Fort Lee, MT · Bergen County
Chimney Verification for Replacement of Fuel-Fired Equipment
This form records chimney and vent verification for fuel-fired equipment work and is completed by the verifying individual for a permit application or code official.
What this form is
Use this form for replacement of fuel-fired equipment for minor and emergency work; it must accompany the permit application. For other work, present it to the code official before final inspection. The form asks for the work-site and owner details, equipment and vent information, replacement type, and a signed verification statement. If a chimney liner is installed, its documentation must accompany the permit application.
Who needs it
The verifying individual completes and signs this form for fuel-fired equipment work; a homeowner cannot submit it instead of the required inspection.
How to submit it
Provide the form with the permit application for minor and emergency work. For all other work, present it to the code official before final inspection.
About notarization
This document is signed and dated without a notary; the form requires the signer to sign and date the applicable verification statement.
How to submit this form
- 1
Download The Form
Download the Chimney Verification form.
- 2
Complete The Form
Provide the requested work-site, owner, equipment, and vent information, select the applicable replacement type, and sign and date the verification statement.
- 3
Gather Liner Documentation
If installing a chimney liner, include all documentation on the liner with the permit application.
- 4
Submit To The City
Include the form with the permit application for minor and emergency work; otherwise, present it to the code official before final inspection.
Frequently asked questions
- Do I need a notary for the Chimney Verification form?
- No. The form is signed and dated without a notary; the applicable verification statement requires the signer’s signature and date.
- How do I submit the Chimney Verification form?
- Provide it with the permit application for minor and emergency work. For all other work, present it to the code official before final inspection.
- What information does the form request?
- It requests work-site and owner details, equipment and vent information, the type of replacement, and a signed verification statement.
- Can a homeowner submit this form instead of an inspection?
- No. The form states that a homeowner may not submit it in lieu of the required inspection.