Division of Professions and Occupations
Notice of Intent to Commence/Cease Permitting and Inspection Services

The Town, City, County, or City/County of:

Is hereby serving written notice to the:
Electrical Board
Plumbing Board
(Separate notice is required for each Board)


For the intent to:
Cease providing permitting and inspection services as an authority having jurisdiction
Commence providing permitting and inspection services as an authority having jurisdiction
Update only to our inspector registration list as personnel have changed.

Beginning July 1, 20

JURISDICTIONAL INFORMATION
Jurisdictional Name:
Building Official:
Phone:
E-mail:
Fax:
Mailing Address:
Inspector Supervisor:
Phone:
E-mail:
Fax:

INSPECTOR INFORMATION
Electrical
Plumbing
Name:
Phone:
E-mail:
Fax:
Residential Certified #
Commercial Certified #
Dual Certified #
Master License #
Journeyman License #
Residential license #

Electrical
Plumbing
Name:
Phone:
E-mail:
Fax:
Residential Certified #
Commercial Certified #
Dual Certified #
Master License #
Journeyman License #
Residential license #


Electrical
Plumbing
Name:
Phone:
E-mail:
Fax:
Residential Certified #
Commercial Certified #
Dual Certified #
Master License #
Journeyman License #
Residential license #


Electrical
Plumbing
Name:
Phone:
E-mail:
Fax:
Residential Certified #
Commercial Certified #
Dual Certified #
Master License #
Journeyman License #
Residential license #


Electrical
Plumbing
Name:
Phone:
E-mail:
Fax:
Residential Certified #
Commercial Certified #
Dual Certified #
Master License #
Journeyman License #
Residential license #



Consumer Protection