Fillable Application For Mechanical Permit Form printable pdf download

APPLICATION FOR MECHANICAL PERMIT

CITY OF ZION-BUILDING DEPARTMENT

(847) 746-4018

JOB LOCATION: Number and Street: __________________________________________________

LEGAL DESCRIPTION: Lot ____________ Block ____________________ Section ____________ Township

46 North, Range 12 East of the Third Principal Meridian, Lake County, Illinois

PROPERTY OWNER: ______________________________________________PHONE: ( _____ )_____________________________

ADDRESS _____________________________________CITY _______________________ STATE________ZIP___________

GENERAL CONTRACTOR: ________________________________________PHONE: ( _____ )_____________________________

ADDRESS _____________________________________CITY _______________________ STATE________ZIP___________

MECHANICAL CONTRACTOR:_____________________________________PHONE: ( ____ _)_____________________________

ADDRESS _____________________________________CITY _______________________ STATE________ZIP___________

MECHANICAL LICENSE NO._________________WITH THE CITY/VILLAGE:_____________________________________

SQUARE FOOTAGE OF AREA:__________________

(HEAT/AIR CONDITIONED)

FURNACE: Mechanical room: _______ Basement _______Other ________________

Type: ___________ Fuel: ____________ BTU input/output _________/_________

Class "B" flue size: _______ Is outside air required? Yes ____ No ____

Combustion air source _____________ Amount of combustion air required _________

AIR CONDITIONING: New:________

Replacement:__________

Size: __________Condenser location: ________Heat pump __________ Seer:________

EXISTING BUILDING (check all that apply): existing vent type ____________

Repair _______

Retro - fit _______

Flue liner _______

Furnace _______

AC _______

FIREPLACE:

Wood burner _______Gas (log/starter) _______Class "A" flue size_______

Masonry _______ Metal _______

Manufactured _______ Insert _______

ESTIMATED VALUE OF MECHANICAL WORK: $_____________________

If no work is performed hereunder within six months from the date a permit is issued or if the work is not completed within one year from the date a

permit is issued, the mechanical permit shall expire by limitation as provided by City code. The undersigned applicant agrees to comply with all

provisions of the mechanical ordinance of the City of Zion and with the provisions of all other law relating to the erection, repair, and alteration of

buildings in effect at the date of the permit issued hereunder. The said applicant herewith agrees not to make any changes in the plans or specifications,

as approved, without first obtaining further approval for such changes from the building inspector.

I hereby certify that I have read the mechanical section of the Municipal Code and know the

contents thereof.

_______________________________________________

________________

Signature of Mechanical Contractor

Date

(for office use only)

PERMIT N0. ME-16-______________

DATE PERMIT ISSUED: _____________________

PERMIT FEE: $_______________