Holland Charter Township

{ BreezingForms : plumbing_permit }

MECHANICAL PERMIT

APPLICATION FOR CONTRACTORS ONLY. THIS IS THE APPLICATION ONLY. YOU WILL BE CONTACTED WHEN APPROVED FOR CREDIT CARD PAYMENT. CREDIT CARD FEES WILL BE ADDED TO YOUR TOTAL.

Job address:

Property owner or business name:

Job description:

Job description (cont.):

RESIDENTIAL NEW CONSTRUCTION - FLAT FEE* PLEASE TYPE THE NUMBER AND FEE AMOUNT

SINGLE FAMILY no fireplace (ITEMIZE BELOW) - $145.00 per unit

SINGLE FAMILY with fireplace(s) (ITEMIZE BELOW) - $180.00 per unit

MULTI-FAMILY (EACH DWELLING UNIT ITEMIZE BELOW) - $125.00 per unit

*RESIDENTIAL FLAT FEE INCLUDES APPLICATION FEE, 1 ROUGH & 1 FINAL INSPECTION

APPLICATION FEE (INCLUDES ONE INSPECTION) - $50.00

FINAL INSPECTION OR ADDITIONAL INSPECTIONS - $50.00 each

GAS/OIL BURNING EQUIPMENT - $30.00 each

ENERGY RECOVERY SYSTEM - $30.00 each

DUCT SYSTEM/HYDRONIC PIPING/SOLAR (per zone) - $20.00 each

FIRE SUPPRESSION SYSTEM (per zone) - $75.00 each

FIREPLACE, WOODSTOVE, ETC. (INCLUDES CHIMNEY) - $35.00 each

FUEL GAS PIPING - $5.00 per opening

AIR CONDITION/HEAT PUMP/MINI SPLIT - $20.00 each

WATER HEATER - $5.00 each

EXHAUST FAN/POWER EXHAUST - $5.00 each

COMMERCIAL KITCHEN EXHAUST HOOD - $30.00 each

DAMPER - flue, vent, fire, smoke, etc. AND/OR FLUE LINER - $5.00 each

LPG AND FUEL OIL TANKS (piping fee included) - $15.00 each

REFRIGERATION SYSTEMS (each unit) - $30.00 each

INVESTIGATION/ADMINISTRATION FEE (HOURLY - 1 HR MINIMUM) - $75.00 per hour

TOTAL FEES:

IF INSPECTION CANNOT BE COMPLETED UPON REQUEST (LOCKED OUT, NOT READY, NO ADDRESS POSTED, ETC.), REINSPECTION FEE WILL BE CHARGED. IF ANY WORK IS STARTED BEFORE THE PERMIT IS OBTAINED, AN ADMINISTRATIVE/INVESTIGATION FEE SHALL BE PAID BEFORE THE PERMIT WILL BE ISSUED. CONTRACTOR INFORMATION

Name:

Phone number:

Address:

E-mail address:

Contractor license number:

Contractor license expiration date:

Federal Employer ID # or exemption reason:

Worker comp. insurance carrier or exemption reason:

MESC employer # or exemption reason:

“Section 23a of the state construction code act of 1972, 1972PA 230, MCL125.1523A, 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 residential structure. Violators of Section 23a are subject to civil fines.”

I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to make this application as his authorized agent, and we agree to conform to all applicable laws of the State of Michigan. All information submitted on this application is accurate to the best of my knowledge.

The applicant is agreeing that the electronic signature on this document be accepted as original.

Electronic signature:

Date:

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Application for a Plumbing Permit (CONTRACTORS ONLY)

Application for a Mechanical Permit (CONTRACTORS ONLY)

MECHANICAL PERMIT

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