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♦ <br /> S� <br /> ;� <br /> FIREPLACES `� <br /> � <br /> Gas factory fireplace ;; <br /> Wood burning f ireplace with flue ; <br /> Wood S <br /> d stove with flue <br /> Brand Name Model No. <br /> VENTILATION <br /> No. Kitchen Exhaust ducted _.. reEirculating cfm <br /> No. Ba e ucted outside) cfm <br /> . Other Fans: I,�cation_c c�mf <br /> FLTEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL) <br /> Installation Removal <br /> Fuel oil: �underground inside outside <br /> LP . gallons <br /> Other Gas opening <br /> PERMIT FEE CALCULATION re <br /> �, <br /> 1. 1.25% of Contract Price* or Mini um Fee 35.00� � <br /> �'`� x .0125 $ ,v� ; <br /> (contract price) <br /> 2. State SurcharQe. ** Add the State Building Code Division <br /> Surcharge to each permit. x .0005 $ '�� � � <br /> or $.50, whichever is greater (contract price) <br /> 3. Posta�e and Handling (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 permitted <br /> work including materials, labor, profit, and other fixed costs. It is the amount to be charged to the customer <br /> for the work done. If any material, equipment, labor, or instailation are rurnisl;ed by tlie owner, tznant 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 '.:R <br /> request the submission of a signed copy of the actual contract. tx <br /> � <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. <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 certifies that all statements made on this application are complete, true <br /> and correct. <br /> Applicant's Signature: Date: `j� —OZ <br /> Approved By: Date: <br /> { � �- <br />� , , s , s,. ,. � . _ . . ._� �`�'�u. ,, , ���N._ � ., „�`` . .� ___, . ... _ �. . �.._ .� �. _ _, �. , , <br />