GOVERNMENT OF THE UNITED STATES VIRGIN ISLANDS DEPARTMENT OF PLANNING AND NATURAL RESOURCES DIVISION OF PERMITS STX DISTRICT TEL: (340) 773-1082 STT/STJ DISTRICT TEL: (340) 774-3320 APPLICATION for MECHANICAL PERMIT (Please Print Clearly) Parcel Identification Number (PIN) ___________________________________________________________ Building Owner: _________________________________________________________________________ Address: ________________________________ City/State/Zip _____________________________________ Contractor: _______________________________________________________________________________ Address: ________________________________ City/State/Zip _____________________________________ Type of Construction: New Construction ☐ Addition/Alterations/Replacement ☐ Demolition ☐ Other ☐ Category of Construction: Single or Two-Family Dwelling ☐ Commercial/Industrial ☐ Multi-Family ☐ Master Builder ☐ Other ☐ General statement of the proposed work: __________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ NOTICE THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICTION AND KNOW SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCITON OR THE PERFORMANCE OF CONSTRUCITON. ________________________________________________________________ _______________________________ Signature of Contractor or Authorized Agent Date ________________________________________________________________ _______________________________ Signature of Owner (If Owner Builder) Date Mechanical Permit Application Page 2 OF 2 Mechanical permit fees are based on the value of the work performed. Indicate the value (rounded to the nearest dollar of all mechanical materials, equipment, labor, overhead and profit. Total Estimated Cost: $ _________________________________________ Description Fee Forced Air System – Btu/h M Ea. Gravity System – Btu/h M Ea. Floor Furnaces Wall Heaters Unit Heaters Gas-fired A.C. Units – Btu/h Air-conditioning Units – Hp Ea. Refrigeration units – Hp Ea. Air-handling Unit C.F.M. Evaporative Coolers Ventilation Fan Range Hood Incinerator Clothes Dryers