Fillable MECH-3 Mechanical Permit Application MECH-3_Mechanical_Permit_Application

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MECH-3 Mechanical Permit Application MECH-3_Mechanical_Permit_Application

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U.S.A. forms for City of Lacey

BROWSE CITY OF LACEY (WA) FORMS

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CITY OF LACEY
Community and Economic Development Department
420 College Street SE
Lacey, WA 98503
(360) 491-5642
OWNER:
Address: City: State: Zip:
Phone: Email:
Address: City: State: Zip:
Contractor's License No. Exp: City Bus. Reg.
Cell Phone:
WATER HEATER
VENT HOOD
GAS OUTLETS
Phone Number:
FURNACE UP TO 100k
BLR 16-30 HP
Email:
TENANT:
I hereby certify that the above information is correct and that the construction on, and the occupancy and the use of
Print Applicant's Name
Date
the above described property will be in accordance with the laws, rules and regulations of the State of Washington.
BLR UP TO 3HP
MECHANICAL PERMIT APPLICATION
CONTACT PERSON:
Business:
Project Address:
Type of Permit (check one): ( ) RESIDENTIAL ( ) COMMERCIAL
SCOPE OF WORK:
Parcel Number:
Suite:
Phone Number:
FURNACE OVER 100k
FLR.FURN INSTALL
COM / IND INCINERATORS
ALL OTHER UNITS
PLEASE LIST QUANTITY OF FIXTURES BELOW:
CLOTHES DRYER
DOMESTIC INCINERATORS
FREESTANDING STOVE
HEAT PUMP
SUSP.HTR/UNIT HTR
VENT FAN
APPL.VENT/OTHER
REPAIR OF APPL.
FIREPLACE INSERT
AIR CONDITIONER
A DIMENSIONED SITE PLAN MUST ACCOMPANY APPLICATIONS FOR THE PLACEMENT OF OUTDOOR MECHANICAL
EQUIPMENT. RESIDENTIAL EQUIPMENT PLACED IN THE SIDE YARD MUST MAINTAIN MINIMUM 1' SETBACK.
BLR 4-15 HP
BLR 51 HP AND UP
AIR HDLR OVER 10k
EVAP COOLER
OTHER VENT SYSTEM
BLR 31-50 HP
AIR HDLR UP TO 10k
FORM: MECH-3 10/11
CASH OR CHECK ONLY PLEASE
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MECH-3 Mechanical Permit Application MECH-3_Mechanical_Permit_Application

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Completed 13 July 2020

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