49,000
alterations
÷ 1000
50,000 & up
=
X $ 25.00
Water heater replacement
# of units
X $ 45.00
=
Underground Installation Fee (Phase I foundations)
$ 345.00
=
Air Admittance Valves AAV's
# of valves
X $ 10.00
=
Applications Processing Fee
$ 35.00
=
Map Room fee for Address Creation
$ 35.00
=
Receipt #
TOTAL FEE DUE
Incomplete information may result in rejection of submittal. #P-4C 8/06
If you have any questions regarding this form, please call: (614) 645-6340.
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