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<br />�x `�:� FIREPLACES ��;
<br /> Gas factory fireplace ,,��
<br /> ` "` ' Wood burning factory fireplace with flue
<br /> ' �^ Wood Stove
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<br /> Wood stove with flue � � �^
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<br /> 'f �. Brand Name Model No. ;�
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<br />�' �� ' VENTILATION �y;;,
<br /> �� ;._ No. Kitchen Exhaust ducted recirculating cfm �� ', ��
<br />� ��, .�" No. Bath E�chaust (must be ducted outside) cfm
<br />' No. Other Fans: Locations cfm
<br />° 1r�`Y � FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL)
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<br /> ` � Installation Removal
<br /> Fuel oil: gallons underground inside outside •
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<br /> "' LP Gas: gallons �:
<br /> r Other Gas opening
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<br /> �, `i' <r PERMIT FEE CALCULATION gi
<br />�{� �" r^.; 1. 1.25% of Contract Price" or Minimum Fee 35.00 �� �
<br />�* ;; � x .0125 $ ���
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<br />� (con[ract price)
<br />� � ;�� 2. State Surchar�e. ** Add the State Building Code Division
<br />, _� ,`,f � Surcharge to each permit. `�� ' x .0005 $ ,l '7�
<br />� �;: � � or $.50, whichever is greater (contract price)
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<br /> � ; 3. Posta�e and Handlin� (Only mail-in applications) $ 1.50 `*
<br /> � `'� ` 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ 'z�.,�/ '
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<br />�,.�'; , . * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted F:'�;
<br />"� '' work including materials, labor, prefit, and other fixed costs. It is the amount to be charged to the customer
<br /> w�y � z "� for the work done. If any material, equipment, labor, or installation are furnished by the owner, tenant or �y
<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 /> �' ** The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or $.50 - whichever is greater.
<br /> F �' �� For valuations over $1,000,000 call the Department of Inspectional Services for the price. f�
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<br /> � ' The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all ��
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<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.
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<br /> �'` ��'° �; Applicant's Signature: ! - Date: `�
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<br /> �°� �'�� '�� A roved B Date: ��
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