Type of equipment: Heating System (not including boilers), Ventilation System, Refrigeration, Air Conditioning System or Other (required if selected).
Sections: sections 2 Type of Equipment, 3 Location Information, 4 Applicant Information and 6 Statement & Signatures are required for all applications.
Equipment specifications: section 5, complete all.
Falsification: falsification of any statement is a misdemeanor and is punishable by a fine or imprisonment, or both.
| Question | Answer |
|---|---|
| Form Name | PW4 |
| Form Length | 1 page |
| Fillable? | Yes |
| Fillable fields | 69 |
| Avg. time to fill out | 12 min |
| Edition | Rev 7/23 |
| Matches the agency's file | Yes, checked October 3, 2026 |
| Other names | PW4, PW-4, PW4 form, PW 4, PW4 certificate, Application for Certificate of Compliance for Equipment |
| Official source | PW4 (Rev 7/23), |
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