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 12/31)	Independence Day
Dr. Martin Luther King, Jr. Day	Labor Day
Presidents' Day	Veterans Day
Memorial Day	Thanksgiving
Juneteenth Day (Observed 6/20)	Christmas (Observed 12/26)

Time

: Hour Minutes AM/PM Option
Today's date *

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

Month Day Year
Date
Preferred Date of Inspection *

Month Day Year
Date
Inspection Type *

Commercial Residential Medical Gas
Inspection Location *

Street Address

Suite Number
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 *

Underground Rough Final Water Heater: Remote Inspection Water Heater: In-Person Inspection (subject to re-inspection fee for no-shows) One-Day Bath: Remote Inspection One-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 Cancel of
Water Heater: Attach Temperature Pressure Relief Valve (include discharge point) Picture *

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Water Heater: Attach Pan Picture

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

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

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Water Heater: Attach Gas Hookup (valve, union, drip leg) Picture

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

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One-Day Bath: Attach Drain (P-Trap, other alterations) Picture *

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

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One-Day Bath: Attach full picture of finished job with surround in place and fully caulked *

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One-Day Bath: Attach Additional Picture(s) if needed

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Upload only two additional pictures or video Cancel of
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 Cancel of
Plumbing Company *
Job Site Contact Name *

First Name Last Name
Job Site Contact Phone *

Area Code Phone 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.