Forms • Michigan City, IN • CivicEngage

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HEATING / AIR CONDITIONING / VENTILATION / REFRIGERATION PERMIT

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Please call 24 hours in advance for inspections

Date of application*

Job Address*

Owner’s Name *

Owner’s Address*

Owner’s Telephone*

Contractor’s Name*

Contractor’s Telephone*

Contractor’s Email*

Description of Work

Please check all that applies*

	Ventilation / Exhaust Fan ($20 each for 500 to 1,000 cfm, Plus $2 for each 5,000 cfm over)
	Furnace / Boiler ($40 each)
	Air Conditioner ($40 each)
	Geothermal ($80 each)
	Heat Pumps ($80 each)
	30,000 btu Space / Portable Heater ($20)

	Fire Place / Wood Burning Stove ($40 each)
	Rooftop Unit ($80 each)
	Refrigeration Units ($80 each)
	Exhaust Hood ($40 each)
	Minimum Inspection ($20)

Total Dollar Amount*

* indicates required fields.

City of Michigan City
100 E Michigan Boulevard
Michigan City, IN 46360
Phone: (219) 873-1400
Fax: (219) 873-1515

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