PLUMBING / MECHANICAL- ELECTRICAL
PERMIT APPLICATION

SCOTTSBORO, ALABAMA

OFFICE OF COMMUNITY DEVELOPMENT

1.  LOCATION OF PROPOSED WORK:

        Address                                                                                                                         Block No.               Lot No.                  

2.  OWNER OF PREMISES:

        Name                                                                             Address                                                                                                                

                                                                                                                                Phone number                                                    

3.  CONTRACTOR:

        Name                                                                             Address                                                                                                                

                                                                                                                                Phone number                                                    

4.  DESCRIBE SCOPE OF JOB:                                                                                                    

** JOB VALUATION (commercial electric or mechanical) $                                                                       

*** SIZE OF SERVICE/BREAKER PANEL (residential electric):                                                    

* NUMBER OF BATHROOMS (residential plumbing):                                                                   

* NUMBER OF FIXTURES (commercial plumbing):                                                                      

SPECIAL ATTENTION NEW CONTRACTORS

*  PLUMBING            (1) State master plumbing certification.

                                    Applicant shall have wallet identification card.

                                    (2) City License required.

** HVAC                      (1) State certified by heating and air conditioning board.

                                    Applicant shall have wallet identification card.

                                    (2) City License required.

*** ELECTRICAL       (1) City License required.

Date: