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;�� c" ` - <br /> (�i,� - -> <br /> �=BURNING EOUIPn'IENT ��I�������� • ''� <br /> � � stove with flue <br /> V�oo�combination or add-on <br /> Factory fireplace with flue �--�__ <br /> Factory Fireplace (s) ��reestand' '% Masonry <br /> Wood Stove (s) �` Franklin, other <br /> Brand Name �� - - � <br /> -v� � �� Model No. ��c�:��_������ �� <br /> Mfgr's Min., Clearances, sid , rear , min. flue dia. <br /> � <br /> VENTILATION � <br /> No. Kitchen Exhaust ducted recirculating cfm ;�;� <br /> :� <br /> No. Bath Exhaust (must be ducted outside) cfm <br /> No. Other Fans: Locations cfm `�� <br /> FUEL STOFtAGE (MUST' �E APPROVED BY FII�E MARSHALj <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 .00 ;�t ,7 <br /> �'���� � x .0125 $ -— �� S� <br /> � (contract price) � <br /> 2. State Surcharge. ** Add the State Building Code Division : <br /> . — � <br /> Surcharge to each permit. S�:��-: `—" x .0005 $ � �d '� <br /> or $.50, whichever is greater (contract price) � <br /> ��. <br /> 3. Posta�e and Handlin� (Only mail-in applications) $ 1.50 � <br /> 4. TOTAL PERMIT rEE (Add lines 1-3 above) $ �/1��. S L� `� <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 _ <br /> customer for the work done. If any material, equipment, labor, or installation are furnished by the owner, <br /> ienant or any other party the reasonable maricet vaiue of such items must be added to the estimated cost ° <br /> or contract price for permit fee purposes. In the event that there is a dispute on the amount of the job cost, `' <br /> the City may request the submission of a signed copy of the actual contract. ��;� <br /> ** The S'fATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50 - whichever is �� <br /> :1 <br /> greater. For valuations over $1,000,000 call the Department of Inspectional Services for the price. <br /> The undersigned hereby appl i�s to the City for issuance of a Mechanical Permit, agrees to do <br /> � <br /> all work in strict accurcance with the ordinances of the City and the regulations of the Minnesota 4� <br /> State Building Code, and certifies that all statements made on this application are complete, true � <br /> and correct. , ��'� ,=-� <br /> ' ` _ <br /> A licant'sSi nature: � ��� Date: � ��'�� l<�� <br /> PP g <br /> Approved By: Date: <br />� . ,. . ; ,;,, ,�,; <br /> f ,�, �� , , `�� �� <br /> < <br /> J , r <br /> 1'Y <br /> I�' � i � . 4 . : Y .F . <br /> h / �a......<<.�.a.�_..�u.. a ..�{rna..-�`.n-sfsi..Li� n�......1� � '3a�Lu�-.,a..k�x�0.'S.. .. . ,.,/ _..�.> �...ri�.......1E.�..._, e,.. ..._,__....._1..._ . _..c_ ..�.,_..__ u. �.v._ ..�.....�..me.�...,..�_... <br />