City of Rocky Mount Mechanical Permit Form

City of Rocky Mount Inspection Services
MECHANICAL PERMIT APPLICATION - Residential

Instructions: Complete all pertinent fields, then read the information at the bottom of the form. Click the Submit button to send the information; click Clear to start over.

Applicant Name: Date:

Project Address:

Subdivision:

Developer:

Telephone:

Property Owner:

Telephone:

Mechanical Contractor:

State License #:

Address:

City:

State:

Zip Code:

Telephone:

Project Supervisor:

Telephone:

Description of Work:

Type of Work (check one): New Construction Change Out New Installation

Misc. (check all that apply, including quantities of each):

Gas Appliance $21.00
Gas Connection $21.00
Additional Connections $11.00 ea.
Exhaust Fan or Hood $21.00
Additional Fans or Hoods $11.00 ea.

Boiler $30.00
Additional Boilers $20.00 ea.
Unit Heater $21.00 ea.
Other $21.00

HVAC Equipment (New Inst. w/ duct work):

Package Units $60.00
Additional Pkg. Units $50.00 ea.
Split Systems $75.00
Additional Split Systems $55.00 ea.

HVAC Equipment (Change outs w/o duct work):

Package Units $55.00
Additional Pkg. Units $25.00 ea.
Split Systems $60.00
Additional Split Systems $30.00 ea.

Cond. or Air H.U. (Change out w/o duct work):

Condensing Unit $40.00
Additional Cond. Units $20.00 ea.
Air Handling Unit $40.00
Additional AHUs $20.00 ea.

Minimum Fee: $65.00	Failure to Obtain Permit: $250.00	Reinspection Fee: $75.00 per Trip
Extra Inspection Fee: $75.00 (minimum two hour charge after normal working hours)

Total Fees

Comments:

I hereby certify that all the information in this application is correct and all work will comply with the State Building Code and all other applicable State and local laws, ordinances and regulations. The Inspection Department will be notified of any changes in the approved plans and specifications for the project permitted herein. I further understand that this is NOT an authorization to begin work. Work may only commence after approval and issuance of the permit.

Owner/Applicant E-mail Address:
Daytime Phone: