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�.,� ��.a.�.r� � • , � ,�.. -1��, , D,�,� , �.:,�`�.� . � <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 /> VENTILATION <br /> No. 1 Kitchen Exhaust ducted recirculating cfm <br /> No. _� Bath Exhaust (must be ducted outside) cfm <br /> No. �... Other Fans: Locations ���1 p(- cfm <br /> _� <br /> FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL) <br /> Installation Removal <br /> Fuel oil: gallons underground inside outside <br /> r�= LP Gas: gallons <br /> Other Gas opening <br /> PERMIT FEE CALCULATION <br /> 1. 1.25% of Contract Price* or Min�mum Fee ($35.00) �s <br /> —� �I� SZ�D x .0125 $ _ � . _ <br /> (contract price) <br /> 2. State Surchar�e. ** Add the State Building Code Division .7� <br /> Surcharge to each permit. � � �, 5-C:� x .0005 $ �. <br /> or $.50, whichever is greater (contract price) <br />�.�; <br />�;; 3. Postage and Handlin� (Only mail-in applications) $ 1.50 <br />�°' 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ �SI. � <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 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 Ciry and the regulations of the Minnesota <br /> State Building Code, and c ' ies that all statements � on this application are complete, true <br /> and correct. <br /> �� Applicant's Signature: '�-'� Date: �S=G'l <br /> ��: �, <br /> �: Approved By: �Y„ ` "'� '`� Date: ��7 1- � "' <br /> � <br /> � �;;: <br /> :� <br /> t�- �� � . , , . :� ,. �a� <br /> � � ,� -�,� - � � ��'� � �: _s� �s <br /> x �* � � 4 ) _ y < r /. ::1 <br /> s�� .r;� 4..,., . .�.,�.; . .. . ... ._..__.. .� _ .._. .. _ ,, _.._ .. .. � � . ,__,�, <br />