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j� 1 <br /> FIREPLACES <br /> Gas factory fireplace <br /> Wood burning factory fireplace with flue <br /> Wood Stove <br /> Wood stove with flue <br /> Brand Name Model No. <br /> VENTILATION <br /> No. Kitchen E�aust ducted recirculating cfm <br /> No. Bath Exhaust (must be ducted outside) cfm <br /> No. Other Fans: Locations cfm <br /> FUEL STOKAGE (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 /Jf� ' ` <br /> .I x .0125 �� V�'�"� � <br /> � (contract price) � � <br /> 2. ` State Surchar�e. ** Add the State Building Code Division . �✓ <br /> ' Surcharge to each permit. x .0005 ' .$ 2 •�"J <br /> �or $.50, whichever'is greater (contract price} � . " � , <br /> 3. Posta�e and Handlin� (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ <br /> * CCINTRACT 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 amou�t to be charged to the customer <br /> for the work done. If any material, equipment, l�bor, or instaliatioh 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�amou�t of the job cost, the City may <br /> request the submission of a signed copy of the actual contract. <br /> ** The STATE SURCHARGE is .0005 of the contract price under$1,000,00�or $.50 - whichever is greater. <br /> 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 all <br /> 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 />::�: <br /> F��' and correct. <br /> : � a��; Applicant's Signature: Date: � �'//� <br />.� <br />� Approved By: Date: <br /> � <br /> N-� <br /> � <br />� ... �. l, _ . <br /> .:t. { - .� .F. ,' �. <br /> 1 <br /> .� <br /> f.J.G�-...5-,.�: vv . .":..�.w7 �8u . v .... . ._.LaiL,a+e._ :.... .'. ,.? S .. � � ......� . . . ..��....._zi�.r ....,. ., � ._�... . r.. , -.! .✓ <br /> _.i. .. ... .. , .e...a,_.. _ .._..._ .. . . . _ ... . _ ��.� . ... 5 <br />