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. g�o�;:w„�� .. r.. ., �,".-.^`.: . � . . <br /> ,:��� _.� , . <br /> . ... . .. _ . � . <br /> _ ._ ._ . _ ,.. ; �,. .. .._ . . . . <br /> M.....-�..r...�.•- - . ... . . � . ..,...,�..,..............�.......�... . . .._ .. ........ ..-,...�.,-..,,.. .�_.. . _...,� <br /> e ,. 06�15�95 08:22 THE CITY OF DRONO 612-473-7357 003 " <br /> ' � <br /> O � N <br /> Wood stove with flue <br /> Wood combination or add-an <br /> Factory fircplace wlth flue . , <br /> Factory Fireplacc (s) Freestanding �asonry <br /> Wood Stove (s) F�ranklin, other_ : <br /> Brand Name Model No. <br /> ` Mfg�r's Min., Clearances, side � , rear __, min. flue dia. <br /> Total <br /> VENT�I.ATION <br /> No. Kitch�n Fxl�aust ductcd recirculating _ cfm <br /> No. Iiath Exhaust (ulust t�e ducted autside) cfm <br /> No. Other Fans: L,ocations cfm <br /> . Total <br /> FUEL 5T4�A�E (MUST �E APPROVED BY FIRE MARSHAL) <br /> Installation Removai <br /> Fuel ofl: gallons �„ under$round insidc outside <br /> � LP 4as: g�iions <br /> Other Gas openin� <br /> P�ItMIT FEE CALGUY.A�'ION <br /> 1. 1.25% of Contra�� l�rice* or tn�F e 3 .00 � <br /> � � .oi2s � <br /> (contract pricc) <br /> 2. State Surchar� ** Add the State Building Code Division <br /> Surchai•ge to each p�rmit. X •�� � <br /> (contract price) <br /> o� $.50, wiuchever is greater <br /> 3. P e and Handlin (Only mail-in dppli�;a�ious) $ 1.50 <br /> 4. TOTAL PERMIT FEE (Ad.d li�es 1-3 above) $ ,���`�.�_ <br /> * CONTRACT PRICE or JOB G03T tneans the actuat or estimatcd dollar amouni c.hac'ged for thc permitted <br /> wark including materiats, labor. profit, anQ o�her flxed coata. It is the amvunc to bG �;Lazged to tha <br /> cuatomer for ihe work done. !f aay matertal, aquipment, labar,ot instatlation are furnished by the owner, <br /> ceaant or any vther party the cEasvnable merkr� vaiuc uf Bu� itC,us �uust bc addcd to tha satimated cost <br /> or concrac�price for permic fce purposes. In the event tha�a�Cn is a dispute on tbe amounc of tht jab cosc, <br /> We City may rcqucst the submission of a aiga�d tapy of tha actual contract. <br /> '* '1'6e STATE SURCHARGE is .0005 of the contract pztCc under �i1,000,000 or $.50 - whicuevcr is <br /> grea�r. For vaivations vver S 1.000.000 call �e Department of Ins�cectional Servicea for thc price. <br /> The undersigned hereby applies to the City for issuance of a 11�ec�anicai P�rnilt, agrecs to do <br /> all wdrk ixi sirlet accordance wlth the ordinances of the C�ty and the regulations vf�hC Minnesota <br /> State BuiIding Code, and ee ifies that all siatemetus made on rhis applicatiu�i a��e complete, true <br /> and correct. � <br /> Applic.�nt's Signature: p�t�- <br /> Apptoved By: Date: <br />