DEPARTMENT OF INSPECTIONS,
LICENSES AND PERMITS
PLUMBING SERVICES DIVISION
220 SOUTH MAIN STREET
BEL AIR, MD 21014
410-638-3215
APPLICATION FOR MECHANICAL PERMIT
JOB ADDRESS________________________________________________________________________________________
SUBDIVISION __________________________________ BLDG _____________ FLOOR ___________ SUITE ____________
WORK DESCRIPTION __________________________________________________________________________________
BUILDING PERMIT # ________________________ RESIDENTIAL COMMERCIAL REPLACEMENT GOVERNMENT
ESTIMATED COST OF COMMERCIAL JOB _______________________________
MANUAL - J ATTACHED MANUAL – N ATTACHED
QTY DESCRIPTION QTY DESCRIPTION
Heating & Air Conditioning BTU TON ______ Solar System
Heating & Air Conditioning BTU _____ TON _______ Oil Piping
Heating System BTU _____ Oil Tank
Air Conditioning TON _____
Backup KW ______
Fire Suppression System
Boiler – Oil BTU _____ Smoke Evacuation
Boiler – Gas BTU _____ Hydronic Heat (under floor)
Forced Air Geothermal System
DUCTED NON DUCTED MINI SPLIT
By submitting this application, the applicant certifies and agrees: (1) That the applicant is authorized to make the application because the applicant is
the property owner or an authorized agent of the property owner; (2) That all the information provided is correct; (3) To comply with all the laws and
regulations of Harford County that are applicable to the request; (4) To perform only the work as specifically described in this application; (5) To grant
County officials/employees the right to enter onto the property for purposes of inspecting the work permitted and posting notices; and (6) currently
holds an active license or registration with Harford County Government. In accordance with Harford County Code §1-22 F, a person who knowingly
makes a misrepresentation or false statement on an application for a County permit or license is guilty of a misdemeanor and, upon conviction, is
subject to a fine not exceeding one thousand dollars ($1,000) or imprisonment not exceeding ninety (90) calendar days or both.
CONTRACTOR’S SIGNATURE _____________________________________________ DATE_____________________
_____
Rev. 05/2020
Find this application an
d more on the web at www.harfordcountymd.gov
This document is available in alternate format upon request.
PERMIT NO.______________________
NOTE: Effective 11/2/15, in accordance with Harford
County Code § 157-30 A, a non-refundable application fee
of $25.00 shall be applied to all mechanical permit
NAME _____________________________________________
OCCUPANT _________________________________________
ADDRESS ___________________________________________
CITY ____________________ ST __________ ZIP __________
TELEPHONE # ____________________________
COMMENTS ________________________________________
__________________________________________________
__________________________________________________
COMPANY ___________________________________________
LICENSEE ____________________________________________
ADDRESS ____________________________________________
CITY ____________________ ST __________ ZIP ___________
HARFORD COUNTY HVACR # ___________
TELEPHONE # ________________________________________
EMAIL ______________________________________________
SIGNATURE _________________________________________
Application Document No. 000342-2020
