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Date:__________ Permit # ___________________ PID # ___________________ Notes: ______ Total $________
This is a fireplace permit application for residential only. If you are putting in a commercial fireplace, complete the Mechanical Permit application.
If applicant is other, please explain
If "Other", please explain
Permits must be paid for before issued.
All permits with plans will need to be picked up.
Indicate who to contact for payment.
I hereby apply for a fireplace permit and I acknowledge that the information above is complete and accurate; that I understand this is not a permit and work is not to start without a permit. I understand and hereby agree that the work for which the permit issued shall be performed according to: (1) the conditions of the permit; (2) the approved plans and specifications; (3) the applicable city approvals, ordinances, and codes; and (4) the state building/mechanical codes and regulations. I understand that the permit will expire, and become null and void if work is not started within 180 days, or if work is suspended or abandoned for a period of 180 days any time after work has commenced; and, that I am responsible for ensuring that all required inspections are requested in conformance with the state building code.
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
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