CITY OF LITTLE ROCK
DEPARTMENT
OF PLANNING & DEVELOPMENT
BUILDING
CODES DIVISION APPLICATION FOR:
723
WEST MARKHAM, 2ND FL MECHANICAL (HVACR) PERMIT
LITTLE
ROCK, AR 72201
PHONE (501) 918-5282 OR (501) 918-5292
FAX: (501) 371-4546 EMAIL: permits@littlerock.gov
OFFICIAL USE ONLY
PERMIT NO. 2019
DATE ISSUED
ISSUED BY
APPLICANT (Please Check)
WILL CALL ROUGH
SLAB FINAL
OTHER
PROJECT ADDRES
S: PROJECT NO.:
(Same as Building Permit No.)
LEGAL DESCRIPTION: LOT BLOCK SUBDIVISION
OWNER/TENANT: TELEPHONE:
ADDRESS: FAX:
CONTRACTOR: L
ICENSE NO.:
ADDRESS: TELEP
HONE/FAX
CLASS OF WORK:
NEW ADDITION REPLACEMENT ALTERATION
PROPOSED USE
(OCCUPANCY):
COMMERCIAL RESIDENTIAL MODULAR/MOBILE HOME BOILER*
SQUARE FEET:
VALUATION:
Heating/Air Mechanical Permit Fees:
A. New one and two-family DWELLING Construction - $.0875/sq ft (INCLUDES ROUGH & FINAL INSPECTIONS)
OTHER OCCUPANCIES
B. Replacements, repairs, alterations and additions and new commercial – heating, ventilation, ductwork, air conditioning, boilers*, and refrigeration
systems shall be as follows:
$32.55 for the first $500.00 up to $1,000 plus $5.40 for each additional thousand or fraction thereof to and including $500,000.00.
$2,727.15 for the first $500,000 plus $4.30 for each additional thousand or fraction thereof, to and including $1,000,000.
$4,877.15 for the first $1,000,000 plus $3.25 for each additional thousand or fraction thereof
THESE PRICES INCLUDE ONLY ONE INSPECTION; ADDITIONAL INSPECTIONS ARE $21.55 EACH:
Minimum fee for any permit shall be $32.55. Additional fee for Data Processing: $5.00 (residential) $7.00 (comm.)
NO. Of
Heating Units: NO. Of Air-Conditioning Units:
Ductwork: Yes No
(ALL DUCTWORK REQUIRES A ROUGH INSPECTION)
Commercial Ventilation System Commercial Refrigeration Split System No. Of Inspections
CHECK ONE OR MORE BELOW:
Electric Gas Fired Split System Package Unit Water Source Condenser Coil Condenser Evaporative Coil Other (Explain)
NOTE: BOILER PERMITS ARE ISSUED WITH PROOF OF SPECIAL BOILER LICENSE
Penalties (Working without a permit): Where work for which a permit is required by the 2010 Arkansas Mechanical payment of such triple fee shall not relieve any
person from fully complying with the requirements of the 2010 Arkansas Mechanical Code in the execution of the work nor from any penalties prescribed herein
and no additional permits shall be granted until all fees have been paid.
NOTICE: SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, GAS, PLUMBING AND HVACR WORK.
I hereby certify that the data submitted on or with this application is true and correct. Any deviation from information contained herein,
Unless approved by the Building Official will render this permit null and void.
SIGNATURE OF CONTRACTOR, OWNER OR AGENT DATE
REV 1/19
