Fillable Applicant (Check One) Owner Contractor Agent Design Professional (City of Newport News)

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Applicant (Check One) Owner Contractor Agent Design Professional (City of Newport News)

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The Applicant (Check One) Owner Contractor Agent Design Professional (City of Newport News) form is 1 page long and contains:

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  • 16 check-boxes
  • 68 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Newport News

BROWSE CITY OF NEWPORT NEWS (VA) FORMS

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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:
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Applicant (Check One) Owner Contractor Agent Design Professional (City of Newport News)

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Completed 4 August 2020

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