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2007-P11722 - gas fireplace
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2630 Countryside Drive West - 04-117-23-12-0015
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2007-P11722 - gas fireplace
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Last modified
8/22/2023 5:07:13 PM
Creation date
5/2/2016 12:56:01 PM
Metadata
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Template:
x Address Old
House Number
2630
Street Name
Countryside
Street Type
Drive
Street Direction
West
Address
2630 Countryside Dr W
Document Type
Permits/Inspections
PIN
0411723120015
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Updated
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� PER�'��tIT FEE CALCUL�TION(S) <br /> � B�SED OFF - 2002 STATE STATUE <br /> ❑ Yes, this section appfies <br /> The replacement of a Rasidential fisture or a�pliance that meets all three of the following requirements: <br /> 1. Does not require modification to electrical or eas service. <br /> 2. Has a total co�t ot 5�00.00 or less; excludina the cost of the fixture or appliance: and <br /> 3. [s improved, installed or replaced by the homeowner or licensed contractor. <br /> Skip next section, if this appli�s; Cost of Permit � I�.00 <br /> State Surchar�e $ .�0 <br /> I�tail-In Fee(If Applicable) $ 1.50 <br /> Total Permit Fee � <br /> i PERNIIT FEE CALCULATION(S) —JOBS OVER $�00.00 <br /> If abo�e does not apply; fo(low guidelines below: <br /> 1. CO�ITR.aCT PRICE * is 1?�°�0 of contractprice with a(1linimum Fee of�35.00) <br /> 3 � J <br /> sZv � � vX .o>>> � � � �� 5 <br /> (contract price) (minimum�>>.00) <br /> 2. STATE SLRCH.aRGE ** .add the State Bldg Code Div. Surcharge(�tinimum Fee of�.�0) <br /> '��Q(J . U�ZJ x .000� � l • � S— <br /> (contracc pnce) (minimum� 50) <br /> 3. POSTAGE & HANDL[NG(Only on Ntail-In Applications) $ 1.�0 <br /> �. TOTaL PE2vI[T FEE (:�dd Lines 1-3 Above) � C� • � <br /> • * CONTRACT PRICE or JOB COST means the actua( or estimatzd dollar amount char�ed for the <br /> permitted work including materials, labor, profit, and other fired costs. It is the amount to be charged <br /> to the customer for the work done. If any materiaL equipment, labor or installations are furnished by <br /> the owner, tenant or any other party, the reasonable market value of such items must be added to the <br /> estimated cost or contract price for permit fee purposes. [n the event that there is a dispute on the <br /> amount of the job cost, the City may request the submission of a signed copy of the actual contract. <br /> ■ ** �['he ST.aTE SURCH,�RGE is .000� of the Building Department at(9�2)249-4600 for the pnce. <br /> MECI�ANICAL PERi'�IIT APPLICATIOiV AGREEMENT <br /> The undersigned hereby applies to the City for issuance of a Mechanical Permit, a�rees to do all <br /> work in strict accordance with the ordinances of the City and the regulations of the State of <br /> �Iinnesota, and certifies that all statement� made on this application are complete, true and <br /> correct. <br /> ��pplicant's Si�nature:`f� � Date: l � � v�� ' G� <br /> 3 <br />
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