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HVAC Permit Application
Project Address
Suite or Unit
Permit Description
Application Information
Furnace BTU
HVAC Contractor*
HVAC Contractor Address
Phone
HVAC Contractor E-mail Address
Wisconsin HVAC Contractor #
Expiration Date
Wisconsin HVAC Qualifier #
Expiration Date
Property Owner
Property Owner Address
Phone
Property Owner E-mail Address
New Building
Existing Building
Residential
Industrial
Commercial
Name & Model # of Warm Air Furnace, Boiler or Other
BTU Input
BTU Output
Total Heat Loss of Building
Cubic Contents of Building
Type of System
Hot Water
Forced Air
Other
Type of Fuel
Oil
Wood
Other
Gas
2# gas pressure (test & label required)
4# gas pressure (test & label required)
low gas pressure (test required)
Remarks
The applicant certifies that all information is correct and that all pertinent City Ordinances will be complied with in performing the work for which this permit is issued.
Print Name
Date
A City of Middleton representative will contact you to request the balance of the information required to process this permit.
Please note that the contractor code is required.
Enter Contractor Code  Get Code