Permit Information and Applications

2. Current Contractor Registration Required to Pull Permit.
4. Contractor Company Name:*
6. Contractor Name:*
7. Contractor Phone Number:*
9. Contractor E-mail*
11. Job Site Address:*
13. Property Owner Name*
15. Property Owner Phone Number:*
17. Business Name

    If Commercial Job provide Name of Business

19. Start Date:*
20. Expected Completion Date:*
22. Job Description:*
    Type of Work i.e. Hot Water Tank Install, Electrical Panel Change Out, Three Piece Change Out, etc.
24. Payment Instructions:

    Pay by phone: 918-209-4610  (Visa / Mastercard only)

    Hours of Operation:

    Monday - Thursday

    7:30 A.M. - 12:00 P.M. / 1:00 P.M. - 5:30 P.M.

    Friday

    7:30 A.M - 11:30 A.M.

Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field