Mechanical Permit Application Form printable pdf download

Township of Springfield

50 Powell Rd. Springfield Pa. 19064

(

610) 544-1300 Fax: (610) 544-5780

Permit Fee_________ Permit #__________ Date Issued_________ Rec’d By________

Mechanical Permit Application

All Mechanical installation and repairs must comply with the International Mechanical Code, International

Residential Code and International Fuel Gas Code. Contractors performing residential installation and repairs must

be registered with the Commonwealth of Pennsylvania as a Home Improvement Contractor. Commercial and new

home contractors must possess a license issued by The Township of Springfield.

Address of Job_______________________________________________ Commercial______ Residential______

Property Owner_______________________________________Telephone________________________________

Owner Address_______________________________________ E mail___________________________________

Mechanical Contractor

Name_______________________________________________ Pa. Reg. #________________________________

Address______________________________________________________________________________________

Business Phone________________________ Cell Phone____________________ Email______________________

Type of Equipment

Boiler___________ Furnace___________ Hot water Heater__________ Other______________________

Type of Fuel: Natural Gas__________ Oil__________ Electric__________ Other___________________

Vent Category_______________ Combustion Air: Interior_______ Exterior________ Combined_______

Chimney Material: Terra cotta____________ Stainless Steel___________ Aluminum_________________

New flue Liner Installed Yes______ No_______ (Relining may be required if appliance is being removed from

chimney leaving a single hot water heater on an exterior chimney)

Describe in detail work to be performed

______________________________________________________________________________________

________________________________________________________________________

Estimated Cost $____________________

Time of commencing_______________________

Signature of applicant_______________________________________Date_________________________

24 hour notice is required for all inspections. (610) 544 - 1300 Ext., 126

Mechanical Permit Application Form