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MECHANICAL PERMIT APPLICATION This document has been designed
Print Clear City of Muskegon to complete online, print, SIGN, and
Date 933Terrace St. P.O. Box 536 Permit #
mail to the city with all associated
Muskegon, MI 49443-0536 fees. This form IS NOT designed to
(231)724-6758 be submitted electronically.
I. JOB LOCATION
Job Address Has a building permit been issued for this project?
YES NO NOT REQUIRED
Name of Owner/Agent Owner Address
II. CONTRACTOR /HOMEOWNER INFORMATION
Contractor Name License Number Expiration Date
Homeowner
Address(Street & Name) City State Zip Code
MI
Telephone Number Federal employer ID Number (or reason for exemption) MESC Employer Number (or reason for exemption)
( )
Workers Compensation Insurance Carrier (or reason for exemption) Contractor information registered with the City of
Muskegon YES NO
III. TYPE OF JOB
Class of work (check all that apply)
NEW BUILDING ADDITION ALTERATION REPAIR
RESIDENTIAL COMMERCIAL INDUSTRIAL OTHER
Description of work
IV. FEE SCHEDULE Enter the number of items being installed. Multiply by the unit price for the total fee.
FEE #ITEMS TOTAL FEE #ITEMS TOTAL
Base Fee (Non-refundable) $35.00 Air Handlers/Heat Wheels
Heating Under 10,000 CFM $20.00
Residential (includes duct & Over 10,000 CFM $60.00
piping) $50.00 Commercial Hoods
$15.00
Gas/Oil burning equipment
New
and/or conversion or replacement $30.00 Heat Recovery Units or Thru-
the-wall fan coils $10.00
Water Heaters $10.00 Unit Ventilators $10.00
Flue/vent Dampers $8.00 Unit Heaters (terminal units) $15.00
Solid fuel equipment complete $30.00 Bath & Kitchen Exhaust $5.00
Gas Fire Places $20.00 Duct $.10 per ft. Min $25.00
$.10 ft
Chimney, Factory Built
(installed Separately) $25.00 Piping includes process,heating,
boiler and refrigeration lines $.05 ft
$.05 per ft. Min $25.00
Heat Pumps (residential $30.00
Restaurant Hood $15.00
Heat Pumps (commercial, Pipe not
included $30.00 Gas Piping
Testing for new service $20.00
Boiler $30.00 Gas Piping (each opening)
(new installation) $5.00
Humidifier $10.00 Fire Suppression/Protection
Air conditioning & Refrigeration Sprinkler $.75 each Min $25.00 $.75 ea
Residential A/C $30.00 Inspections (additional or
Evaporator Coils $30.00 reinspection or final) $35.00
Refrigeration (Split systems) $30.00 Special/Safety Inspection $50.00
Chiller $30.00 Inspection to turn on gas
(Flat fee) $25.00
Cooling Towers $30.00 Hourly Rate
$50.00
Plan Review Fee 25%
Compressor $30.00 Other
Rooftop Htg/AC Combo $60.00 Rcvd By App. By Total Fee
V. HOMEOWNER AFFIDAVIT
I hearby certify the mechanical work described on this permit application shall be installed by myself in my own home which I am living or am about to
occupy. All work shall be installed in accordance with the mechanical code and shall not be enclosed, covered up, or put into operation until it has been
inspected and approved by the Mechanical Inspector. I will cooperate with the plumbing inspector and assume responsibility to arrange all necessary
inspections.
VI. APPLICANT SIGNATURE
Section 23a of the state construction code act of 1972, 1972 PA 230, MCL 125.1523a, prohibits a person from conspiring to circumvent the licensing
requirements of this state relating to persons who are to perform work on a residential building or a residential structure. Violators of section 23a are
subjected to civil fines."
Signature of Licensee or Homeowner(Homeowner Date
signature indicates compliance with Section V)
M3/02