www.greenbaywi.gov
FURNACE: Gas ___________ Electric __________ Oil __________ Forced Air __________
AIR CONDITIONER: Forced Air __________ Central Air __________
BOILER: Steam _______ Hot Water ________ Res ________ Industrial ________ Commercial _______
SPACE HEATER: Type __________ Unit __________
Class __________
Contractor’s Signature: ___________________________________ Credential # _____________________
Check box for Online Payment
The information below must be provided for notification of project number and permit fee. This information is
required to make payment on-line.
Phone ___________________ Fax _____________________
Department of Community
and Economic Development
100 N. Jefferson Street, Rm 608
Green Bay, WI 54301-5026
(920) 448-3300 - phone
(920) 448-3426 - fax
inspmail@greenbaywi.gov
LICENSED CONTRACTOR
HEATING PERMIT
APPLICATION
This section for City use only
Project #:
Permit Code:
Permit Fee:
Parcel #:
Receipt #:
Date:
To schedule an inspection, submit an online Inspection Request or call (920) 448-3300 at least one
business day in advance. Final inspections are required for all projects.
Email ________________________
(Rev 6/20)
All fields must be completed before permit will be processed.
Project Address:
Owner's Name:
Phone #:Owner's Email:
Heating Contractor:
Contractor's Address:
Contractor’s Email:
Contractor's Phone #:
Unit Price: Value of Work:
I hereby make application for a permit for the following described heating work at the above location.
Check all that apply:
click to sign
signature
click to edit
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