Laserfiche WebLink
� <br /> s <br /> WOOD BURNING EQUIPMENT <br /> Woc�d 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 E�chaust ducted recirculating cfm � <br /> No. �_ Bath Exhaust (must be ducted outside) cfin <br /> No. Other Fans: Locations ��m <br /> Total <br /> FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL) <br /> Installation Removal <br /> '� Fuel oil: gallons underground inside outside <br /> � gallons <br /> LP Gas: <br /> �` <br /> Other Gas opening <br /> PERMIT FEE CALCULATION <br /> 1. 1.25% of Contract Price* or Minimum Fee ($35.00) <br /> � oct5�n(� x .0125 $ 3s,oC <br /> (contract price) <br /> 2. State Surcharge. ** Add the State Building Code Division � <br /> Surchai•ge to each permit. �(�G�.00> x .0005 $ -�J� '�' <br /> (contract price) <br /> � or $.50, whichever is greater <br /> `�' 3. Posta�e and Handlin� (Only mail-in applications) $ 1.50 <br />�i` 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ 3�•�� <br /> ,,; <br />��, <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 fi.�ed costs. It is the amount to be chazged to the <br />�; customer for the work done. If any material, equipment, labor,or installation aze furnished 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 permit fee purposes. In the event that there is a dispute on the amount of the job cost, <br />�y`' 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 accord ce with the ord' es o the City and the regulations of the Minnesota <br /> State Building Code, and ifies that al stateme ts ade on this application are complete, true <br /> and correct. <br /> Applicant's Signature: Date: <br /> Approved By: Date: <br /> w' - <br /> �_ <br />