Full Text
… … … … 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. 10/2019) 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……………. Lavatory……………… Drinking Fountain……… Shower……………….. Dental Chair…………….. Urinal…………………. Floor Drain………………. Water Closet (Toilet) Area Type of Building (required) Single Family Multiple Family Commercial/Public Accessory Building Type of Work (required) New Kitchen Sink………..… Indirect Waste…………… Alteration/Addition Service Sink……….…. Grease Trap…………… Wash/Laundry Tray…. Bar Dishwasher………… Floor/Mop Sink………… Laundry Sump Drain/Lift Station… Car Wash Sump…… Glass Washer………….. Ice Machine………….. Aspirator………………… Glass Fill Station…….. X-Ray Tank……………… Sewer Service Type (required) Public Sewer System Septic System Potable Water Source (required) 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 = 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 = Each plumbing fixture or trap total from boxes above***) $10 X = Master Plumber Signature Print name Total: $ Date: Make checks payable to: City of Belgrade City of Belgrade Public Works, Planning, & Building - 91 East Central Ave. - Belgrade, MT 59714 Phone (406) 388-3783