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• � 1 <br /> FIREPLACES <br /> l Gas factory fireplace <br /> Wood burning factory fireplace with flue <br /> Wood Stove <br /> Wood stove with flue <br /> Brand Name D���(Z--- Model No. � � �� C'� <br /> VENTILATION <br /> No. Kitchen E�aust 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 /> PERMIT FEE CALCULATION <br /> 1. 1.25% of Contract Price* or Minimum Fee ($35.00) <br /> �(o�f�� �� x .0125 $ 35 .o � <br /> contract price) <br /> 2. State Surcharge. ** Add the State Building Code Division <br /> Surcharge to each permit. x .0005 $ � � <br /> or $.50, whichever is greater (contract price) <br /> 3. Postage and Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ 3� . ;� � <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 /> ** 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 /> ;' � <br /> Applicant's Signature: Date: � -�� �3 <br /> Approved By: Date: <br /> 'r' f ' � 1 ,, ; + �r 'r , . y�-�„ 't �' <br /> , � � <br /> '�r.W,.u�a'>Q..,.�.s�:.�.a�S,r:,Gi..�.. ...,.;5... w�..�3,ae.t�a_.. ....�.,.'��_.. .§.,u�.. �..,._..a,a �. .>_ .,...,.. .._,..�n,_....r,.. ,._._..W�`. _ .a iz.�.�.n�'.,ru�g..�.,�..��.,r3,. �. �.. - - .,.,�..�. <br />