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;{ � <br /> + .l� t *� <br />�"` ' : , { � . , �' � : , <br /> _ }� <br />� �:. , , - : <br /> �` <br /> � ��� FIREPLACES � <br /> Gas factory fireplace <br /> Wood burning factory fireplace with flue <br /> ��'�� Wood Stove <br /> � Wood stove with flue <br /> � <br /> s� �` � Brand Name Model No. � <br /> , <br /> VENTILATION <br /> � No. Kitchen Exhaust ducted recirculating cfm <br /> No. Bath Exhaust (must be ducted outside) cfm <br /> No. Other Fans: Locations cfm <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 /> PERIVIIT FEE CALCULATION <br /> 1. 1.25% of Contract Price" or Minimum Fee 35.00 <br /> ,'�r��� `" x .0125 $ <br /> (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 pri.ce) <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 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 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 <br /> request the submission of a signed copy of the actual contract. <br />� <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 /> y; and correct. <br /> ;:�r"� <br /> Applicant's Signature: � Date: �� S�- �?� <br /> , .- � ; � <br /> .� �;- �: Approved By: Date: <br /> ,; <br /> �' �� �i <br /> A .� <br /> . <br /> ,, <br /> ,� � , <br /> . , <br /> � . , f <br /> � . � <br /> � � � <br /> a <br /> „ � . <br /> . _ _ . � � �. ,�a,�, ,.�.�. ,�.�.�� � � , � .. _ . ,. ..��.�_ _. <br />