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Step 1

Gas Piping Permit Application
Please include permit number for applications to existing construction projects with approved zoning and/or building permits.
Enter existing Permit # or “New”*
AEC User Name
Date*

Date
Property Owner Name*
Owner Contact #*
Project Street Address*
Project City*
Project State
Project Zip Code
Parcel Identification #
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Contractor Information
This part must contain complete contractor's information, either the Licensed Contractor's or the Homeowner's. If the homeowner is acting as the contractor, the homeowner must complete Step 2 and Step 3.
Permit Applicant is:*
1. Licensed Contractor
2. Homeowner
Homeowner Acknowledgement*
1. By selecting homeowner, I acknowledge that this is my Primary Residence and I understand I am taking full responsibility for the work that is being completed and the inspections for this trade permit.
Gas Piping Contractor Name*
Contractor Contact #*
Contractor License #*
Contractor Email Address*
Contractor Fax #
Contractor Street Address*
Contractor City*
Contractor State*
Contractor Zip Code*
Brief Description of Work*
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Gas Piping Project Information
Estimated Project Cost*
# of Gas Outlets*
Pipe Addition or Modification*
1. Yes
2. No
Other Information
Permit Information
I hereby certify that all information in this application is correct and all work will comply with the state code and all other applicable state and local laws, ordinances and regulations. The inspection department will be notified of any changes in the approved plans and specifications for the project permitted herein. This application becomes a permit only when validated and approved. A notification email message will be sent when the permit is issued.
Electronic Signature*
By checking, you agree and acknowledge your electronic signature is valid and binding in the same force and effect as a handwritten signature.
1. I Agree

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