HomeMy WebLinkAbout1994-12-02 Permit, Mechanical Gas Furnace #006676■0
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5 .
G EQUIPMENT
Wood stove with flue
Wood combination or add-on
Factoiy fireplace with flue
Factoiy Fireplace (s)____ Freestanding ___
Wood Stove (s) ____ Franklin, other
Masonry
Brand Name ModelNo.
Mfgr’s Min., Clearances, side rear , min. flue dia.
Total
No.
No.
No.
Kitchen Exhaust ducted recirculating cfim
Bath Exhaust (must be ducted outside)
Other Fans: Locations
cfin
cfin
3\Dcx V x \ -1 CC)OH\-p / l^yi^olal.
FUEL CjJlL*
II
RAGE (MUST BE APPROVED BY FIRE MARSHAL)
Bsollation ____ Removal
Ftieloil: ____ gallons ____ underground ___
LPGas: ____ gallons
Other
inside outside
, _______________ ____ Gas opening
\ \ ^073^5 fA(i I t;oko \/wyt^(CX fit
PERMIT FCS CALCULA1
1. 1.1^% of Contract Price* or Minimum Fee fS35.00) _
X 1.25 $
2.
3.
4.
(contract price)
State Surcharge. ** Add the State Building Code Divisi
/(c/QOO»^ X .
(contract price)
Pnstaye and Handling (Only maU-in applications)
TOTAL PERMIT FEE (Add lines 1-3 above)
Surcharge to each permit.
on
0005 9.fD
L
$
* CONTRACT PRICE or JOB (X)ST means die actual or estimated dollar amount charged for the permitted
woric ineiiMting materials, labor, profit, and other fixed costs. It is the amount to be charged to die
customer for the work done. If any material, equipment, labor, or installation are furnished by the owner,
fynant or any other parly die reasonable maricet value of sudi items must be added to the estimated cost
or contract price for permit fee purposm. In the event that there is a diqiute on the amount of die job cost,
the City may request the submission of a signed copy of the actual contract.
♦* The STATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50 - whidiever is
greater. For valuations ovet $1,(X)0,000 call the Dqiartment of Inflectional Services for the price.
The undersigned hereby applies to the Ci^ for issuance of a Mechanical Permit, agre^ to do
all work in strict accordance with the ordinances of the City and the regulations of the Minnesota
State Building Code, and certifies that all statements made on this application are conqilete, true
and correct.
Applicant’s Signature
Approved By:
#-.5V^S Date; I I
Date:
. V
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