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Plumbing Application

  1. Planning & Development

    205 S Redding Street
    West Memphis, AR 72301

    Cash or Check Only. No Credit/Debit Accepted

  2. Work/Service Information

  3. Work

  4. Water/Sewer Service

  5. Type of Property

  6. Power

  7. Occupied

  8. Permits

  9. Plumbing Fixtures

  10. Permit Cost

  11. Permit



    Plumbing Permit (Including first four fixtures) 



    Additional Fixtures 

     $2 each 

    $3 each 

    Gas Permit 



    Gas Openings 

    $1 each 

    $3 each 

    Water Permit 



    Sewer Permit



  12. Electronic Signature

  13. By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.*

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  15. This field is not part of the form submission.