Mechanical Permit Application - City Of St. Louis Park, Minnesota

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City of St. Louis Park
Mechanical Permit Application
Job Site Address: ___________________________________________ Unit # __________ Zip __________
Project Valuation: $_________________________
The Applicant Is:
Owner and Occupant
Contractor
(must include fair market value of material and labor costs)
Property Owner *Required*
Name_________________________________________
Email_______________________________________
Address__________________________________________________________________ Unit # ____________
City ______________________________________________________________ State ______ Zip __________
Phone (
)
Contractor
Name________________________________________
Email_______________________________________
Address_____________________________________________________________________________________
City ______________________________________________________________ State ______ Zip __________
Phone (
)
SLP Mechanical License #
Property Use
Type of Structure
Type of Work
Residential
Principal Building
New Building
Commercial
Garage
Existing Building
Industrial
Accessory Building
Code Compliance
Addition
Institutional
Temporary Building
Disconnect
Remodel
Public
Swimming Pool
Repair / Replace
Other______________
Mechanical Item(s)
(check all that apply)
Air Conditioning
Furnace
Refrigeration
Minor Appliance
Boiler
Piping - Gas
Rooftop Unit
Stove
Chimney / Flue
Piping - Medical
Space / Unit Heater
Dryer
Ductwork
Piping - Oil
Temporary Heating Unit
Gas Log
Factory Fireplace
Piping - Steam / Hot Water
Ventilation
Other __________
Specific Description of Work to be Completed
Permit will become void one year from date of issuance. Permits issued and inspections made by the City are a public service and do not
constitute any representation, guarantee or warranty, either implied or expressed, to any person as to the condition of the building or
conformance to applicable construction codes. The Undersigned acknowledges that this application has been read and that the above is
correct and agrees to comply with all the ordinances and laws of the City of St. Louis Park regulating building construction.
Applicant’s Signature
Date
Permit # ______________________
Called _____________________________________
Ck__________ CC
CH
Entered ____________ Zoning App/Date ________________
Building App/Date __________________
Issued _____________

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