HomeMy WebLinkAboutE-Plan Plumbing Plan Review ApplicationGeneral Plumbing Plan Review Application
Project Information - Fill in all known information:
Building, Project, or Tenant Name:
Previous Tenant Name:
Project Street Address:
City/State/ZIP Code:
Project Scope:
Designer Information:
Designer Name:
License Number:
Email:
Phone number:
Company:
Address:
City/State/ZIP Code:
Type of Submittal - Check all that apply:
E -PLAN
EXAM
❑ New Construction ❑ Permission to Start (verify eligibility on page 2)
❑ Addition ❑ Extension to a previously approved plan
❑ Alteration ❑ Multiple identical buildings
❑ Revision to previously approved Plans Number of Buildings:
Project Specific Information — Fill in all known information:
Indicate the total number of interior fixtures', including roof drains and hose
Total
bibs included in this submittal:
Fixtures'
Building area (New Construction & Addition projects only):
Sq. Ft.
Storm Area drained to a plumbing system:
Acres
Combined size in inches of water supply and sanitary lateral(s) serving
inches
structure:
1"Plumbing fixture" means a receptacle or device which meets at least one of the following:
(a) Is either permanently or temporarily connected to the water supply system of the premises and demands a
supply of water from the system.
(b) Discharges wastewater or waste materials either directly or indirectly to the drain system of the premises.
(c) Requires both a water supply connection and a discharge to the drain system of the premises.
E -Plan Exam - Plumbing Plan Review Application
Types of Installation Components (Equipment Types) - Check all that apply:
❑ Building Drain & Vent, Sanitary'
❑ IAPMO Water Demand Calculator
❑ Regulated Contaminant Water
❑ Building Drain & Vent, Storm'
❑ Interior Containment Tank
Treatment -Other2
❑ Building Sewer, Sanitary"
❑ Interior Cross Connection Control
❑ Regulated Contaminant Water
❑ Building Sewer, Storm"
Assembly, Health Care**
Treatment - Radium2
❑ Campground/Recreational Vehicle
❑ Interior Grease Interceptor
❑ Sanitary Dump Station
Park Drainage System, Sanitary
❑ Interior Mixed Wastewater
❑ Siphonic Roof Drain Engineered
❑ Campground/Recreational Vehicle
Treatment Device
System
Park Drainage System, Storm
❑ Interior Non -Potable Water System
❑ Sovent Engineered System*
❑ Campground/Recreational Vehicle
❑ Storm Detention System'
Park Water Supply System
❑ Interior Oil Interceptor
❑ Storm Subsurface Infiltration
❑ Car Wash Interceptor
❑ Interior Potable Water Tank
Plumbing2
❑ Chemical Waste System
❑ Interior Wastewater Treatment
❑ Water Distribution System"
❑ Controlled Roof Drain Engineered
Device
❑ Manufactured Home Community
❑ Water Reuse - Blackwater2
System
Water Supply System
❑ Water Reuse - Clearwater
❑ Drainage System, Storm
❑ Multipurpose Piping System
❑ Water Reuse - Graywater2
❑ Exterior Containment Tank
❑ Private Interceptor Main Sewer,
❑ Water Reuse -Stormwater2
❑ Exterior Cross Connection Control
Sanitary'
❑ Water Service'
Assembly, Health Care**
❑ Private Interceptor Main Sewer,
❑ Water Treatment -.5 Chlorine2
❑ Exterior Grease Interceptor
Storm'
❑ Water Treatment— Chloramine2
❑ Exterior Mixed Wastewater Treatment
❑ Private Water Main'
❑ Water Treatment —Chlorine
Device
❑ Provent Engineered System***
Dioxide2
❑ Exterior Non -Potable Water System
❑ Pure Water System (RO)
❑ Water Treatment-Silver/Copper2
❑ Exterior Oil Interceptor
❑ Regulated Contaminant Water
❑ Water Treatment -Therma12
❑ Exterior Potable Water Tank
Treatment - Arsenic2
❑ Water Treatment - Ultrafiltration2
❑ Exterior Wastewater Treatment
❑ Water Treatment - Ultraviolet
Device, Storm
❑ Regulated Contaminant Water
System2
❑ Garage Catch Basin
Treatment - Bacterial
❑ Alternate Vacuum Waste System
❑ Hospitals, Surgery Centers & CBRFs2
❑ Regulated Contaminant Water
Treatment- Nitrate2
* * Submit to DSPS for review and registration of Exterior and Interior Cross Connection Control Assemblies located in a
Health Care Facility. Note - Reference SPS 382.20-1 Table Section #5 for a complete list of devices.
* * * Submit to DSPS for review. We cannot review Provent, Sovent or other similarly classified Experimental Systems.
' Permission to Start can be applied for.
2 Delegated authority for this installation is municipal specific. Check the current list of delegated municipalities to
determine whether this installation can be submitted to E -Plan Exam or if it needs to be submitted to DSPS for review.
Attestation
The applicant acknowledges that the submittal is complete and accurate, and that any additional
application or submittal information requested must be received within five (5) business days or the plan is
subject to denial. The applicant further acknowledges that any additional plan review information
requested must be received within fifteen (15) business days or the plan is subject to denial.
Applicant Signature Date
Applicant Name:
Applicant Email:
Applicant Phone:
E -Plan Exam - Plumbing Plan Review Application
Optional - Permission to Start Request:
The request for an early Permission to Start is optional and an additional fee will be applied. As specified
within the Alternate Approval, a submittal of a complete set of plans is required to utilize the permission to
start. Scope of installations are limited to below grade only and a maximum of 18 -inches above floor.
As the building owner, I request to begin plumbing installations prior to plan review approval I agree to
make any changes required after plans have been reviewed, and to remove or replace any non -code
complying construction and make revisions to plans on any changes. I will not permit any installation to
exceed 18 inches above the unexcavated floor.
Request is for the following specific plumbing installations:
❑ Building drain &vent, sanitary
❑ Building drain &vent, storm
❑ Building sewer, sanitary
❑ Building sewer, storm
❑ Private interceptor main sewer, sanitary
❑ Private interceptor main sewer, storm
❑ Private water main
❑ Water distribution system
❑ Water service
Building Owner's Signature Date
Building Owner's Printed Name:
Building Owner's Email:
Building Owner's Phone:
E -Plan Exam - Plumbing Plan Review Application