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City of Belgrade Application for Plumbing Permit I hereby make application for a permit to conduct plumbing work in accordance with all Title 50, Chapter 60, Section 505, MCA and ARM 24.301.301 and ARM 24.301.361. BCP-1 (Rev. 6/2022) You must provide accurate LOCATION and OWNER information, as it is required for the permitting process Address: City: State: MT Zip: Name of Building or Business in Building (if applicable): Directions to property: County: Is job located inside the city limits? (circle one) YES NO 17 digit GEOCODE: Parcel: Lot: Block: Size of Property (acres): Section: Township: Range: Owner Name: Mailing Address : City: State: Zip: Email: Phone: Master Plumber: Master Plumber License Number: Mailing Address (for Permit): City: State: Zip: Email: Phone: Number of Fixtures/traps in each box $10 Each Bath Coffee Maker……………. Type of Building (required) Single Family Multiple Family Lavatory……………… Drinking Fountain……….. Commercial/Public Shower……………….. Dental Chair…………….. Urinal…………………. Floor Drain………………. Accessory Building Type of Work (required) Water Closet (Toilet)… Area New Kitchen Sink………..… Indirect Waste…………… Alteration/Addition Service Sink……….…. Grease Trap……………… Wash/Laundry Tray…. Bar Sewer Service Type (required) Public Sewer System Dishwasher…………… Floor/Mop Sink……………. Septic System Laundry Sump Drain/Lift Station… Car Wash Sump……… Glass Washer………….. Potable Water Source (required) Ice Machine………….. Aspirator………………….. Glass Fill Station…….. X-Ray Potable Water Source Public Utility Fee Schedule: Fee Number Amount Due Gray water system, commercial or residential… $60 Repair or alteration of drainage or vent piping $30 Alteration or repair of water piping and/or treatment $30 X yes / no = X yes / no = X yes / no = Master Plumber Signature Print name Total: $ Date: Make checks payable to: City of Belgrade City of Belgrade Community Development Department - 91 East Central Ave. - Belgrade, MT 59714 Phone: (406) 388-3560 Each connection of building water supply to water service/public utility or private well… $20 X = Each connection of building drain to sewer system/ public or septic $20 X = Each NEW water heater (or replacement) $25 X = Each storm drain and storm drainage $30 X = Each lawn sprinkler, fire protection system, any meter, or backflow protection device $30 X = Each hose bibb, vacuum, breaker, and/or backflow device $6 X = Each industrial water pre-treatment equipment including its drainage and vent $30 X = Single-Family Residential Gas line - (any type) ***Commercial see mechanical permit*** $48 X = Each plumbing fixture or trap total from boxes above***) $10 X =