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s � � <br /> �' �~� t <br /> FIREPLACES . 1) n�, � . <br /> Gas factory fireplace <br /> Wood burni.ng factory fireplace with flue <br /> Wood Stove <br /> Wood stove with flue <br /> Brand Name Model No. <br /> VENTILATION <br /> No. � Kitchen Exhaust l ducted recirculati.ng cfm <br /> No. ,..3 Bath Exhaust (must be ducted outside) cfm <br /> No. Other Fa.ns: Locations �� <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 /> PERMIT FEE CALCULATION <br /> 1. 1.25% of Contract Price* or Minimum Fee 35.00 <br /> StiC-� � x .0125 $ <br /> (contract'price) <br /> 2. State Surchar�e. ** Add the State Building.Code Division = <br /> Surcharge to each permit. _� rj b o '—� x ;0005 $ <br /> � or $.50, whichever is greater (contract price) <br /> , " ' . . �� �.... ���Mi Mr aMvs�M�/i�r� . . . <br /> 3. Posta�e and Handlin� (Only mail-in applications) $ 1.50 _ <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ <br /> * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the peimitted <br /> • work including materials,labor,profit,and otiier fixed costs. It is the amount ta.be charged to the customer <br /> for the work done. If any material, equipment;labor,or installation are fumished by the owner, fenant 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 <br /> request the submission of a signed copy of the actual conttact. <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 3nspectional Services for the price. <br /> � The undersigned hereby applies to the Ciry for issuance of a Mechanical Pernut, agrees to do all <br /> work in strict accordance witli the ardinances of the City and the regulations `of the Muinesota <br /> .;:� . , <br /> ' �� �"`St�te-Building�Co�e; and=certifies�that all stat�ments,made on tlus;apphcation are complete, true <br /> . . . t«.,yw.f.,. 'i":'YY . <br /> and correct. ' �; <br /> ` v <br /> � .:_� ...'-: _ , ;�s � � � <br /> �,.� �.� a� ,��,> <br /> _ �_ <br /> . .;. ;. � <br /> Applicant's Signa e: ` - - Date: �' <br /> APProved By: Date: <br />