Form Center

2. 
3. 
   City of Edna
   CODE ENFORCEMENT
   126 West Main Street- Edna, TX 77957
   Telephone 361-782-3122
   Fax 361-782-2093
5. PLUMBING PERMIT:
7. Permit Date*
9. Plumbing Contractor:*
10. Phone #:*
12. Location:*
13. Building Type*
15. Owner:*
16. Used For:*
18. City*
19. State*
20. Zip*
24. PLUMBING FEES:
25. $25.00
27. IN ADDITION:
29. Each plumbing fixture or trap or set of fixtures or one trap (including water and drainage piping) $2.50
30. Quantity*
31. Amount*
33. For each sewer service $2.50
34. Quantity*
35. Amount*
37. For each water service $2.50
38. Quantity*
39. Amount*
41. For each water heater and/or vent $2.50
42. Quantity*
43. Amount*
45. For each gas piping system of (1) to (5) outlets $4.50
46. Quantity*
47. Amount*
49. For each gas piping system of (6) or more outlets/outlet $1.50
50. Quantity*
51. Amount*
53. For installation of water piping for water treating equipment $2.50
54. Quantity*
55. Amount*
57. Lawn sprinkler system: 1 - 5 sprinkler heads $2.50
58. Quantity*
59. Amount*
61. Each additional sprinkler head/each $1.50
62. Quantity*
63. Amount*
65. PERMIT FEE
66. Total*
68. INSPECTION REQUESTED:
70. Water Heater
71. Date*
72. Time*
74. Top Out
75. Date*
76. Time*
79. Sewer
81. Date*
82. Time*
84. Rough In
86. Date*
87. Time*
89. Final
90. Date*
91. Time*
93. Re-inspection
94. Date*
95. Time*
97. PLEASE READ AND ACCEPT:*

    1. I have read and accepted the terms and conditions.
99. Signature of Applicant*
100. Date*
     Date
104. INTERNAL USE ONLY
     City Cashier/Signature: ____________________________
     
     Plumber:_______________________________________ Phone: ___________________
     
     Inspection Requested Date: ___________________ Time: ____________
     
     List Type of Inspection: _________________________________________
     
     Passed Inspection: ___________ Unsatisfactory: ___________
     
     Comments:__________________________________________________________
     
     Signed By: ____________________________________
     
     City Inspector: _______________________________ Date:________________________
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107. Email address

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