Gas Permit Application

Gas Permit Application

Inspections & Permitting
2850 19th Street South
4th Floor
205-332-6800

PERMIT FEES
- 9.50/$1,000 of job cost for residential properties (minimum $100)
- $10.50/$1,000 of job cost for commercial properties (minimum $101)
Project Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Property Owner Name*

First NameLast Name
Property Owner Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Property Owner Phone Number*

Area CodePhone Number
Property Owner Email*
example@example.com
Is there a building permit number associated with this project?*

YesNo
Permit Number
Gas Company Name*
Gas Company Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Gas Company Email*
example@example.com
Gas Company Phone Number*

Area CodePhone Number

Cost of Project*
State of Alabama Master Plumber License Number*
Name of Applicant*
Today's Date*

MonthDayYear
Date
E-Signature *

First NameLast Name
*By signing your name electronically on this form, you are agreeing that your
electronic signature is the legal equivalent of your manual signature.
Should be Empty: