BoroughofCollegeville
491E.MainStreet
Collegeville,PA19426
610.489.9208–610.489.6661(fax)
www.collegeville‐pa.gov
MECHANICALPERMITAPPLICATION
1.MECHANICALPERMITAPPLICATION
Street,City,State,Zip
ForBoroughUseOnly
ParcelNo.Block&Unit ZoningDistrict
2.IDENTIFICATION
PropertyOwner:________________________________________________________________________________________
Address:________________________________________________________________________________________________
CellPhone:______________________________________________OtherPhone:____________________________
E‐Mail:_________________________________________________________________________________________________
Tenant:________________________________________________________________________________________
Address:_______________________________________________________________________________________
CellPhone:___________________________________________OtherPhone:_________________________
E‐Mail:________________________________________________________________________________________
Contractor:_____________________________________________________________________________________
Address:_______________________________________________________________________________________
CellPhone:___________________________________________OtherPhone:___________________________
E‐Mail:________________________________________________________________________________________
3.TypeofMechanicalWork(Pleasecheckone)
NewConstructionTypeofUnitBeingInstalled_______________________NumberofUnits:_____________
ReplacementTypeofFuelSource___________________
TypeofSizingCalculations:ManualJASHRAE/ACCA183StandardCOM/RESCheckOther
Fireplaces,WoodStoves,GasStoves(Pleasecheckone)
WoodGasFreestandingUnitInsertUnit
TotalcostofMechanicalWork:PermitFee:(SeeFeeSchedule)
DescriptionofWork:_____________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Bysigningthisapplication,thecontractor/applicantcertifiesthatallinformationgiveniscorrectandthepropertyownerhasauthorized
thework.DepositofcheckrepresentingfeesforthisapplicationdoesnotconstituteapprovaloforgrantingofsamebyCollegeville
Borough.
SignatureofContractor/Applicant__________________________________________________Date_______________
Validation(ForBoroughUseOnly)
PermitNo.:PermitIssued:PermitFee: CheckNo.: