Laserfiche WebLink
.��.� ....:. �...r..,n.Y.���-..�-.�.rYi� .. .., wu.�.`.--•�.. . . <br /> Cir�Y o� ����� APPLICATION FOR <br /> ��cha�n��aIl Pe��it <br /> GENERAL INFORMATION <br /> 1. vou way apply (o+t ■cchanica� peanito by mQIC oa Ln penaon at fhe C.ity a66acee. �lalfed-in penmlte arte aubject io !he <br /> po�tage a�d AaedLE�g 6ac♦ ♦tiowM below. <br /> t. ae1■il caade wi�l be ♦eni by 1etuln wa<L the eam¢ day the applicat4on <e nece.ived. PEk6f1TS AkE NOT VALID UNTIL YOU <br /> RECEIVE A FtRN11 CAQD. WORK 11US7 N07 SEG1N UN7IL 7NE PER�11T CARD IS POSTED ON 7NE JOB SJ7[. <br /> S. Whtn any new eonetauction on 1er�od¢Cing ie �nvoLu¢d, a oepanat¢ buiCding p¢4m4L mudl be o6tatncd. <br /> I. AL[ wo�M wuet be doee En aceoldanct with Stat¢ Building Code aeQuiatrnenie. p� ' <br /> MAR 2 6 I ` !� <br /> 5. A�[ wott wu�t bt ie�pected (Rough-in and bi.naCl. Ca[1 173-1351 21-houn nol�ee aequ[rted. . �p4 <br /> 6. Houec Ne¢ting Te�t Recoad wuet be eubn�itted be6oae 64na1 - •ee attached. 4`���� Y 1' <br /> Cowp[etc a!l itewe on thi� a l.ication. Com uie th¢ � ���'� }�� ��" <br /> INSTRUCTIONS pp p penmlt 6e¢, S<gn`'d'r�'Q"`Q$.CY-��eh�i6ication. <br /> INCOYVLf7E APPlTCA7JONS WTIL NOT BE VROCfSSfD, i6 yau hav¢ Queet<ona, call 173-1357 <br /> (�'ALK- IN PFRMITS App.�y a.t C�,.ty O�b�.ced , 1335 Sau.th Bnowvt Road (c�y. Rd. 14G ) <br /> MAIL- TN P�RtitITS Fne�2aae �ee - Ma�.� �a : P. U. Box G6, Cny�S.ta.2 Bay, Mn. 55323 <br /> * � s *,► �*��►y*�►��vs**�►�k**����►k��s�r*�►s******+►�v�*�****�*��k**��**��**���a*******s** <br /> JOB S ITE � � �GL �� � L� �.J�t�/!%�-_ <br /> Occupancy 7ypt+ _ 1t�4dteti � � eow■eacial; Othea <br /> Owner' s Name � L?jG Telephone Number <br /> Mailing Address � �-� � � ��� <br /> Contractor' s Name RAY N. WELTER HEAT4��G CO. Telephone Number �I,�.J vd�/ <br /> 3 �cago ve. o. <br /> Mailing Address Minneapolis, fVlN 55407-3592 <br /> *********************,r*****t�•2r��8"0q********************************************** <br /> MINIMUl1 FEE (520.00 p�r pzo�act) <br /> •••..•.••..•.••••••••.••••••••••••••••••.••e••••.••r••••i•r••••••••••••••••�•.•.•r•�••�••••••••.•••*•�••..••••.w••••■�*f••.• <br /> HEATING SYSTEMS $15.�Geach unit <br /> FUEL ✓nat, gae, lp gae, ail, elect. � <br /> ocher (�pecify if combination burner) ��S ��2G� �i�� ����� �J(,��� <br /> EQUIP. (if tnore than 1 uait per bldg., liet each eeparately) <br /> No. Type 8tuh Inpu[ �rand Name Model No. <br /> Lf. a, furnace "_�� � � � �G//f-J <br /> hw boiler ' <br /> _ unit heatez <br /> solar htg. %��G� <br /> _ equipment �SU•U�each syetem Total <br /> •����������f������������1ff1���A�����A��r�f���iff���ff�����}*f����iff��i�fA���kA�►fffw��ff�tff��lf���rt���f�ff�if�lMlr����t�• <br /> A--I�A C —ITIO—NING $1�j.�� each unit <br /> 1/ Central Aiz � Separace Central Air Syetem <br /> w/furnace / ���} <br /> Brand Name %�- Hodel No. / �� �� Tone � <br /> -��=.f.^t�'_ � Total ��. _.�, <br /> •�������ff�►�f�f���f►���tf��ffi�ff��f���f*fl�fff�f��it���r�tR+f��tifA���fA►• i�k�1�t��f��}�f1�fr��A�A�f�Afif�ff�ff�►fi/rf�Rk4�fi <br /> tipoD BL�F�NtNG EQI7IPMENT (attach copy of mfgr'e inatallation speca.) �15.VU each unit Wood stove with flue <br /> Fectozy Fireplace(s) freestanding built-in $3�.�� each unit Wood combination or udd-on unit <br /> wood Stove(s) _ franklin, other <br /> $15.�Q each unit factory fireplace with flue <br /> Bzand Name Nodel No. <br /> Mfqr'� Min. Cleazances, side , reaz , Min. Flue Dia. Total <br /> •���������������l������f��d��R}������f�►���lfff��te�\��flfff�riiAR���t��/�it�i��fr*►�if��4�������Miif���#*f������ff�f*k����1 <br /> �T�Ti� - S 5.00 each exhaust fans (bath, kitchen, <br /> No. _ Kitchen Exhaust _ ducted _ recirculating __ cfm attic, etc.) <br /> No. Bath Exhauet (must be ducted outside) cfm <br /> No. _ Other Fans: Locetions _ cfm Total <br /> •�����t����ff����������f����������������t�fii�f��i����it��f�f�i�plwfif►f�f��if�����1t�f�����fi�r�I�f���r►►�►���f�f�rff�r�0�0• <br /> rT i 520 n^. . (must be approved by fire marshal) <br /> _ Fuel Oil, _ qallons _ underground � inside ^ outside <br /> Lp Gas, gallona <br /> Other, <br /> •�•�����•������r���������������r��rr���►�:����r�►�aa�t�r*r+rrrs�.���+���►r�rr*���tr�r��►*i*���r*w���*�tf*►�r�.��:��.,*��t���r• <br /> �P SNKi.F$��SmgMS_ c�� Tit_'S'1C1eI1C1�11 �Z�.�U <br /> ($20.00 minimum; $100.00 ma:cimum) <br /> Number of Heads No. ot Riaoza b� Commercial a��.00 Plan Review <br /> Type of System (3 sets of plans required for review) �2.00 per head Total _ <br /> •����������t����f���f1�r������►��r�����t����if�l��ff�����i�1��Rf�►�f��A����1�������1�fii�i������ff������f���fAt�Rf�t�/���t�r�• <br /> Commercial, Industrial t Multi-Family see Fee Schedule <br /> PERMIT FEE CALCULATION <br /> 1 . Total of above Installations or P�Iinimum Fee (�20. 00) $ ,�Q, � <br /> 2. State Sureharge Add tke Siate 8uild<ng Code Dtvieion Suachaage ta ¢ach pean4t � . 50 <br /> 3. Postage and Handling Un aLG wa�Ctd-in appt�eat<on1, add th¢ po�tage and handCLng 6ee $ 1. �� <br /> ,,...—,,—�,?;-,T,�,�-._..-...... <br /> add f4nee 1-3 nbove :`!;;>'::`.".''�'�:.`;,'�`i`,!`:, '�i;i:; <br /> 4 . TOTAL PERMIT FEE t: ...�.:::.. <br /> �.. <br /> $::::'::;,':::::`.;.. ::�t�::...:.<::::>:�: <br /> he uRd¢a�<gned heae6y applie♦ to the C<ty o6 Ononu 6on leeuance o6 a Meehanicat Penrntt, agrte¢e to do aCC wo2k Ln 6I4LC.L • <br /> ccnldance with Lhe oadinancee o6 tht City and Zl�e ntgulafione o6 Lhe Ninneeota S4ate Bu<fding Code. and cenLi64ee that <br /> fl etate.�cnie wade oe thie appCicatton a4e ca�fptete, taue and coaaect. <br /> , '�� ���� ��!���� �`�` <br /> �-.� .___ <br />