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Home My WebLink AboutPLUMBING PERMIT APPLICATION (2) MAIL TO: DEPARTMENT OF PUBLIC WORKS COUNTY OF HAWAI‘I PICK UP PHONE # BUILDING DIVISION PLUMBING PERMIT APPLICATION BUILDINGPERMIT# Legal OwnerPhonePlumbing ContractorLicense NoPhone Lessee/TenantPhoneAddressCell PROJECT LOCATION: Email EST COST OF WORK:JourneymanLicense NoPhone EngineeringDateFlood ZoneAddress TYPE OF WORK RESIDENTIALNON-RESIDENTIAL NEWREPAIRGASAS BUILTIRRIGATION NO WORK STARTED ADDITIONSOLARSEWER ABANDONEDCESSPOOLPLUMBING ONLY CONNECTION ALTERATIONOTHER SUPPLEMENT TO M______________________ STRUCTURE CONNECTED PUBLIC SEWER* Wastewater Approval _________________________________________________ TO: Received Electronic Approval *Sewer connection shall be approved by Waste Management prior to backfilling. Failure to notify the division may result in re-excavation for inspection. PRIVATE SEWER CESSPOOL SEPTIC SYSTEM DESCRIPTION OF WORK FEE DETAILS ON BACK DRAINAGE AND WATER SUBTOTAL$ 0.00 FUEL GAS SYSTEMSUBTOTAL$ 0.00 BASE PERMIT FEE$ 10.00 WAIVER$ PENALTY FEE$ CHECK NO.: TOTAL FEE$ READ CONDITION BELOW Permitee is qualified to do the work and possess a valid license pursuant to the provisions of Chapter 444 or 448E of the Hawai‘i Revised Statutes. Permitee is hereby authorized to install the plumbing as shown, in accordance with provisions of the County of Hawai‘i Plumbing code as amended. Per Section 17-18 (f) of the Hawai‘i County Code (“Suspension or Revocation”), the administrative authority may, inwriting, suspend or revoke a permit issued under provisions of this code whenever the permit is issued in error, or on the basis of incorrect information supplied, or in violation of any ordinance or regulation or any of the provisions of this code. This permit becomes null and void if work is suspended at any time during construction for 120 days or more, or if any work is done on the same building or structure in violation of the County of Hawai‘i Plumbing Code or State Statutes governing same. Refund request for permit fee paid must be received by the Building Division within 90 days from issue date of this permit. Notification for Inspection is mandatory. I hereby acknowledge that I have read this application and state that the above is correct and aereby acknowledge that I have read this application and state that the above is correct and agree to comply with all County and State Laws regarding gree to comply with all County and State Laws regarding plumbing. APPLICATION NUMBER PERMITEE’S SIGNATURE ** DATE M JOURNEYMAN’S SIGNATURE**DATE APPROVED BY SIGNATUREDATE **Signature required Ver 6.0 01/18/2012 Hawai‘i County is an Equal Opportunity Provider and Employer DRAINAGE AND WATER SYSTEM UNIT QTYITEMFEE CHARGE Bathtubs Rough In Qty ____@ $ 4.00 Dishwashers@ $ 4.00 Drinking Fountains@ $ 4.00 Floor Drains@ $ 4.00 Floor Sinks@ $ 4.00 Garbage Disposals@ $ 4.00 Grease Interceptors@ $12.00 Interceptors (Sand, dirt, etc…)@ $12.00 Laundry Trays@ $ 4.00 Showers Rough In Qty ____@ $ 4.00 Sinks(Kitchen)Rough In Qty ____@ $ 4.00 Sinks, Bar@ $ 4.00 Sinks, Service@ $ 4.00 Sinks, Hand@ $ 4.00 Sinks, 3 compartment@ $ 4.00 Stand Pipe w/trap (clothes washers)@ $ 4.00 Sumps (Sewage)@ $12.00 Urinals@ $ 4.00 Wash Basins Rough In Qty ____@ $ 4.00 Water Closets Rough In Qty ____@ $ 4.00 Building Sewer or Building Drain Stubout@ $20.00 Sanitary Drainage &/or vent piping (.,@ $20.00 Grey Water Drainage(Utility Room ONLY)@ $20.00 Vacuum Breakers or Backflow Device@ $12.00 Water Heaters (@ $ 4.00 Water Piping (@ $ 4.00 Water Sprinkling System including backflow preventer (Lawn, garden, etc.)@ $12.00 Water Supply System@ $ 4.00 Water Treatment Equip. (UV Filter)@ $ 4.00 Water Pump@ $ 4.00 MISC. FIXTURES @ $ 4.00 @ $ 4.00 DRAINAGE AND WATER SYSTEM SUBTOTAL$ 0.00 FUEL GAS SYSTEM UNIT QTYITEMFEE CHARGE Gas Piping (For the installation of gas appliances)@ $12.00 Gas Piping System (Lab Equip. or other misc. outlets)@ $12.00 Gas Piping System (Ext. Lamps, Luau torches, etc.)@ $12.00 Broilers (Gas)@ $ 4.00 Dryers@ $ 4.00 Hot Plates@ $ 4.00 Ovens@ $ 4.00 Ranges@ $ 4.00 Refrigerators@ $ 4.00 (Gas) Water Heater gas connection@ $ 4.00 Fireplace@ $ 4.00 BBQ@ $ 4.00 MISC. APPLIANCES @ $ 4.00 @ $ 4.00 FUEL GAS SYSTEMSUBTOTAL$ 0.00 Ver 6.001/18/2012