Electrical Plumbing Gas Mechanical ApplicationAPPLICATION – ELECTRICAL/PLUMBING/GAS/MECHANICAL PERMIT
Building Department 102 West Main Street Prattville, AL 36067 334.595.0400 FAX 334.361.3677 building@prattvilleal.gov
I certify that I have read this document and state that the information is correct. I agree to comply with all City of Prattville ordinances and state laws related to facilities listed above.
Applicant Signature Date
Commercial Residential Date: ____________ Job Location (Address): ___________________________________________ Please circle below Applicant/Contractor: ___________________________________ Telephone: _________________ Prattville Business License #: ____________ AL or Local Professional License #:_____________ Please circle below Owner/Home Builder/General Contractor: ______________________________________________
Telephone: _______________________ Job Amount (if commercial) $______________________
Scope of Work: ____________________________________________________________________
ELECTRICAL FACILITIES Alabama Power Repair/Replacement WWC Electrical Service Provider: Central Alabama Electric Co-Op Upgrade Service _____ AMPS
Number Number Number
Range/Cooktop Dishwasher Temp Pole
Clothes Dryer Exhaust Fan Sign/Outdoor
Water Heater Heating Appl. Reconnection
Garbage Disposal Meter Loop/AMPS Outlets/Lights/Switches *
A/C Units Swimming Pool Misc. *total # outlets, lights, & switches PLUMBING FACILITIES GAS FACILITIES Type of Waste Disposal: Public Sewer Private Septic System Potable Water Source: Public System Well
Number Number Number
Bath Tubs Lavatories Cook Top – gas
Dishwasher Sinks Furnace – gas
Disposal Units Shower Gas Logs
Drinking Fountain Washing Machine Grill Connection – gas
Floor Drain Water Closets Range – gas
Grease Trap Water Heater Water Heater - gas Laundry Tubs Vacuum Breaker/Backflow MECHANICAL FACILITIES
Fuel Type: Electrical Natural Gas Propane CHANGEOUT ONLY
Number Tonnage (If multiple units, please separate) Heating/Cooling/ Ventilation Units
Refrigeration Units