City of Tomah HVAC Permit

City of Tomah HVAC Permit
Job Location *
Owner/Builder Name *

First Name Last Name
Owner Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Contractor Name *
Contact Person *

First Name Last Name
Company Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Contractor Phone *

Area Code Phone Number
Contractor Email *
example@example.com
Contractor State License#
Description of Work
Type of building or structure:

New Existing
Estimated Cost *
Under $10,000, please input total project value below:
Over $10,000, please input total project value below:
Over 10K Fee Calculation
Project Amount
Fee Schedule
Base Fee
Over 10K Fee
Total Fee
-FAILURE TO OBTAIN PERMIT PRIOR TO WORK, EXCEPT EMERGENCY CASES: -FIRST OFFENSE, DOUBLE FEES

PLEASE CALL 374-7429 FOR INSPECTIONS- 24 HOUR NOTICE REQUIRED
Contrators Signature

Clear
Date

Month Day Year
Date
Should be Empty: