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Revised 7/2025 Page 1 of 2 MECHANICAL PERMIT APPLICATION CITY OF MIDLAND – BUILDING DEPARTMENT 333 W. ELLSWORTH ST., MIDLAND, MI 48640 [PHONE REDACTED] email: [EMAIL REDACTED] PROJECT ADDRESS OWNER EMAIL CONTRACTOR INFORMATION CONTRACTOR ADDRESS LICENSE # EXPIRATION DATE CELL/ALT. PHONE FAX # HOMEOWNER AFFIDAVIT: (if permit is under homeowner’s name) I hereby certify the mechanical work described on this permit application shall be installed by myself in my own home in which I am living in or about to occupy. All work shall be installed in accordance with the Michigan Building Code and shall not be enclosed, covered up, or put into operation until it has been inspected and approved by the City Mechanical Inspector. I will cooperate with the City Mechanical Inspector and assume the responsibility to arrange for necessary inspections. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ THIS APPLICATION AND ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. SECTION 23a OF THE CONSTRUCTION CODE ACT OF 1972, 1972 PA 230, MCL 125.1523A, 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 SUBJECTED TO CIVIL FINES. SIGNATURE OF OWNER OR CONTRACTOR (Homeowner signature indicates compliance with Homeowner Affidavit) PRINTED SIGN ---PAGE BREAK--- Page 2 of 2 LOCATION AND DESCRIPTION OF WORK: FEE SCHEDULE PERMIT ITEM QTY. FEE TOTAL BOILER, COMPRESSOR, ABSORPTION SYSTEM: OVER 3 – 15 HP/ 100,000 – 500,000 BTU $32.00 OVER 15 – 30 HP/ 500,000 – 1,000,000 BTU $42.00 OVER 30 – 50 HP/ 1,000,000 – 1,750,000 BTU $53.00 UP TO 3 HP/ LESS THAN 100,000 BTU $19.00 AHU ˂ 10,000 CU FT PER MINUTE $12.00 AHU ˃10,000 CU FT PER MINUTE $10.00 ANNUAL PERMIT (AS AUTHORIZED BY IBC SECTION 105.1.1) $1500.00 APPLIANCE VENT, CHIMNEY OR VENT DAMPER $32.00 EVAPORATIVE COOLER, OTHER THAN PORTABLE $13.00 RESIDENTIAL NEW HEATING SYSTEM PER FURNACE $115.00 (INCLUDES DUCT, VENT, GAS, AND ONE FURNACE) $0.05 $11.00 $13.00 $21.00 $23.00 $11.00 $13.00 $13.00 $13.00 $19.00 $19.00 $19.00 $15.00 DUCTS/AIR DISTRIBUTION PER SQ FT (CONDITIONED SPACES ONLY) EXHAUST FAN DUCTS FIRE SUPPRESSION (PER SYSTEM) FURNACE ˂ 100,000 BTU FURNACE ˃ 100,000 BTU or RTU GAS WATER HEATER GAS PIPING, UP TO 5 OUTLETS GAS LOG FIREPLACE/ LOG LIGHTER MECHANICAL OTHER (ANY CODE REGULATED ITEM NOT LISTED) AIR CONDITIONING / SPLIT SYSTEM SOLID FUEL BURNING APPLIANCE SUSPENDED, WALL, FLOOR – HEATER CONTRACTOR’S LICENSE REGISTRATION (YEARLY) BASIC PERMIT ISSUING FEE (ALWAYS APPLIES) Revised 7/2025 $53.00 $53.00 TOTAL: (Must be separate permit, fire suppression cannot be combined with general mechanical permits.)