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***All Incomplete Applications will be Returned Unprocessed*** CITY OF BELGRADE APPLICATION FOR MECHANICAL PERMIT I hereby make application for a permit to do mechanical work in accordance with all Title 50, Chapter 60, Section 104, MCA and ARM 24.301.172 ~BCP‐1 (Rev. 1/2012) LOCATION OF WORK Accurate LOCATION and OWNER information is required for permitting. Property Address City State MT Zip Directions to property County Is job located inside city limits? Yes No Name of Building or Businesses in building 17-digit GEOCODE Parcel Number Lot Block Size of Property (acres) Section Township Range Property Owner Mailing Address City State Zip Email Phone Mechanical Contractor Mailing Address for Permit City State Zip Email (IMPORTANT: For notifications) Phone Type of Building Single Family Multi Family Type of Work New Project Value $ Commercial/Public Accessory Building Public Building Factory Building Warehouse Building Addition/remodel Alteration Calculated Fee $ Fee Schedule Cost of Mechanical System Mechanical Permit Fee 0‐10,000 $48 for the 1st $1,000 + $14 for each additional $1,000 or fraction thereof 10,001‐50,000 $166 for the 1st $10,000 + $9 for each additional $1,000 or fraction thereof 50,001‐or more $514 for the 1st $50,000 + $6 for each additional $1,000 or fraction thereof EXAMPLE: If Project value is $9460 then $48 for first $1000 leaving $8460 which is more than $8000; the fraction thereof is $9000, so 9 ($1000 fractions) x $14.00 = a total of $126.00 + $48.00 = $174.00 Description of Work (check all that apply) Air Handling Unit Absorption System Forced Air Furnace w/ ducts Repair, alteration or addition to heating or cooling system Ventilation System ‐ not part of heating or cooling system Refrigeration Work ‐ new or repair Venting for appliances Heaters ‐ suspended, recessed wall, or floor mounted units Gas Piping ‐ any type Incinerator ‐ commercial/industrial/ domestic Mechanical Exhaust System ‐ hood, ducts, etc. Evaporator Cooler ‐ New Install or Repair Floor Furnace with attached vents Compressor ‐ New install or repair In Floor Piping/Heat Other SIGNATURE Mechanical Contractor DATE PRINT Make checks payable to: City of Belgrade City of Belgrade Public Works, Planning, & Building - 91 East Central Ave. - Belgrade, MT 59714 Phone (406) 388-3783