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Hood Installer Contractor Registration (Official PDF)

Building Department · South Bend, Indiana

Editable official PDF

Edit the agency’s original form, save your draft, attach documents, and review your completed PDF before signing or ordering delivery.

Print and mail service is available for your prepared packet. Review the destination and the agency’s acceptance requirements before ordering. Government payment is separate from document and postage charges.

Applicant inputs are mapped directly on the official agency PDF. Agency receipt and professional certification fields remain reserved.

Official form and instructions
Your application steps6 steps · Building DepartmentView steps
  1. 1Prepare your answersComplete here

    Edit and save your answers on the official PDF.

    Official source
  2. 2Add supporting documentsComplete here

    Attach the supporting records listed by the agency. Check that every page is legible and complete.

    • Include all supporting documents and plans listed on the official PDF checklist.
    • The agency reviews the completed application before issuing a permit or license.
    • Provide the original signed surety bond or continuation certificate required by the registration instructions. A printed copy does not replace a required original.
    • Complete the sworn declaration with a notary; leave notary fields for the notary to complete.
  3. 3Review and signPrepare here, finish outside

    Complete each applicable applicant signature after reviewing the full declarations. Required notary, professional and witness signatures remain separate.

  4. 4Choose paymentPrepare here, finish outside

    $125 annual registration fee; confirm any arrears or additional fees with the Building Department. Government fees are separate from the optional prepared PDF and postage. Review the exact amount and recipient before authorizing a check.

  5. 5Submit or order deliveryPrepare here, finish outside

    Submit this official application and all required supporting documents to the Building Department by mail or email. Fees are assessed separately under the current schedule; keep the application and payment reference together. Complete the notarial act and supply required originals before delivery. Confirm the exact fee and check payee with the department before ordering a separate government-fee payment.

    Official submission instructions
  6. 6Keep your receiptComplete here

    Save your agency confirmation and payment receipt. Track any mailing from My applications. Delivery does not mean the agency approved your application.

Official requirements and sources

Complete your application

Required fields are marked *. Fields follow the agency’s published form. Save your work before leaving this page.

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Page 1 of 3 · 7 editable blanks
PAYMENT: CHECK # *WE DO NOT ACCEPT CARD AMERICAN EXPRESS CASH *EXACT PAYMENT MAY BE REQUIRED IF WE ARE UNABLE TO MAKE CHANGE FOR CASH PAYMENTS *Applications can be emailed to cpalafox@southbendin.gov for review. APPLICATION FOR HOOD INSTALLER CONTRACTORS *A Hood Installer Contractor Registration may be issued to a person or company that is principally engaged in the business of installing hoods, grease ducts, and makeup air systems relating to commercial kitchen hoods. *Application must be submitted and approved prior to Registration COMPANY NAME: E-MAIL: ADDRESS: TELEPHONE NUMBER: PRESIDENT/LICENSE HOLDER: Provide proof of current licenses in applicable fields Provide proof of two previous installations, including frequencies and spec sheets Provide welding certificate, if applicable Submit a fifty dollar ($50.00) non-refundable application fee (this does not include Prometric’s exam registration fee) *All applicants must be reviewed by the Board of Examiners (submit application, documents, and payment to the address below). The board members have ten (10) business days to review the application to determine if requirements are met as set forth in the ordinance. Upon review, applicant will be notified of the next step and given any applicable documentation via email. I, BEING DULY SWORN UNDER OATH, DEPOSE and say that all the statements in this application herewithin are true. I will be responsible for compliance with all ordinances and laws in effect governing work performed under building permits issued by the St. Joseph County/City of South Bend Building Department. Signature of Applicant Subscribed and Sworn to before me this day of Signature of Notary My Commission Expires: Resident of County EXCELLENCE I ACCOUNTABILITY I INNOVATION I INCLUSION I EMPOWERMENT 215 S. Martin Luther King Jr. Blvd. | Suite 100 | South Bend, IN 46601 | p. 574.235.9554 | f. 574.235.5541 | 1 www.southbendin.gov

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Review every page before signing. Professional, agency and notary signature areas stay reserved.Original blank form