Plumbing and Medical Gas Inspection Request Form

Plumbing and Medical Gas Inspection Request
BEGINNING SEPTEMBER 7, 2021, FRANKLIN COUNTY PUBLIC HEALTH WILL REQUIRE THAT INSPECTION REQUESTS BE RECEIVED BEFORE 12:00 P.M. FOR NEXT DAY INSPECTIONS. ANY REQUESTS RECEIVED AFTER THAT WILL NOT BE ABLE TO BE SCHEDULED FOR THE NEXT DAY.

The plumbing and medical gas inspection request form below is for contractors to complete. This form will be used for both in-person or remote/virtual inspections. Please enter information into all required fields (*) and click on the submit button at the end of this form.

Please note that Franklin County Public Health is closed on the following days:

New Year's Day (Observed 01/02)	Independence Day
Dr. Martin Luther King, Jr. Day	Labor Day
Staff Training (01/25)	Veterans Day
Presidents' Day	Thanksgiving & Friday (11/23, 11/24)
Memorial Day	Christmas
Juneteenth Day (Observed 06/19)

Time

:HourMinutesAM/PM Option
Today's date*

MonthDayYear
Date
**INSPECTION REQUESTS WILL BE ACCEPTED UNTIL 12:00 PM (NOON) FOR NEXT DAY INSPECTIONS**
Preferred Date of Inspection*

MonthDayYear
Date
Preferred Date of Inspection*

MonthDayYear
Date
Inspection Type*

CommercialResidentialMedical Gas
Inspection Location*

Street Address

Suite Number

CityState / Province

Postal / Zip Code
Select County (Select Franklin or Madison)*
Select the correct city, township or village*
Select the correct city, township or village*
Permit Number*
INSPECTION PROCESS CHANGES FOR RESIDENTIAL PLUMBING:

MAJOR HOME and BATHROOM REMODELS:
All residential major home and bathroom remodels will require in-person inspections.

ONE-DAY BATHROOM REMODELS:
All residential one-day baths require inspection. These inspections can be conducted in-person or remotely by submitting digital pictures/video using this form below.

RESIDENTIAL WATER HEATERS:
All residential water heaters require inspection. These inspections can be conducted in-person or remotely by submitting digital pictures/videos using this form below.

If you have any questions, please contact Sandy Cameron at 614-525-3635. Thank you for your cooperation.
Type of Inspection*

UndergroundRoughFinalWater Heater: Remote InspectionWater Heater: In-Person Inspection (subject to re-inspection fee for no-shows)One-Day Bath: Remote InspectionOne-Day Bath: In-Person Inspection (subject to re-inspection fee for no-shows)Back Water Valve: Remote Inspection ONLY
Water Heater: Attach Hot & Cold Pipes and Shut-Off Valves(s) Picture*

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Upload only one image Cancelof
Water Heater: Attach Temperature Pressure Relief Valve (include discharge point) Picture*

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Upload only one image Cancelof
Water Heater: Attach Pan Picture

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Upload only one image Cancelof
Water Heater: Attach Flue Piping from the Water Heater to Termination Point (Gas only) Pictures

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Upload up to three images Cancelof
Water Heater: Attach Direct Vent (include termination and rodent screening) Picture

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Upload only one image Cancelof
Water Heater: Attach Gas Hookup (valve, union, drip leg) Picture

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Upload only one image Cancelof
One-Day Bath: Attach Rough Valve Body *Hot Picture*

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Upload only one image Cancelof
One-Day Bath: Attach Drain (P-Trap, other alterations) Picture*

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Upload only one image Cancelof
One-Day Bath: Attach Check Hot Water Temperature Picture*

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Upload only one image Cancelof
One-Day Bath: Attach full picture of finished job with surround in place and fully caulked*

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Upload only one image Cancelof
One-Day Bath: Attach Additional Picture(s) if needed

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Upload only two additional pictures or video Cancelof
Back Water Valve: Attach Picture(s) showing Connection of Back Water Valve on Existing Pipe and Close Up of Level on Back Water Valve. *

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Upload only one image Cancelof
Plumbing Company*
Job Site Contact Name*

First NameLast Name
Job Site Contact Phone *

Area CodePhone Number
Project Name
Lot/Building/Suite Number (if applicable)
Email*
example@example.com
Additional Information
Should be Empty:

Plumbing and Medical Gas Inspection Request

The plumbing and medical gas inspection request form below is for contractors to complete. This form will be used for both in-person or remote/virtual inspections. Please enter information into all required fields (*) and click on the submit button at the end of this form.