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4 � � ��F � r f y .rtY i¢ � .y_a 4 ..,.� �=y� �.���.`' „ �.� �L.�+.�a � � • <br /> � � � <br /> � �"� _ j� T�. :t _ *�'.wr.� �"�' 7�w��- � a c -ax .�5 �i <br /> � i�4 "'c }��*� Y 's�� � � ` �4' 'taa...• + .��'. <br /> .�, .a ., 4 � y� z �: <br /> � ��sY�' , " -ds� y i ,�� �' � y, F�;�. <br /> ._. �� ���': �`', .. .� ._.� . . .� ..K. .x, g.. . . . -...�c_ ..s�... . "�_� �.t�.. <br /> ;�', <br /> � :ii; <br /> 3;: <br /> s� � ba. <br /> � FIREPLACES ��� <br /> :€. <br /> Gas factory fireplace �������� <br /> Wood burning factory fireplace with flue ,° _'�'�� ;��' ` �� "`F <br /> Wood Stove ; :�� � � •"- <br /> Wood stove with flue -" ��� ��� -�� ���'°� ���� � - � <br /> , <br /> Brand Name Model No. <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 /> LP Gas: gallons <br /> Other Gas opening <br /> PERMIT FEE CALCULATION - <br /> 1. 1.25% of Contract Price" or Minimum Fee ($35.00) <br /> lI[':�U.c�_, x .0125 $ �S cz> <br /> (contract price) <br /> 2. State Surchar�e. �`* Add the State Building Code Division <br /> SurcharQe to each permit. u pp�� x .0005 $ -�,�- <br /> or $.50, whichever is greater (contract price) � <br /> 3. Posta�e and Handlin� (Only mail-in applications) $ -'�56� <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ �5.;.� ; <br /> m�_ <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 customer <br /> for the work done. If any material, equipment, labor, or installation are furnished by the owner, tenant or <br /> any other party the reasonable market value of such items must be added to the estimated cost or contract <br /> price for permit fee purposes. In the event that there is a dispute on the amount of the job cost, the City may <br /> request the submission of a signed copy of the actual contract. <br /> ** The STATE SURCHARGE is .000� of the contract price under$1,000,000 or $.50 - whichever is greater. <br /> For valuations over $1,000,000 cali 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 all <br /> j 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 correct. <br /> Applicant's Signature: �,,_ - Date: �//��Y � <br /> - � <br /> Approved By: Date: <br /> •,. <br /> ;� <br /> ��`�a�*3`���` f ���" �"��s'* :� �� , �q. �� ,t� . , _ � <br /> �.:,.�._ .`°�R':�:�t.,. ''��`'_ .€����,x..t_ �. _ .....vr.��"-...�....._ ... . ��5'r...a�.,,�...4."ar'?,3... .__ ..ky_�i 4,��. � <br />