PLUMBING 2025

VILLAGE OF MINERVA PARK

2829 MINERVA LAKE RD. COLUMBUS, OH 43231 614-882-5743 minervapark.gov
Plan Approval Number (Office Use Only)
PERMIT INFORMATION
CommercialResidential
With Approved PlansMinor ModificationWater Heater Only
PROJECT INFORMATION
Project Name*
Project SummaryDescription
Address*

Project Address

Street Address Line 2

CityStateZipState / Province

Postal / Zip Code
Total Project Fixture Count*
see next page to determine final count
YesNo
PLUMBING CONTRACTOR/HOMEOWNER
Name*
Business Name
Address

Address

Street Address Line 2

CityStateZip CodeState / Province

Postal / Zip Code
Email Address*
example@example.com
Phone Number*
The undersigned hereby applies for a permit to perform plumbing services and allow an inspection of the work performed at the location sited below in accordance with the Ohio Plumbing Code and Franklin County Public Health Regulation 103. SignatureDate
Signature*

Clear
Administrative/Technology Fee of $135 is added to ALL permits. $135
Commercial Fixture Count
Commercial Fixture Fee
# of fixtures X $40
Residential Fixture Count
Residential Fixture Fee
# of fixtures X $20
TOTAL PERMIT FEE
$135 + Fixture Fee

Credit/Debit Dard-Choose your product belowCash or Check-other forms of payment may be mailed or dropped off at 2829 Minerva Lake Rd. 43231 - please call 614-882-5743 with questions