Laserfiche WebLink
q�7� � - I � g �� <br /> � I � � . �O , . � <br /> � . r� <br /> . � <br /> � <br /> WOOD BURNING EQUIPMENT -� <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 /> Total <br /> VENTILATION <br /> No. Kitchen Exhaust ducted recirculating cfin <br /> No, Baih �xnau�t (must bz �ucte�i outside) c�u <br /> No. Other Fans: Locations cfm <br /> Total <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%o of Contract Price* or Minimum Fee ($35.00) C� 1��'��` <br /> � ��, �(�(j x .0125 $ �j . l> V <br /> ^ (contract price) , <br /> 2. State Surcharge. ** Add the State Building Code Division � � (�1 <br /> � , � <br /> S u r c h a r g e t o e a c h p e r m i t. � � �i U C,�U x .0005 $ <br /> contract price) <br /> or $.50, whichever is greater <br /> 3. Posta,�e and Handlin� (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (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 fumished 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 /> all 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 conect. r�� <br /> / <br /> , � � � <br /> ��� J,� �� l <br /> A licant'sSi nature. ��'�/u��-� `x- �Z`��'��� Date: � � <br /> PP g <br /> �� �� '/ <br /> 'r�'�' �J/ Date:� `� , <br /> Aprroved By: c� ( <br />