Gas Fitter Request for LPG

Gas Fitter Request for LPG
Type of work*
Account Number*
Installation type*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Property type*
Is it a strata-title or does it share common ground?*

YesNo
Is it a new (under-construction) or existing property?*
Builder's Name*
Please specify
Site contact name for Installation*
Site contact number*
Please enter a valid phone number.
Is the distance from the meter box to the property's front boundary more than 6 meters?*

YesNo
6 meters or under = standard connection fee, over 6 meters will require a quote

Standard connection fee is $825 (inc GST)
We will be in contact with you to provide a new connection quote
Do you authorise Supagas to bill the standard connection fee of $825 (inc GST)?*

YesNo
Meter Location*
Pressure*
Date connection required*
Is a meter box installed?*

YesNo
Is there a Type B appliance?*

YesNo
Gasfitter's Name

First NameLast Name
Gasfitter's license number*
Gasfitter's contact number*
Please enter a valid phone number.
Gasfitter's email*
example@example.com
Should be Empty: