Plumbing Permit Application - Charter Township of Commerce

2009 TOWNSHIP DRIVE
COMMERCE, MI 48390
(248) 960-7060
COMMERCE TOWNSHIP
PLUMBING PERMIT
APPLICATION
JOB ADDRESS: ____________________________________
DATE: ________________
OWNER INFORMATION
Owner Name
Telephone
Address City State Zip
CONTRACTOR INFORMATION
Contractor Name Contractor License Number Expiration Date
Address City State Zip Telephone
Drivers License Number Birth Date Liability Insurance
Workers Compensation Insurance Federal Employer ID MESC Employer number
Name of Master Plumber Master License Number Expiration Date
Address City State Zip Telephone
TYPE OF JOB
Single Family
Manufactured Home
Commercial
PLAN REVIEW REQUIRED
New Alteration Sewer Only Water Only
Plans must be submitted with an Application for Plan Examination before a permit can be issued, except as listed below:
1. One and Two Family dwelling containing not more than 3,500 square feet of building area.
2. Alterations and repair work determined by the Plumbing Official to be of a minor nature PLANS NOT REQUIRED
3. Buildings with a required plumbing fixture count less than 12
4. Work completed by a governmental subdivision or state agency costing less than $15,000.000
Plans are required for all other building types and shall be prepared by or under the direct supervision of an architect or engineer licensed
pursuant to 1980 PA 299 and shall bear that architect’s or engineer’s seal and signature.
APPLICANT SIGNATURE
Section 23a of the state construction code act of 1972, 1972PA 230, MEL 125.1523A, prohibits a person from conspiring to circumvent
the licensing requirements of the state relating to persons who are to perform work on a residential building or a residential structure.
Violator of Section 23a are subjected to civil fines.
Signature of licensee or Homeowner: X________________________________________________________________________
(Homeowner signature indicates compliance with Homeowner Affidavit, see below)
Homeowner Affidavit
I hereby certify the plumbing work described on this permit application shall be installed by myself in my own home in which I am living or about to occupy. All work shall be
installed in accordance with the Plumbing Code and shall not be enclosed, covered up, or put into operation until it has been inspected and approved by the Plumbing Inspector.
I will cooperate with the Plumbing Inspector and assume the responsibility to arrange for necessary inspections.
COMPLETE BACKSIDE
G:\Shared\Department\Building\MASTERS\Applications\PLUMBING\Plumbing front 2009.doc EFFECTIVE 10/29/2009

FIXTURES INCLUDE: Water closet, all sinks, drinking fountain, shower, bathtub, laundry, urinal, bidet, jacuzzi, dishwasher, ice maker,
humidifier, eye wash, garbage disposal plus any other fixture or water connected appliance not specifically listed.
GENERAL: Plumbing work shall not be started until the application for permit has been filed and issued. All installations shall be in
compliance with the Michigan Plumbing code. NO WORK SHALL BE CONCEALED UNTIL IT HAS BEEN INSPECTED. All concealed
plumbing work must be tested according to Section 312 Michigan Plumbing Code.
FIXTURES
FEE QTY TOTAL SEWERS FEE QTY TOTAL
Fixtures (listed above)
$ 8.00
Residential - sewer line per 100' $ 25.00
Water softener $ 8.00
Commercial - sewer line 2" $ 30.00
Water Heater $ 8.00
per 100' 4" $ 35.00
Hose bib $ 8.00
6" $ 40.00
3 Compartment sink $ 8.00
over 8" $ 45.00
WATER
FEE QTY TOTAL Additional 50' or portion there after $ 10.00
Water service 1" $ 20.00
Manhole, utility holes $ 14.00
100' 1 1/2" $ 30.00
Backwater valve $ 11.00
2" $ 35.00
Clean-outs $ 5.00
over 2" $ 40.00
Floor Drain $ 8.00
Additional 50' or portion there after $ 10.00
Interceptor (grease, oil, sand) $ 13.00
Sewage ejection pump / basket $ 17.00
Water distribution 3/4" $ 15.00
Branch drains $ 14.00
100' 1" $ 20.00
Stacks, vents $ 8.00
1 1/4" $ 25.00
Air admittance valve $ 15.00
1 1/2" $ 30.00
OTHER FEE QTY TOTAL
2" $ 35.00
Medical gas (each outlet) $ 8.00
over 2" $ 40.00
Medical gas pressure test $ 30.00
Additional meter $ 20.00
Dental chair $ 8.00
Backflow preventer $ 11.00
Beverage dispenser $ 8.00
Pressure reducer valve $ 7.00
Condensate drain $ 8.00
Storage tank $ 32.00
Acid waste drain $ 8.00
Expansion tank $ 7.00
Pedicure station $ 8.00
Recirculation pump
$10.00 Mobile/Modular tie in only $ 20.00
Hot water return line
$ 5.00 In ground pool $ 36.00
Tempering valve
$ 7.00 EXTRAS FEE QTY TOTAL
STORM SEWERS FEE QTY TOTAL Additional inspection $ 50.00
Commercial - storm sewer 4" $ 25.00
Re-Inspection $ 50.00
per 100' 6" $ 30.00
Renewal $ 73.00
8" $ 35.00
New business inspection $ 57.00
over 10" $ 40.00
Registration $ 15.00
Additional 50' or portion there after $ 10.00
Plan Review $ -
Manhole, utility holes $ 14.00
Roof sump $ 9.00
Strom drain conductors $ 8.00
ADMINISTRATIVE FEE $ 30.00 1 $ 30.00
Clean-outs $ 5.00
BASE FEE 2 inspections $ 30.00 1 $ 30.00
Sub-soil/ weeping tile $ 25.00
Sump pump / basket 10.00
Sump discharge pipe $ 7.00
$ TOTAL $
EFFECTIVE 10/29/2009