Plumbing Permit Application

City of Mountain Home Plumbing Permit Application

[{"type":"paragraph","subtype":"p","label":"To report an emergency, call 911 (where applicable) or your local law enforcement office. This form is for non-emergency contact only. We will contact you once we have received your submission, if your contact information is provided. If you do not hear from us in 24 hours, please call our office.  870-425-2550.<div><br></div>","className":"d-block"},{"type":"text","required":true,"label":"Applicant Name:","name":"Applicant-Name","className":"d-block","subtype":"text"},{"type":"date","required":true,"label":"Date of Application:","name":"Date-of-Application","className":"col-lg-4"},{"type":"text","label":"Permit #:","name":"Permit-","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","required":true,"label":"Site Address:","name":"Site-Address","className":"d-block","subtype":"text"},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"paragraph","subtype":"p","label":"Property Owner Information","className":"d-block"},{"type":"text","required":true,"label":"Property Owner Name:","name":"Property-Owner-Name","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Property Owner Address:","name":"Property-Owner-Address","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Phone #:","name":"Phone-","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","required":true,"label":"Email Address:","name":"Email-Address","className":"col-md-6","subtype":"text"},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"paragraph","subtype":"p","label":"Contractor Information","className":"d-block"},{"type":"text","required":true,"label":"Contractor Name:","name":"Contractor-Name","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Mailing Address:","name":"Mailing-Address","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Office #:","name":"Office-","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","label":"Cell #:","name":"Cell-","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","required":true,"label":"Master License #:","name":"Master-License-","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","required":true,"label":"License Exp. Date:","name":"License-Exp-Date","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","required":true,"label":"Email Address:","name":"Email-Address","className":"col-md-6","subtype":"text"},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"paragraph","subtype":"p","label":"General Information","className":"d-block"},{"type":"number","required":true,"label":"# of Closets","name":"-of-Closets","min":0,"className":"col-md-6 col-lg-3"},{"type":"number","required":true,"label":"# of Sinks","name":"-of-Sinks","min":0,"className":"col-md-6 col-lg-3"},{"type":"number","required":true,"label":"# of Lavatories","name":"-of-Lavatories","min":0,"className":"col-md-6 col-lg-3"},{"type":"number","required":true,"label":"# of Showers","name":"-of-Showers","min":0,"className":"col-md-6 col-lg-3"},{"type":"number","required":true,"label":"# of Bathtubs","name":"-of-Bathtubs","min":0,"className":"col-md-6 col-lg-3"},{"type":"number","required":true,"label":"# of Washing Machines","name":"-of-Washing-Machines","min":0,"className":"col-md-6 col-lg-3"},{"type":"number","required":true,"label":"# of Dishwashers","name":"-of-Dishwashers","min":0,"className":"col-md-6 col-lg-3"},{"type":"number","required":true,"label":"# of Urinals","name":"-of-Urinals","min":0,"className":"col-md-6 col-lg-3"},{"type":"number","required":true,"label":"# of Water Heaters","name":"-of-Water-Heaters","min":0,"className":"col-md-6 col-lg-3"},{"type":"number","required":true,"label":"# of Floor Drains","name":"-of-Floor-Drains","min":0,"className":"col-md-6 col-lg-3"},{"type":"number","required":true,"label":"# of Drinking Fountains","name":"-of-Drinking-Fountains","min":0,"className":"col-md-6 col-lg-3"},{"type":"number","required":true,"label":"# of Rough-in-Charges","name":"-of-Rough-in-Charges","min":0,"className":"col-md-6 col-lg-3"},{"type":"number","required":true,"label":"Gas Service","name":"Gas-Service","min":0,"className":"col-md-6 col-lg-3"},{"type":"number","required":true,"label":"Water Service","name":"Water-Service","min":0,"className":"col-md-6 col-lg-3"},{"type":"number","required":true,"label":"Sewer Service","name":"Sewer-Service","min":0,"className":"col-md-6 col-lg-3"},{"type":"number","required":true,"label":"# of Backflow Devices","name":"-of-Backflow-Devices","min":0,"className":"col-md-6 col-lg-3"},{"type":"number","required":true,"label":"Grease Trap","name":"Grease-Trap","min":0,"step":0,"className":"col-md-6 col-lg-3"},{"type":"text","required":true,"label":"Job Description","name":"Job-Description","className":"d-block","subtype":"text"},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"checkbox-group","required":true,"label":"Is the Property:","name":"Is-the-Property","className":"col-md-6","values":[{"label":"Commercial","value":"Commercial"},{"label":"Residential","value":"Residential"}]},{"type":"checkbox-group","required":true,"label":"Is the Property:","name":"Is-the-Property","className":"d-block","values":[{"label":"New Construction","value":"New Construction"},{"label":"Addition","value":"Addition"},{"label":"Remodel","value":"Remodel"}]},{"type":"paragraph","subtype":"p","label":"ALL COMMERCIAL ISOMETRIC DRAWING SHALL BE SUBMITTED TO THE STATE HEALTH DEPARTMENT FOR APPROVAL.  THIS DEPATMENT HAS TO HAVE THE APPROVAL LETTER PRIOR TO A PLUMBING PERMIT BEING ISSUED.<div><br></div><div>PLUMBING PLANS CAN BE SUBMITTED BELOW FOR PLAN REVIEW.</div>","className":"d-block"},{"type":"file","label":"Please select one or more files for upload. You may upload up to 20 files (35 Mb max). Files can be PDF, JPG, JPEG format. To upload multiple files, please hold control while clicking on multiple files before clicking \"Open\".","name":"file-1772719583994","subtype":"file","multiple":true,"className":"d-block"}]