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-�-�— <br /> \. <br /> �' � ` . . <br /> FIREPLACES � `` <br /> as factory fireplace <br /> Wood burning factory fireplace with flue <br /> �� <br /> Wood Stove <br /> �,I' Wood stove with flue `�' <br /> �i= �;=_. <br /> ::�; <br /> _:;' Brand Name kG Z`� 1\E�� Model No. 9��. <br /> r;,�' <br /> � � � - . �� �' <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 �� <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 openinQ <br /> PERMIT FEE CALCULATION <br /> 1. 1.25% of Contract Price* or Minimum Fee ($3�.00) <br /> s�,S� , c� � x .o12s $ �� .�3 <br /> ( ontract price) <br /> 2. State Surchar�e. ** Add the State Building Code Division <br /> = Surcharge to each permit. x .0005 $ � . � 3 <br /> or $.50, whichever is greater (concract price) <br /> 3. Postage and Handlin� (Only mail-in applications) $ 1.�0 <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ �? � � `� �o <br /> * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted <br /> R : work including materials, labor,profit, and other fixed costs. It is the amount to be charged to che customer <br />� ; for the work done. If any material, equipment, labor, or installation are furnished by the ow�nzr, 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: [he Cit}�may <br /> ` request the submission of a signed copy of the actual contract. <br /> � �* The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or $.50 - whiche��er is greater. <br /> i 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 /> �'� <br /> State Building Code, and certifies that all statements made on this application are complete, true <br /> and correct. <br /> , <br /> Applicant's Signature: - Date: � a '-� � � <br /> �_ Approved By: Date: <br /> E, <br /> .rt <br /> �. ,- - <br />