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� <br />�` > <br /> WOOD BURNING EQUIPMENT <br /> Wood stove with flue <br /> Wood combination or add-on <br /> � Factory fireplace with flue ��- '���` . 8�_� w�=�-�� `` <br /> Factory Fireplace (s) Freestanding Masonry '}�`:' h } <br /> ; � <br /> ' Wood Stove (s) Franklin, other ` <br /> ~ Brand Name Model No. r <br /> Y Mfgr's Min., Clearances, 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 STORAGE (MUST BE APPROVED BY FIRE MARSHAL) <br /> Installation Removal <br /> �` Fuel oil: gallons underground inside outside ;� <br /> 1�9 <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 /> ��(�,— x .0125 $ � ��' �� <br /> (contract price) <br /> 2. State Surchar�e. ** Add the State Building Code Division <br /> ar e to each ermit. ,— x .0005 $ �' �� <br /> Surch g p <br /> or $.50, whichever is greater (contract price) � <br /> � <br /> , <br /> 3. Posta�e and Handlin� (Only mail-in applications) ��� $ 1.50 �� <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ �1�C� <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 estis�ated 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 /> � <br />�: <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 a�plies 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: %v�G �"ilC,( � ���� y <br /> Date: 3-��0-`��,-, <br />,� , � � <br /> Approved By: Date: � <br /> � <br />� <br />�,�.� <br /> LS ; , - <br />� � �� � ; �. . <br /> .. a,'3..:�.�.�.a&�.. ., ..=..f.:,.�,...':Yai . .. ... ..�.s . .._k... .. .,�ua3., .._ .. � . , _n . . � ._ . ... :�i> .,: . . , ,.._. � . . ��� <br />