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Plan Review/Construction Inspection Request Form

2. Maricopa County Environmental Services Department <br> Phone: (602) 506-6824<br> esplanreview@maricopa.gov

   Maricopa County Environmental Services Department
   Phone: (602) 506-6824
   esplanreview@maricopa.gov

4. Mobile Food Inspections
   Mobile Food Inspections

   To schedule a mobile food inspection, please click on link above, otherwise please continue filling out form below.

6. Which type of facility are you requesting an inspection for?*
   -- Select One --Food Establishment (fixed location), Public Accommodations, School GroundsOnsite Wastewater/Septic SystemSwimming Pool/Spa/Wading/Splash Pad

8. Application/Permit Number (s)*

   This application/permit # is provided once you have submitted an application to the Department (see link below).

10. Applications
    Permits, Forms, Applications

12. Project Name

13. Identifying Name

15. Owner Name*

17. Project Address*

    If property does not have address, please provide cross streets

18. City

20. Gate Code

21. Lock Code

23. Contact Name*

24. Phone Number*

26. Email*

27. Fax Number

29. Contractor*

31. Type of Inspection*

    1. Final Construction
    2. Final Construction Partial

    1. Abandonment/Closure
    2. Final Construction Re-Inspection

    1. Domestic Well Location
    2. Site and Soils Evaluation

33. Preferred Date
    Preferred Date

35. Type of Inspection*

    1. Advisory
    2. Construction

    1. Equipment
    2. Plumbing

    1. Final Construction
    2. Re-Inspection

37. The Request for Discharge Authorization form must be received before Final Construction Inspections are conducted. Upload complete Request for Discharge Authorization forms here. *

39. Request for Discharge Authorization
    Request for Discharge Authorization

41. Type of Facility*

    1. Pool
    2. Spa

    1. Wading
    2. Splash Pad

    1. Special Use

43. Type of Construction Inspection*

    1. Rough Plumbing Inspection
    2. Rough Plumbing Re-Inspection

    1. Pre-plaster Inspection
    2. Pre-plaster Re-Inspection

    1. Final Inspection
    2. Final Re-inspection

45. Upload Notarized Construction Certification Letter

    Notarized Construction Certification Letter must be received via fax or email before Final Inspections are conducted. Please be aware that the letter uploaded has to be a document in PDF format.

47. Type of Project*

    1. New Pool
    2. Deck

    1. Resurface
    2. Circulation

    1. Disinfection
    2. Fence

49. Comments/Special Instructions

51. Disclaimer
    Information entered on this form will be retained by Maricopa Environmental Services Department and is a record as defined by Arizona law. This form will be provided without redaction in response to a public record request unless any of the information is exempt from release under Arizona law.

    Information entered on this form will be retained by Maricopa Environmental Services Department and is a record as defined by Arizona law. This form will be provided without redaction in response to a public record request unless any of the information is exempt from release under Arizona law.

Leave This Blank:


53. 1. Receive an email copy of this form.
54. Email address

    This field is not part of the form submission.

55. Submit

* indicates a required field