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DESCRIPTION: Installing 2 new Lennox Furnaces, 2 new Lennox Air Conditioners, 2 Aprilaire <br /> #550 Humidifiers, 1 Lennox�it �eater, Venting Kitchen Hood, 5 Bath Fans, & 1 <br /> Dryer, Gas to Fireplace, 2 T8600 Stats, and splitting plenum - basement - for <br /> future. <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 /> Total <br /> VENTILATION �j C� <br /> No. Kitchen Exhaust ducted recirculating cfm <br /> No. � Bath E�aust (must be ducted outside) cfm <br /> Nfl. �_ Other �a�s: I,ecatio*zs cfm <br /> �`'�.� Total <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 /> —�� <br /> PERMIT FEE CALCULATION <br /> 1. i.25% of �ontract Price* or Minimum Fee 35.00 <br /> x .0125 $ o� l� � <br /> ( ontract price) <br /> 2. State SurcharL�e. ** Add the te Building Code Division <br /> Surcharge to each permit. � 1� ��j�� x .0005 $ � - S� <br /> (contract price) <br /> or $.50, whichever is greater <br /> 3. Posta�e and Handlin� (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ a�� ,`>�_ <br /> * CONTR�SCT PRICE ar J03 CGST m�ans the actLal c�r estimated dollar amount chazged 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 fumished 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 City and the regulations of the Minnesota <br /> State Building Code, and certifies that all s tements made on this application are complete, true <br /> and correct. <br /> Applicant'sSigna r . Date: �� c1-�3 <br /> Approved By: Date: � <br />