Laserfiche WebLink
. ' ► <br /> WOOD BURNING EOUIPMENT <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., Cleazances, 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 /> FUEL S'TGRAGE (MLTST BE A1 PROVED BY FIRE MARSHA�) <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 /> t��o X .oi2s $ 35.�v <br /> (contract price) <br /> 2. State Surcharge. ** Add the State Building Code Division <br /> Surcharge to each permit. x .0005 $ � 1� <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) $ �� .2,r� <br /> * CONTRACT PRICE or JOB COST means the actual or estimated dollaz 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 aze fumished by the owner, <br /> - tenant or any other party the reasonable mazket value of such items must be added to the estimated cost <br /> or contract price for pemut fee purposes. In the event that there is a dispute on the amount of the job cost, <br /> w��-�1�-� =�� -� the City may request the submission of a signed copy of the actual contract. <br />°r � � ** 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 />`4 - ' '" 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. <br /> Applicant's Signature: �j y��Q, �S�Q j2 Date: (Q-�S-q`� <br /> �' Approved By: Date: <br /> :�; <br /> ,i< <br /> � <br /> .. . .{,di�. � .. ,� .. . * t . <br /> ',. ' } {�:: +-w��.�er3�F�� . �I 1 7��. 7>.T � �Y �'a.' !N <br /> y �� <br /> ��` . \��� �� � . . . � . . ; .� . . . . . ^ . � '��, <br /> � . . . � . �. - . � . . . . . .. ' . ` � ` .. � � �...� <br /> � + , <br /> � <br /> . : .. . . .� � � . . <br /> .: . . . , � . � . . .. . , . .. .. . . <br /> , . ... ; : � : � : . . <br /> .,: .: . ... :... . .... . _.__:� .L.,"_„�._ _ .�. <br />