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2002-P04913 - gas fireplace
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2166 Shadywood Road - 17-117-23-42-0011
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2002-P04913 - gas fireplace
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Last modified
8/22/2023 3:41:04 PM
Creation date
9/26/2018 12:06:04 PM
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x Address Old
House Number
2166
Street Name
Shadywood
Street Type
Road
Address
2166 Shadywood Road
Document Type
Permits/Inspections
PIN
1711723420011
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f. - <br /> FIREP A S <br /> Gas factory fireplace <br /> � Wood burning factory fireplace with flue <br /> Wood Stove <br /> Wood stove with flue <br /> Brand Name -� ��,- ` �v �� Model No. ����,� <br /> � <br /> VENTILATION <br /> No. Kitchen Exhaust ducted recirculating cfm <br /> No. Bath Exhaust (must be ducted outside) cfm <br /> No. Other Fans: Locations cfm <br /> FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL) <br /> Installation Removal <br /> Fuel oil: gallons underground inside outside <br /> LP Gas: gallons <br /> Other Gas opening <br /> PERIVIIT FEE CALCULATION <br /> 1. 1.25% of Contract Price* or Minimum Fee ($35.00) <br /> ����-, c�-�- x .0125 $ �_�-�,�, <br /> (contract price) <br /> 2. State Surchar�e. ** Add the State Building Code Division <br /> Surcharge to each permit. ��:_>�,_,,", � x .D005 $ '. � �-� <br /> or $.50, whichever is greater (contract price)�"`�' <br /> , <br /> � , <br /> 3. Posta�e and Handling (Only mail-in applicaEiQns) $ -�— <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ ;�� � �: <br /> * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted <br /> work including materials, labor, profit, and other fixed costs. It is the amount to be charged to the customer <br /> for the work done. If any material, equipment, labor, or installation are furnished by the owner, tenant or <br /> any other party the reasonable market value of such items must be added to the estimated cost or contract <br /> price for permit fee purposes. In the event that there is a dispute on the amount of the job cost, the Ciry may <br /> request the submission of a signed copy of the actual contract. <br /> ** The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or $.50 - whichever is greater. <br /> For valuations over $1,000,000 call the Department of Inspectional Services for the price. <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all <br /> work in strict accordance with the ordinances of the City and the regulations of the Minnesota <br /> State Building Code, and certifies that all statements made on this application are complete, true <br /> and correct. <br /> Applicant's Signatu e: '�d���- �, . s�„ Date: � �? <br /> Approved By: Date: <br />
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