Date:
Application #:
MECHANICAL PERMIT APPLICATION
Associated
Building Permit #:
Permit # MP
City of Newport News
Department of Codes Compliance
Permit Fee:
2400 Washington Avenue 3
rd
floor, Newport News, Virginia 23607
757-933-2311/757-926-8311 (fax)
www.nnva.gov/codes-compliance
Project Address:
Unit:
Parcel ID:
Applicant (Check One) Owner Contractor Agent Design Professional
Property Owner
Tenant
Applicant Name
Phone #
Name
Applicant Address
Address
Contractor Business Name
Phone #
City/State/Zip
Contractor Address
Phone #
Fax #
Contractor State License #
Class
A
B
C
CID #
Email Address
Email/Other Contact Information
Work to be performed on: Type of work: I agree to perform the proposed work in conformance with the Virginia Uniform Statewide Building Code and the ordinances and
regulations of the City of Newport News.
Residential New Repair/Alt
Print name_________________________________________Signature________________________________Date________________
Commercial Addition Other
Multi-Family Project Cost $___________________ Remarks_____________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
QUANTITY & TYPE OF DEVICES/EQUIPMENT
Boiler
Pre-Fab Fireplace NG
Fire/Smoke Dampers
Type I Kitchen Exhaust Hood
Furnace
Pre-Fab Fireplace LP
Residential Bath Fan
Type II Kitchen Exhaust Hood
Central A/C
Pre-Fab Fireplace Wood
Residential Kitchen Hood
Grease Duct
Heat Pump
Gas Log Set NG
Steam Piping
Gas Piping
Rooftop Unit
Gas Log Set LP
Hot Water Piping
Other
Package Unit
Exhaust System
Chilled Water Piping
FUEL STORAGE AND DISTRIBUTION
Space Heater
Ventilation System
Geothermal Piping
LP
Fuel Oil
Gasoline
Other
Air Handler/Fan Coil/VAV
Air Distribution System
Refrigeration Piping
Aboveground Tank
Manufacturer
Chiller
Make-Up Air System
Refrigeration Equipment
Underground Tank
Capacity
_________________________________________________________________________________________________________________________________________________________________________________________
Office Use Only
Remarks:
Cash:
Check:
Escrow:
Customer ID #:
Approved By:
Date:
Cashier:
This application may be printed blank or
filled in online and then printed.
Reset Form
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome