Laserfiche WebLink
"'N" F � ..�_"^'Ys'uF�. .. .r , ... ' ., . . .i . . . . _ _ ,�RWv%r .. . <br /> l � <br /> WOOD BURNING EQUIPA'IENT <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 /> No. Bath Exhaust (must be ducted outside) cfm <br /> No. Other Fans: Locations cfm <br /> FUE ST0�2AGE (MUST RE APPROVED BY FIRE MARSHAL) <br /> Installation � Removal <br /> ���`� Fuel oil: ��� gallons o?�d underground `� inside outside <br /> LP Gas: gallons 1��:�-�< <br /> Other �s opening <br /> PERMIT FEE CALCULATION <br /> 1. 1.25% of Contract Price* or Minimum Fee ($35.00) <br /> �,�yaa ��' x .0125 $ <br /> (contract price) <br /> 2. State Surcha�e• ** Add the State Building Code Division <br /> Surcharge to each permit. x .0005 $ <br /> or $.50, whichever is greater (contract price) <br /> 3. Posta�e and Handlin� (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT PEE (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 <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 S'rATE 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 hereb� appl i�;s to the City for issuance of a Mechanical Permit, agrees to do <br /> all work in strict accurc".ance 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 /> � � . G7/. �� �cous �,�r �I . / .� <br /> Applicant s Signaturc. Datc. � <br /> Approved By: ;,�,__ Date: (�"-`�� '� �v <br />