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Plumbing (Residential Only)

  1. Date:__________ Permit # ___________________ PID # ___________________ Notes: ______ Total $________

  2. This is a plumbing permit application for residential only. If you are putting in commercial plumbing, complete the paper Plumbing Permit application.

  3. Structure Type*

  4. Construction Type*

  5. The Applicant Is*

  6. If applicant is other, please explain.

  7. Provide a detailed description of the work that will be done to complete this project.

  8. Fixtures:*

    Check all that apply

  9. If you selected the "other" box above, please explain.

  10. All fees are based on valuation, including cost of labor and materials. The minimum fee is $45 plus state surcharge.

  11. 1.5% of Total Job Valuation - minimum $45

  12. .0005 x Total Job Valuation

  13. Make checks payable to City of Elk River

  14. Method of Payment*

    Permits must be paid for before being issued.

  15. Receipt of Permit*

  16. Indicate who to contact for payment.

  17. This is an application for a permit - it is not valid until processed*

    I hereby apply for a plumbing permit, and I acknowledge that the information above is complete and accurate; that I understand this is not a permit and work is not to start without a permit. I understand and hereby agree that the work for which the permit issued shall be performed according to: (1) the conditions of the permit; (2) the approved plans and specifications; (3) the applicable city approvals, ordinances, and codes; and (4) the state building/plumbing codes and regulations. I understand that the permit will expire, and become null and void if work is not started within 180 days or if work is suspended or abandoned for a period of 180 days any time after work has commenced. I understand that I am responsible for ensuring that all required inspections are requested in conformance with the state building code.

  18. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  19. Approved for issued by: _________ Date:________ Hard Card or Soft Card Soft card reference permit # _________ Called or L/M Date: _______ Int: ______

  20. Leave This Blank:

  21. This field is not part of the form submission.