Full Text
Revised 7/2025 Page 1 of 2 PLUMBING PERMIT APPLICATION CITY OF MIDLAND – BUILDING DEPARTMENT 333 W. ELLSWORTH ST, MIDLAND, MI 48640 [PHONE REDACTED] email: [EMAIL REDACTED] PROJECT ADDRESS OWNER EMAIL CONTRACTOR INFORMATION CONTRACTOR ADDRESS MASTER PLUMBERS LICENSE # EXPIRATION DATE CONTRACTOR LICENSE PHONE HOMEOWNER AFFIDAVIT: (if permit is under homeowner’s name) 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 in or about to occupy. All work shall be installed in accordance with the Michigan Plumbing Code and shall not be enclosed, covered up, or put into operation until it has been inspected and approved by the City Plumbing Inspector. I will cooperate with the City Plumbing Inspector and assume the responsibility to arrange for necessary inspections. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ THIS APPLICATION AND ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. SECTION 23a OF THE CONSTRUCTION CODE ACT OF 1972, 1972 PA 230, MCL 125.1523A, PROHIBITS A PERSON FROM CONSPIRING TO CIRCUMVENT THE LICENSING REQUIREMENTS OF THIS STATE RELATING TO PERSONS WHO ARE TO PERFORM WORK ON A RESIDENTIAL BUILDING OR RESIDENTIAL STRUCTURE. VIOLATORS OF SECTION 23a ARE SUBJECTED TO CIVIL FINES. SIGNATURE OF OWNER OR CONTRACTOR (Homeowner signature indicates compliance with Homeowner Affidavit) PRINTED SIGN ---PAGE BREAK--- Revised 7/2025 Page 2 of 2 LOCATION AND DESCRIPTION OF WORK: ENTER APPROPRIATE # OF FIXTURES IN EACH SPACE: BATHTUB EMERGENCY SHOWER LAVATORY/WASH BASIN SUMP PUMP CLOTHES WASHER EYE WASH SHOWER URINAL DISHWASHER FLOOR SINK/DRAIN KITCHEN SINK/DISPOSAL WATER CLOSET DRINKING FOUNTAIN LAUNDRY TRAY SLOP SINK FEE SCHEDULE PERMIT ITEM NO. FEE TOTAL TOTAL OF EACH PLUMBING FIXTURES ABOVE $25.00 (EA) ANNUAL PERMIT (AS AUTHORIZED BY IBC SECTION 105.1.1) $1,500.00 BACK FLOW PREVENTION DEVICE ˂ 2 INCHES $15.00 BACK FLOW PREVENTION DEVICE ˃ 2 INCHES $32.00 WATER HEATER NEW $21.00 WATER HEATER REPLACEMENT BASE FEE LAWN SPRINKLER ON ONE METER W/VACUUM BREAKER $15.00 PLUMBING OTHER (ANY CODE REGULATED ITEM NOT LISTED) $13.00 PRIVATE SEWAGE DISPOSAL SYSTEM $84.00 RAIN WATER SYSTEM, PER DRAIN (INTERIOR) $11.00 VACUUM BREAKER $15.00 WASTE INTERCEPTOR (COMMERCIAL), INCLUDING TRAP & VENT $17.00 WATER PIPING AND/OR WATER TREATING EQUIPMENT $15.00 (INSTALL, REPAIR, ALTERATION) CONTRACTOR’S LICENSE REGISTRATION (YEARLY) $15.00 BASIC PERMIT ISSUING FEE (ALWAYS APPLIES) $53.00 $53.00 TOTAL: