MECHANICAL PERMIT

MECHANICAL PERMIT

JURISDICTION OF CITY OF LACY LAKEVIEW
WHEN THE PERMIT IS APPROVED AND PRICED, PLEASE CALL THE LACY LAKEVIEW BUILDING OFFICIAL AT 254-799-2458 TO MAKE A PAYMENT.
JOB ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
OWNER
OWNER MAILING ADDRESS:
OWNER PHONE NUMBER:
Please enter a valid phone number.Format: (000) 000-0000.
CONTRACTOR:
CONTRACTOR MAILING ADDRESS:
CONTRACTOR PHONE NUMBER
Please enter a valid phone number.Format: (000) 000-0000.
CONTRACTOR EMAIL ADDRESS
example@example.com
USE OF BUILDING:
CLASS OF WORK:
DESCRIPTION OF WORK:
PERMIT FEES
AIR CONDITION
REFRIGERATION UNITS
BOILERS
GAS FIRED AC
FORCED AIR SYSTEMS
GRAVITY SYSTEMS
FLOOR FURNACE
WALL HEATERS
UNIT HEATERS
EVAPORATIVE COOLER
CLOTHES DRYER
VENTILATION FAN
RANGE HOOD
AIR HANDLING UNIT
INCINERATOR
NOTICE

SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING.

THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 3 MONTHS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 3 MONTHS AT ANY TIME AFTER WORK IS COMMENCED.

I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATION CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.

WORK COMMENCING BEFORE PERMIT ISSUANCE

ANY PERSON WHO COMMENCES ANY WORK ON A BUILDING, STRUCTURE, ELECTRICAL, GAS, MECHANICAL, OR PLUMBING SYSTEM BEFORE OBTAINING THE NECESSARY PERMITS, SHALL BE SUBJECT TO A PENALTY OF 100% OF THE USUAL PERMIT FEE IN ADDITIONAL TO THE REQUIRED PERMIT FEES.

*PER CITY OF LACY LAKEVIEW RATE/FEE SCHEDULE*
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

MECHANICAL PERMIT

WHEN THE PERMIT IS APPROVED AND PRICED, PLEASE CALL THE LACY LAKEVIEW BUILDING OFFICIAL AT 254-799-2458 TO MAKE A PAYMENT.