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� * ;' i <br /> �/ �. �} <br />. ... , .. .. r fi - . - <br /> FIREPLACES ����� <br /> �,�: <br /> Gas factory fireplace " ' ' t � <br /> Wood burning factory fireplace with flue �� <br /> y ��� Wood Stove <br /> �`� �, Wood stove with flue ' <br /> � #` } � <br /> �r �, <br /> �f Brand Name Model No. ,`: �; <br /> � <br /> >: <br />� VENTILATION <br /> `,� <br /> - No. Kitchen E�aust ducted recirculating cfm <br /> No. Bath Exhaust (must be ducted outside) cfm <br /> No. Other Fans: Locations cfrn <br /> --- �;:'. <br /> � <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 /> ,:€ <br /> PERMIT FEE CALCULATION � � <br /> 1. 1.25% of Contract Price" or Minimum Fee ($3�.00) �y <br /> - 3�_� i 5 ' `= ` x .0125 $ '--i 3 <br /> (contract price) <br /> 2. State Surchar�e. ** Add the State Buildin� Code Division � <br /> Surcharge to each permit. 3�� � �e� -` ` x .000� $ � , `7 C� �� <br /> r ��� or $.50, whichever is greater (contrac�price) � <br /> ,-, <br /> k< '{a <br />��; �s i�, <br /> _, ,.. 3. Posta�e and Handlin� (Only mail-in applications) $ 1.50 ri <br /> '' ' � 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ y 7 ' �`" ��� <br /> s� . � ;;� <br /> a� f � <br /> l.`! <br />� "� "`"�< * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted �'%�' <br />� , work including materials, labor,nrofit: and other fiYed costs. it is the a.mou�t t�hP char¢ed r�,h,��,;�r �`� <br /> � ; -: � . � omer n� <br />, ' E�; for the w�ork 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 �s� <br />�,�.r price for permit fee purposes. In the event that there is a dispute on the amount of the job cost, the City may ,, <br />,�_ request the submission of a signed copy of the actual contract. ,�, <br /> . � <br /> 4 ' ** The STATE SURCHARGE is .0005 of the contract price under S1,000,000 or $.50 -whichever is greater. � <br />� � <br /> ��- For valuations over $1,000,000 call the Department of Inspectional Ser�-ices for the price. <br /> �.� /i <br /> '� The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all '� <br /> r� <br /> work in strict accordance with the ordinances of the City and the regulations of the Minnesota ; <br /> ; ,, <br />�� State Building Code, and cert' ies that all statement ade on this application are complete, true - <br /> d^ <br /> and correct. <br />��' <br /> Applicant's Signature: ��` _ Date: �2- �� �' `� <br /> :y _ <br /> �� <br /> Approved By: Date: <br /> '�,,, <br /> .:;,,,:� <br /> < r." . � ' - <br /> . . `� .... , , ` � <br />