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. , � � � <br /> ` . ' ` ► <br /> _ � � � �� � " � _` � �: �-:: `' <br /> , . <br /> WOOD BURNING EQUIPNIENT <br /> Wood stove with flue <br /> Wood combination or add-on '' <br /> � Factory fireplace with flue <br /> �, . Factory Fireplace (s) Freestanding Masonry <br /> � Wood Stove (s) Franklin, other <br /> Brand Name Model No. <br /> Mfgr's Min., Clearances, side , rear , min. flue dia. <br /> VENTILATION <br /> No. Kitchen Exhaust ducted recirculating cfm <br /> , �r No. Bath Exhaust (must be ducted outside) cfm <br /> f 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 /> �: <br /> � <br /> PERMIT F'EE CALCULATION � .��� �'�� <br /> 1. 1.25% of Contract Price* or Minimum Fee ($35.00) �; <br /> �' x .0125 $ �� �� � � <br /> I:':� (contract price) <br />.;; 2. State Surcharge. *�` Add the State Building Code Division 1 <br />_° Surcharge to each permit. x .0005 $ �C-�� <br />'`.' or $.50, whichever is greater (contract price) <br /> �' <br /> 3. Posta�e and Handlin� (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ fr,� -,.�,5' <br />; '; <br />�'r� * <br /> tt, 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 <br /> customer for the work done. If any material, equipment, labor, or installation are furnished by the owner, <br /> tenant or any other party the reasonable market value of such items must be added to the estimated cost <br /> or contract price for permit fee purposes. In the event that there is a dispute on the amount of the job cost, <br /> the City may 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 <br /> greater. 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 <br /> ail �ork ir� strict acco:dance with the ordinanc�s ef 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 Signatur�/ Date: l� — <br /> Approved By: Date: &5J 6I?" <br /> „ ,:, <br /> � ; • , <br /> , _ <br /> . _ . : <br /> , <br /> ._ _._. . .__, �. . . ._ ., , <br /> _ , . . . . ,..... ._. .,. �. . �� <br />