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<br />���`' FIREPLACES -u
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<br /> Gas factory fireplace
<br />' �_ Wood burning factory fireplace with flue '
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<br /> �,� Wood Stove �7�
<br /> Wood stove with flue �
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<br /> .� Brand Name i�(���5�2 Model No. `,���`�� ��
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<br /> 3'�� VENTILATION �i,
<br /> �E; No. Kitchen Exhaust ducted recirculating cfm '
<br />'`� No. Bath Exhaust (must be ducted outside) cfm :�
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<br />'� No. Other Fans: Locations cfm
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<br /> FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL) �'
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<br /> Installation Removal '
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<br /> Fuel oil: gallons underground inside outside ��
<br />�� LP Gas: gallons �
<br /> Other Gas opening
<br />�� PERMIT FEE CALCULATIO`'
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<br />�:'' 1. 1.25% of Contract Price" or Minimum Fee ($35.00)
<br />` �j �� x .0125 $
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<br /> 4r' (contract price)
<br /> ` 2. State Surchar�,e• ** Add the State Building Code Division �
<br /> Surcharge to each permit. x .0005 $ �;
<br />� or $.50, whichever is greater (contract price)
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<br />,�; . 3. Postage and Handlin� (Only mail-in applications) $ 1.50 ` :
<br />��;,, 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ ��
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<br />�� * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted �,
<br /> work including materials, labor, profit, and other fixed costs. It is the amount to be charged to the customer �;:,h
<br /> for the work 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 -;
<br /> price for permit fee purposes. In the event that there is a dispute on the amount of the job cost, the City may �
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<br /> �,,y, request the submission of a si�ed copy of the actual contract. �;
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<br /> ** The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or $.50 - whichever is greater. , �
<br />£'� For valuations over $1,000,000 call the Department of Inspectional Services for the price.
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<br />>�:� The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all
<br /> � ' �` work in strict accordance with the ordinances of the City and the regulations of the Minnesota �
<br /> State Building Code, and ce 'fies that all statements made on this application are complete, true �'
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<br /> and correct. ���
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<br /> 3� Aprlicant's Signature: Date: � � �J
<br /> Approved By: Date:
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