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Permit Number
CITY OF COOPERSVILLE
289 DANFORTH STREET
COOPERSVILLE, MI 49404
616-997-9731 VOICE 616-997-6679 FAX
Authority:
Completion:
Penalty:
1972 PA 230
Mandatory to obtain permit
Permit cannot be issued
Application for Mechanical Permit
Mechanical Inspector - Robert Modreske, Phone #616-477-4940
The City of Coopersville will not issue permits for Commercial, Industrial, or Multi-Family housing construction without detailed, certified, blue prints from
each trade.
Date:
Expiration Date:
Contractor:
Please call 616-477-4940 for an inspection 24 Hours in Advance
Address
Name
City, State, Zip
Job Location:
Phone #
Name
License #
Address
Expiration Date:
City, State, Zip
Federal Employer ID #
Workers Compensation Insurance Carrier:
Owner:
MESC Employer #
Name
Address
Has a Building Permit been obtained for this project?
City, State, Zip
Yes
No
Not required
Type of Job:
Residential
Apartment
Industrial
New
Manufactured Home
School
Commercial
Remodel
Condominium
State Owned
Other
Alteration
Work Description:
Plan Review Required
Plans must be submitted with an Application for Plan Examination and the appropriate deposit before a permit can be issued, except as
listed below.
Plans are not required for the following:
1. One and two family dwellings when the total building heating / cooling system input rating is 375,000 Btu's or less.
2. Alterations and repair work determined by the mechanical official to be of a minor nature.
3. Business, mercantile, and storage buildings having HVAC equipment only, with one fire area and not more than 3,500 square feet.
4. Work completed by a governmental subdivision or state agency costing less than $15,000.00.
If work being performed is described above, check box below "Plans Not Required".
What is the building size in square footage? _____________________
What is the input rating of the heating system in this building? ___________________________
Plans are required for all other building types and shall be prepared by or under the direct supervision of an architect or engineer licensed pursuant to
1980
PA 299 and shall bear that architect's or engineer's seal and signature.
Plan Review Submission No. _____________________________________
Plans not required
Applicant Signature
Section 23a of the state construction code act of 1972, 1972 PA 230, MCL 125.1523A, prohibits a person from conspiring to circumvent the licensing
requirements of this state relating to persons who are to perform work on a residential building or a residential structure. Violators of section 23a are
subjected to civil fines.
SIGNATURE OF CONTRACTOR OR HOMEOWNER
(Homeowner's signature indicates compliance with Homeowner Affidavit listed below)
Date
Homeowner Affidavit
I hereby certify the mechanical work described on this permit application shall be installed by myself in my own home in which I am living or about to
occupy. All work shall be installed in accordance with the Michigan Mechanical Code and shall not be enclosed, covered up, or put into operation
until it has been inspected and approved by the Mechanical Inspector. I will cooperate with the Mechanical Inspector and assume the responsibility to
arrange for necessary inspections.
Fee Clarification for Items listed below
Item #2, Residential Heating System: This item is used for the installation of a heating system in a new residential structure. Replacement
systems should be itemized.
Item #4, Residential Boiler: A residential boiler must be installed by a licensed boiler installer. Provide boiler installer license number above.
Items #14 and #15 Tanks: A homeowner must own tank to install. If homeowner does not own tank, a licensed mechanical contractor must install tank.
# Items
1.
2.
Estimated cost for project
3.
22.
23.
Residential Heating System (includes
ducts & pipe)
# Items
New Building only*
Duct
Heat Pumps; Commercial (pipe not
included)
Air Handlers/Heat Wheels
Gas/Oil Burning Equipment (Furnace)
24.
Under 10,000 CFM
New and/or Conversion Units
25.
Over 10,000 CFM
4.
Residential Boiler*
26.
Commercial Hoods
5.
Water Heater
27.
Heat Recovery Units
6.
Flue/Vent Damper
28.
V.A.V. Boxes
7.
Solid Fuel Equip. (includes chimney)
29.
Unit Ventilators
8.
Gas Burning Fireplace
30.
Unit Heaters (terminal units)
9.
Chimney, factor built (installed separately)
31.
Fire Suppression/Protection
10.
Solar; set of 3 panels (includes piping)
11.
(minimum fee $50.00)
Gas Piping; each opening - new
32.
Evaporator Coils
installation
(residential)
33.
Refrigeration (split system)
12.
Air Conditioning (includes split system)
34.
Chiller
13.
Heat Pumps (complete residential)
35.
Cooling Towers
14.
Bath & Kitchen Exhaust
Tanks
36. Compressor
Inspections
15.
Aboveground*
37.
Special / Safety Insp.
16.
Aboveground Connection
38.
Additional Inspection
17.
Underground*
39.
Final Inspection
18.
Underground Connection
19.
Humidifiers
Piping
Total Fee
20.
Piping
21.
Process Piping
*
See above notes for clarification
Make checks payable to the City of Coopersville
Instructions for Completing Application
General: Mechanical work shall not be started until the application for permit has been filed with the City of Coopersville. All installations shall be in
conformance with the Michigan Mechanical Code. No work shall be concealed until it has been inspected. The telephone number for the inspector is 616477-4940. When ready for an inspection, call the inspector providing as much advance notice as possible. The inspector will need the job location and
permit number.
Expiration of Permit: A permit remains valid as long as work is progressing and inspections are requested and conducted. A permit shall become invalid
if the authorized work is not commenced within six months after issuance of the permit or if the authorized work is suspended or abandoned for a period of
six months after the time of commencing the work. A PERMIT WILL BE CLOSED WHEN NO INSPECTIONS ARE REQUESTED AND CONDUCTED
WITHIN SIX MONTHS OF THE DATE OF ISSUANCE OR THE DATE OF A PREVIOUS INSPECTION. CLOSED PERMITS CANNOT BE REFUNDED
OR REINSTATED.
Mechanical Fees
RESIDENTIAL
Each unit
Mobile Home
Remodeling
Additional inspections
$100.00
$ 50.00
$ 50.00
$ 50.00/hour
COMMERCIAL
Less than $1,000
Over $1,000
Additional inspections
$100.00
$200.00
$ 50.00/hour
INDUSTRIAL
Less than $1,000
Over $1,000
Additional inspections
$200.00
$400.00
$ 50.00/hour
COMMERCIAL
1 – 9 Heads
10 or more Heads
Additional inspections
$ 50.00
$100.00
$ 50.00
INDUSTRIAL
1 – 9 Heads
10 or more Heads
Additional inspections
$ 50.00
$200.00
$ 50.00
Fire Suppression Fees
Number of Heads to be installed
______
Type of Backflow Preventer
__________________________________