Hvac Permit Application - Commercial Or Multi-Family
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1HVAC P
A
- C
M
-F
ERMIT
PPLICATION
OMMERCIAL OR
ULTI
AMILY
PROPERTY INFORMATION
Property Address: _______________________________________________________
Zoning District: ________ Ward: _______
Location of Work (space, floor level, suite, etc.):________________________________
Parcel ID: ________ - _____ - ________
Owners Name: _______________________________________________________________email:________________________
Address: ______________________________________________________________
Phone: (
) ______ - ___________
City: ______________________________ State:______ Zip Code: _____________
Fax:
(
) ______ - ___________
CONTRACTOR INFORMATION
Name: _____________________________________________________________________ email: _______________________
Address: ______________________________________________________________
Phone: (
) ______ - ___________
City: ______________________________ State:______ Zip Code: _____________
Fax:
(
) ______ - ___________
____________________________________________________
Signature
HVAC DIMENSIONAL INFORMATION (Complete only if HVAC unit(s)are located outside of the building)
Type
Location
Height
Length
Width
(furnace, A/C)
(ground, roof, etc.)
(Feet)
(Feet)
(feet)
Main Structure
HVAC Unit
HVAC Unit
HVAC Unit
If unit(s) is/are located outside of the building, please attach a survey or plot plan to this application for zoning approval.
HVAC UNIT DESCRIPTION AND QUANTITIES
Quantity
ITEMS INSTALLED
New
Replacement
Furnaces
A/C Units
Heat Pumps
Fan Units/Fan Coil Units
Other Mechanical and Duct Systems (List Below)
TOTAL COST (Materials and Labor) for Mechanical Installation
$
FEE SCHEDULE
Up to $1,000.00 of Total Installation Cost
$100.00
For Each Additional $1,000.00 up to $1,000,000.00
ADD $13.00 per $1,000.00
For Each Additional $1,000.00 over $1,000,000.00
ADD $6.00 per $1,000.00
Plan Review Fee
PA UCC Fee
$4.00
SUBTOTAL OF HVAC FEE
Electrical Permit Fee
(If separate electrical permit is required)
PA UCC Fee
ADD $4.00
(If separate electrical permit is required)
Scanning Fee- $2.00 per page or drawing
Document Storage Fee- $1.50 per page or drawing
GRAND TOTAL OF ALL FEES
$
Permit No.___________
Invoice No.___________
Check No.___________
Approved by: _________________________________________________________
Date: ______________________
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Parent category: Financial